Sentinel Node/Lymph Node Dissection
The identification and surgical excision of the primary lymph nodes that drain a specific anatomical area to evaluate the potential spread of malignant cells.
Surgical instruments
13 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.
- The Surgery Sparknotes
- Make incision and dissect using 15 blade, metz, debakeys, and tonsil. Use skin hooks or army-navys for retraction.
- Collect specimens using forceps and scissors. Send to lab for analysis.
- Inject methylene blue before surgery to locate nodes. Use sterile or unsterile technique. Use a probe if necessary.
Walkthrough
What the surgeon does — and what to have in your hand before they ask.
Incision and Dissection
During a Sentinel Node/Lymph Node Dissection, the surgeon will make an incision with a 15 blade loaded on a #3 knife handle. They will then dissect down to the nodes using instruments such as metz, debakeys, and a tonsil. The surgeon may also use skin hooks or army-navys for retraction, depending on the depth of the dissection.
Specimen Collection
Once the nodes have been located, the surgeon will collect the specimens using a combination of forceps and scissors. These specimens will then be sent to the lab for analysis to determine if there is any cancer present. Depending on the surgeon's preference, they may choose to close the incision before receiving the lab results.
Methylene Blue Injection
To make the nodes easier to locate, methylene blue may be injected prior to the start of the surgery. This can be done either unsterile or sterile, depending on the surgeon's preference. A probe may also be draped and used to assist in finding the nodes.
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