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Groin lymph node dissection: what the operation involves | CION Cancer Clinics
A groin lymph node dissection removes the lymph nodes from one or both groins, along with the fat they sit in, when a cancer has spread there or is likely to. It is done under general anaesthetic through a cut along the groin crease, with a drain left in afterwards. This page explains what is removed, what recovery looks like and what the report will say. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- What is a groin lymph node dissection?
- What actually happens during the operation?
- What is removed, and what stays?
- What does recovery look like, week by week?
- Words you will see on the operation note and the report
- Three things families tell us before this operation
- Common questions about groin node surgery
The short answer
What is a groin lymph node dissection?
A groin lymph node dissection is an operation to remove the lymph nodes (small glands that filter fluid from the leg and lower body) from one or both groins. It is done when a cancer has spread to those nodes, or when the risk of spread is high enough that the team wants them out and examined.
Why the groin
Fluid from the leg, the skin of the lower body, the vulva, the penis and the area around the anus all drains through the groin first. So when a cancer in any of those places spreads, the groin nodes are usually the first stop. Removing them takes out cancer that has already reached them and tells the team how many nodes were involved, which shapes what treatment comes next.
Who it is usually offered to
Most often it is offered for melanoma of the leg or lower trunk, vulval cancer, penile cancer, and some skin and anal cancers. It is not offered to everyone with those cancers. If the nodes look clear and the tumour is small, a much smaller sentinel node test may be done instead.
What this page cannot tell you
It cannot tell you whether you or your parent needs this operation. That depends on the type of cancer, the scans, the biopsy and general fitness, and only your treating team can weigh those together.
Bring every report and scan you have to the surgical appointment, including the biopsy slides if you were given them.In theatre
What actually happens during the operation?
You are put to sleep
The operation is done under general anaesthetic. The anaesthetist sees you first to check your heart, lungs and medicines. Tell them about every tablet you take, including blood thinners.
The cut is made along the groin crease
The surgeon makes a cut in the fold of the groin, running roughly along the crease or slightly across it. The skin and a thin layer of fat are lifted off the tissue underneath so the nodes can be reached.
The nodes and the fat around them are removed
Nodes are not removed one by one. They sit in a pad of fat, and the surgeon removes that whole pad as one block. This may be the nodes just under the skin only, or those and the deeper nodes as well.
A drain is placed and the wound is closed
Because lymph fluid keeps flowing after the nodes are gone, a thin tube is left in the wound to carry that fluid out into a bottle. The skin is then closed with stitches or clips.
The tissue goes to the laboratory
Everything removed is examined under the microscope. The report takes days rather than hours and tells the team how many nodes held cancer.
Not sure whether this applies to you?
Ask an oncologistThe parts
What is removed, and what stays?
The word "dissection" makes people picture a large part of the leg being taken. It is not. Only the nodes and the fat they sit in are removed.
The superficial nodes
These lie just beneath the skin of the groin, above a thin sheet of tissue called the fascia. They are the first nodes that most cancers of the leg, vulva and penis reach, and they are removed in every groin dissection.
The deep nodes
A smaller group sits below the fascia, beside the large vein that carries blood back from the leg. They are removed when the superficial nodes already show cancer, or when a scan suggests they are involved.
Sometimes also removed
- Pelvic nodes, through a separate cut higher up
- A small vein that runs through the groin
What stays where it is
The main artery and vein to the leg, the nerve to the front of the thigh, and every leg muscle stay in place. Sometimes a strip of inner thigh muscle is swung across to cover the vessels; you would not notice any weakness from this.
Ask your surgeon which nodes are planned for removal, and why.Afterwards
What does recovery look like, week by week?
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The first day or two
You wake with a dressing over the groin and a drain tube beside it. Pain is usually well controlled with regular tablets. Nurses will get you walking short distances on the first day, because lying still raises the risk of clots.
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The rest of the first week
Most people go home within a few days, often with the drain still in place. You will be shown how to empty and measure it. The wound is checked every day or two for redness, fluid or gaps in the skin edge.
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Weeks two to four
The drain comes out once the daily fluid falls low enough, which varies a lot between people. Some swelling of the thigh and lower leg is common. Walking should increase steadily, but standing still for long periods and heavy lifting are usually kept for later.
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The results appointment
Your surgeon goes through the laboratory report with you: how many nodes were involved and whether radiotherapy or medicines are being suggested next. Bring the family member who helps you decide.
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The months after
The wound settles into a scar along the crease. Numbness over the upper thigh is common and may be permanent. The main long-term risk is swelling of the leg, and you will be shown how to lower that risk and spot it early.
