Current evidence on the efficacy of laparoscopic retroperitoneal lymph node dissection is limited and there are safety concerns about the procedure. It should therefore not be used without special arrangements for consent and for audit or research.
Clinicians wishing to undertake laparoscopic retroperitoneal lymph node dissection for testicular cancer should take the following actions.
Inform the clinical governance leads in their Trusts.
Ensure that patients understand the potential serious complications associated with this procedure and provide them with clear written information. In addition, use of NICE's information for the public is recommended.
Audit and review clinical outcomes of all patients having laparoscopic retroperitoneal lymph node dissection for testicular cancer.
This procedure is technically demanding and should only be performed in units with experience in open and laparoscopic techniques, and in the context of a multidisciplinary team.
Publication of safety and efficacy outcomes will be useful. NICE may review the procedure on publication of further evidence.