Lumpectomy
This breast-conserving surgery involves the wide local excision of a primary tumor along with a surrounding margin of normal breast parenchyma. The goal is to remove the malignancy while preserving the majority of the breast tissue and appearance.
Surgical instruments
21 on this table — tap a photo to zoom, the name for its full card.
The case
Spark notes
The 30-second rundown — scan this outside the room.
- Incision: Use a 15 blade loaded on a #3 knife handle. Senn retractors, skin hooks or army-navys may be used.
- Dissection: Use Adson pickups, metzenbaum scissors, and a bovie to dissect the tissue. Remove the lump with an Allis clamp or kocher.
- Marking the lump: Mark with a directional stitch for orientation.
- Specimen handling: Quickly pass off the specimen to the circulator who will take it to pathology. Margins may be taken if needed.
Walkthrough
What the surgeon does — and what to have in your hand before they ask.
Incision
The surgeon will begin the Lumpectomy procedure by making an incision over the lump being removed. They will use a 15 blade loaded on a #3 knife handle to make the incision. The incision made during a Lumpectomy is typically small, so senn retractors or skin hooks may be used at the beginning to hold the incision open. If the tissue is deeper, army-navys might be used.
Dissection
After making the incision, the surgeon will use Adson pickups, metzenbaum scissors, and a bovie to dissect the tissue. These instruments are crucial during the Lumpectomy procedure as they are used to carefully separate the lump from surrounding tissues without damaging the tissue. The lump will be grasped by either an Allis clamp or kocher and removed from the incision.
Marking the lump
Once the lump is removed, the surgeon will mark it with a directional stitch to ensure that it is properly oriented. This stitch helps the pathologist to identify the location of the lump and determine if there are any cancerous cells present.
Specimen handling
After marking the lump, you will pass off the specimen to the circulator quickly. The circulator will then take it to the pathology lab for examination. If the pathologist determines that more tissue needs to be taken, margins may be taken to ensure that all cancerous cells are removed.
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