Groin dissection

What is a groin dissection?

A groin dissection is an operation to remove the lymph nodes in your groin. This is done when cancer cells have travelled from the original skin cancer and settled in these lymph nodes.

What are lymph nodes?

Lymph nodes are small round structures that trap things like cancer cells, bacteria, or other harmful substances in lymph. Lymph nodes are found mainly in your neck, armpits, and groin. You may have felt swollen lymph nodes when you have had an infection like a cold. 

Do I have cancer in my lymph nodes?

Normally when a lump is found, the first step is to take a sample. This is called an ultrasound core biopsy, and it is done in the Radiology (X-ray) department. Once the sample has been taken, it is sent to the laboratory to be looked at under the microscope. You may also have CT scans before your surgery.

When will my groin dissection happen?

A groin dissection is done once all your test results are available. You will come to hospital early on the morning of your surgery and stay for about 2-3 days.

Pre-operative assessment

The pre-operative assessment checks you are ready for surgery. You will answer some questions about your health and may also have tests like blood pressure checks, blood tests, an ECG, and skin swabs.

You may have been asked some of the questions before, but we need to make sure nothing has changed.

You will also receive more information about your surgical pathway (what will happen after surgery).

If the assessment reveals a problem that needs treating before surgery, this may delay surgery until the problem is resolved. Pre-assessment staff will keep in touch with you and your GP about the best way to sort the issue.

What does the surgery involve?

The operation takes about 2-3 hours, and is done using general anaesthesia (you will be asleep). All the nodes in that area and some tissues will be removed. You will have a scar across your groin and going a short way down the inside of your leg.

What can I expect after the operation?

After your surgery, one or two small plastic tubes are placed in your skin to drain any fluid from the wound. The other ends are connected to bags with small openings at the bottom.

You might feel some pain, especially in the first few days, but it may take a couple of weeks to disappear completely. If required, you will be given regular painkillers.

The following day, you will be encouraged to gently walk around the ward. You may also need to see the physiotherapists or be given an exercise programme.

You will be discharged home with the drain once you have been taught how to look after it and are happy to do so. You can contact your Skin Cancer Nurse, during the week, and they will arrange a clinic appointment to remove the drain. The drain(s) can stay in for 8-10 weeks if needed. It will be removed once the fluid draining is reduced.

What are the possible complications immediately after surgery?

There are potential problems with any operation. Complications are rare with this surgery, but you may have some of the following:

• Numb skin around the groin.
• Bleeding.
• Collection of fluid around the wound.
• Infection.
• Wound breaking open.
• Swelling in your leg.

If any of these happen, please contact your Skin Cancer Clinical Nurse Specialist who will be able to advise you.

What are the possible long-term complications after surgery?

• A visible scar and hollow area in your groin.
• Numb skin around the surgery area.
• Swelling in your leg (called lymphoedema).

Lymphoedema

Lymphoedema is swelling in your leg. This happens when your lymphatic system is not working properly and there is a build up of lymph. 

Signs of lymphoedema

Lymphoedema can affect you in a variety of ways. If you notice any of these symptoms, speak to your Skin Cancer Nurse or GP.

• Swelling.
• Heaviness of your leg.
• Tightness and stretching of the joints.
• Reduced movement of the joints.
• Thickening and dryness of the skin.
• Discomfort or pins and needles sensation.

Can you prevent lymphoedema?

While we don’t know exactly what causes lymphoedema, an infection or injury to the affected limb may slightly increase your risk. Looking after your skin is vital:

• Clean even small cuts and grazes straight away. If you have any sign of infection, see your GP straight away.
• Use a moisturiser daily to keep your skin soft and supple.
• Take care when cutting nails to avoid breaking the skin.
• Avoid hot baths and saunas- this may increase swelling.
• Avoid sunburn by using a SPF30 sunscreen or above and wear loose fitting clothing.
• Avoid cuts when shaving and use an electric razor.

What to expect after you go home

At first you will feel tired and should take it easy for the first week or so. Slowly get back to your usual activities.

You will be able to drive once you feel safe to do so, usually after a few weeks. Do not drive if you are feeling unwell, are not fully alert or able to do an emergency stop. You are advised to check with your insurance company before driving.

You can start work once you feel ready. If your job involves a lot of lifting or heavy work, you may need more time to recover.

Following surgery, you will be referred to your local oncology hospital to discuss next options.

Exercise

• Avoid gaining weight and try to lose some extra if you are already overweight as this may place extra pressure on the lymphatic system.
• Avoid strenuous exercise and heavy lifting.
• Do gentle exercises like walking or swimming, it will keep your joints supple and help with lymph drainage.
• Move around during long journeys. 

References and further Information

© North Bristol NHS Trust. This edition published March 2025. Review due March 2028. NBT002430