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  • Title
  • 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

Wide Local Excision of an Intermediate-Thickness Back Melanoma with a Sentinel Lymph Node Biopsy of Left Axillary Lymph Nodes

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Kailan Sierra-Davidson, MD, DPhil1; Ogonna N. Nnamani Silva, MD2; Sonia Cohen, MD, PhD1
1Massachusetts General Hospital
2Brigham and Women's Hospital

Procedure Outline

  1. Intradermal Injection of Isosulfan Blue
  2. Confirm No In-Transit Nodes with Probe
  3. Marking
  4. Inject Local Anesthetic
  1. Release Edges
  2. Find the Plane
  3. Complete the Excision
  1. Marking
  2. Inject Local Anesthetic
  1. Dissect Down to Axillary Fascia
  2. Use Probe for Orientation
  3. Lift Node with Silk Stitch
  4. Dissect out the Node
  1. Dissection of Second SLN
  2. Dissection of Next Node Cluster: SLN 3 and 4 with Non-Sentinel Nodes
  3. Confirm No More Hot Nodes

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Authors

Filmed At:

Massachusetts General Hospital

Article Information

Publication Date
Article ID337
Production ID0337
Volume2023
Issue337
DOI
https://doi.org/10.24296/jomi/337