Under normal conditions, removing cancerous lymph nodes from the groin would require major surgery.
Surgeons would have cut through muscle and fat layers, leaving behind a scar that could be up to 10 inches long. Recovery time would be weeks, and maybe even months.
Martinsville resident Stacey Yount was already facing a lengthy treatment for melanoma. The last thing she wanted was a surgery keeping her from the activities she loved.
Thankfully, a new procedure offered her an alternative.
“It let me get back to moments of feeling normal sooner, and feeling like I had some sore of control over my life sooner. That’s what this surgery did,” Yount said.
An advanced approach to melanoma surgery is cutting down on the time it takes patients to recover, allowing them to return to their normal activities more quickly while moving on to the other aspects of their treatment.
Videoscopic inguinal lymphadenectomy uses small incisions and scoping equipment to remove cancerous lymph nodes in the groin. Instead of having to cut through muscle tissue and ligaments, while avoiding large arteries, the procedure can be done with minimal invasiveness.
“This is a surgery in an area of the body that’s very uncomfortable to heal, that’s very difficult,” said Dr. Juliana E. Meyer, a melanoma surgeon and director of the Melanoma Clinic at Franciscan Health Indianapolis Cancer Center. “When you’ve given someone a new diagnosis of a new place or type of cancer, they need to do their best to focus on other things — chemotherapy, radiation, the social and psychological issues that go along with that.”
When cancers, particularly melanomas, reach the lymph nodes in the groin area, the traditional treatment has been a surgery. These procedures, called a lymphadenectomy, required a large incision to reach the lymph nodes.
Surgeons needed to cut through the inguinal ligament in the thigh, extending the time the body needed to recover. The work is all done around the femoral artery, which is the main supply of blood to the legs.
“It’s a pretty extensive, open incision to get out the lymph nodes required for melanomas of the lower body and lower abdomen,” Meyer said.
“The big goal with any surgery with cancer when you add a new approach to it, you want to make sure you’re still treating the cancer appropriately,” —Dr. Juliana E. Meyer
The new technique allows surgeons to approach the area with a video scope. Meyer could make three small, 1-inch cuts, and use the device to navigate to the lymph nodes and then remove the cancerous ones.
“You get the same procedure performed using laparoscopic equipment, without having a large incision that needs to heal, and crosses a rather large space in the body,” Meyer said. “People can get up and around much more efficiently while doing the same cancer surgery on the inside.”
Videoscopic inguinal lymphadenectomy has become more popular with surgeons only in the past decade, after years of research to determine the effectiveness of the treatment compared to existing methods.
Research showed that patients had the same survival rates and could have the same number of lymph nodes removed using this style of lymphadenectomy, but with much fewer wound complications, Meyer said.
She began using the procedure at Franciscan Health Indianapolis in early 2015.
“The big goal with any surgery with cancer when you add a new approach to it, you want to make sure you’re still treating the cancer appropriately,” Meyer said. “People could get the same care, but were up and moving around sooner and better with it.”
Many of the ideal candidates for the procedure are similar to Yount, who want to minimize their recovery time post-surgery. But the technique also benefits those who are morbidly obese or diabetic, Meyer said.
“They have less wound healing issues overall. With an open incision, there’s a lot of concern with people with diabetes or obesity of poor wound healing,” Meyer said. “It’s a nice balance.”
For Yount, she was able to start walking weeks after the surgery. She is an avid runner, and by one month after the procedure, she was able to go on light jogs.
Around the cancerous lymph node, Yount has three small scars, each about 1 inch long. The minimal visual effect of the treatment is simply another benefit of the procedure, Meyer said.
“Having that limited appearance of having cancer, that’s one less thing to worry about,” she said.