Wide Local Excision of an Intermediate-Thickness Back Melanoma with a Sentinel Lymph Node Biopsy of Left Axillary Lymph Nodes
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Procedure Outline
Table of Contents
- 1. Introduction
- 2. Surgical Approach
- 3. Incision
- 4. Dissection
- 5. Orientation of the Specimen and Hemostasis
- 6. Closure
- 7. Confirm Mapping to the Left Axilla
- 8. Approach to Sentinel Lymph Node Biopsy
- 9. Incision
- 10. Dissection
- 11. Take Count on the Node
- 12. Exploration for More Sentinel Lymph Nodes
- 13. Closure
- 14. Post-op Remarks
- Intradermal Injection of Isosulfan Blue
- Confirm No In-Transit Nodes with Probe
- Marking
- Inject Local Anesthetic
- Release Edges
- Find the Plane
- Complete the Excision
- Marking
- Inject Local Anesthetic
- Dissect Down to Axillary Fascia
- Use Probe for Orientation
- Lift Node with Silk Stitch
- Dissect out the Node
- Dissection of Second SLN
- Dissection of Next Node Cluster: SLN 3 and 4 with Non-Sentinel Nodes
- Confirm No More Hot Nodes