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On your report
Words you will see on the operation note and the report
- Inguinal
- Simply means "of the groin". An inguinal lymph node dissection and a groin node dissection are the same operation.
- Lymphadenectomy
- The formal word for removing lymph nodes. Your discharge summary may use this instead of "dissection".
- Node positive, node negative
- Whether cancer cells were found inside the removed nodes. The report will say how many nodes were examined and how many were positive.
- Extranodal extension
- Cancer has grown through the outer wall of a node into the fat around it. This often leads the team to suggest radiotherapy afterwards.
- Seroma or lymphocele
- A pocket of clear fluid collecting under the wound after the drain is out. Very common, usually harmless, and sometimes drawn off with a needle in clinic.
!
Call the same day if any of these happen after you go home
Spreading redness around the wound, a fever, the wound edges coming apart, cloudy or foul-smelling fluid, or a calf that becomes painful, hot or swollen on one side. Do not wait for the next clinic date and do not put anything on the wound yourself. Call the ward or the helpline and describe what you see.
Commonly believed
Three things families tell us before this operation
"If they take the glands out, the leg will stop working."
The nodes carry fluid, not movement. No muscle or main nerve to the leg is cut. Walking is expected from the first day and full movement returns. What can change is fluid drainage, which is why leg swelling is watched for.
"Opening the groin will make the cancer spread faster."
Removing nodes that already hold cancer does not spread it. It removes it, and it tells the team how far things have gone. Delaying the operation because of this fear is far more likely to change the outcome than the operation is.
"Once the nodes are out, the cancer is gone."
Removing the groin nodes deals with the nodes. Whether further treatment is needed depends on what the laboratory finds and on the original cancer. The report, not the operation, is what tells the team what happens next.
Questions we are asked
Common questions about groin node surgery
How long will I be in hospital?
Usually a few days, though it depends on whether one or both groins were done and how the wound looks. Many people go home with the drain still in and come back to clinic to have it checked. Your surgeon will tell you what they expect for you.
Will I be able to walk afterwards?
Yes, and you will be asked to. Nurses will get you up on the first day. Walking helps the leg pump fluid, lowers the risk of clots and keeps the chest clear. What to avoid early on is long periods of standing still, squatting and lifting anything heavy, because these strain the wound.
Why is the drain kept in so long?
Lymph fluid keeps flowing into the groin after the nodes are removed, and it has nowhere to go until new channels form. The drain carries it out so it does not collect under the skin. It is removed once the daily amount falls, which takes longer here than after most other operations.
Is the operation done by keyhole?
Most groin dissections are done through an open cut. A camera-based version through small cuts exists and is used in some centres for selected patients. Whether it suits you depends on the cancer and the size of the nodes. Ask your centre what they offer and why.
Will the wound heal properly? I have heard groin wounds are difficult.
Groin wounds do open or leak more often than wounds elsewhere, because the skin is thin, the area moves and lymph keeps flowing. Most settle with dressings and time. Smoking, diabetes and being very overweight raise the risk, so tell your team about all of these so they can plan around them.
Will my leg swell for life?
Some people develop lasting swelling of the leg, called lymphoedema, and it is the most common long-term effect of this operation. It cannot be predicted for one person in advance. Early signs can be managed with compression and exercises, so you will be shown what to watch for before you leave.
Can both groins be done at once?
Yes. For vulval and penile cancer both sides are often needed, because fluid from those areas drains to both groins. Doing both at once means one anaesthetic and one recovery, but a longer stay and more drains. Your team will explain which applies to you.
Is it covered by Aarogyasri or insurance?
Cancer surgery is usually covered when it is part of an agreed treatment plan. Aarogyasri, CGHS, ECHS and EHS are accepted at CION, and most cashless insurers are empanelled. Call the helpline with your card details and we will check what your cover includes before you travel.
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Sources
- Macmillan Cancer Support — Lymph node removal (lymphadenectomy)
- Cancer Research UK — Surgery for vulval cancer
- Cancer Research UK — Surgery for melanoma
- NHS — Lymphoedema
- American Cancer Society — Surgery for penile cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Superficial vs Deep Inguinal DissectionWhich nodes are taken, and what decides itWhich Cancers Need Groin Node SurgeryMelanoma, vulval, penile and the othersLeg Lymphoedema After Groin Node RemovalThe main long-term effect and how to lower the riskDrains, Tubes, Lines and CathetersHow to manage a drain at homeGroin Dissection Cost in HyderabadIndicative ranges and what schemes cover
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