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

General Surgery

Procedure Outline

Table of Contents

  1. 1. Introduction
    1. 2. Surgical Approach
      1. 3. Incision
        1. 4. Dissection
          1. 5. Orientation of the Specimen and Hemostasis
            1. 6. Closure
              1. 7. Confirm Mapping to the Left Axilla
                1. 8. Approach to Sentinel Lymph Node Biopsy
                  1. 9. Incision
                    1. 10. Dissection
                      1. 11. Take Count on the Node
                        1. 12. Exploration for More Sentinel Lymph Nodes
                          1. 13. Closure
                            1. 14. Post-op Remarks
                              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