Case 8 (2023): Removal of an axillary lymphnode
Roskilde
Abstract
A 65-year-old male with a palpable lump in his right axilla. Admitted from the department of hematology to perform a lymphadenectomy diagnose for lymphoma. The patient had lost 6 kilos of weight through the last 3 months and his health was beginning to deteriorate.
BeforeAfterA 65-year-old male with a palpable lump in his right axilla. Admitted from the department of hematology to perform a lymphadenectomy diagnose for lymphoma. The patient had lost 6 kilos of weight through the last 3 months and his health was beginning to deteriorate.
The pectoral muscle is marked anteriorly. The latissimus muscle is marked posteriorly. The palpable lymphnode is marked centrally A lazy-S incision is drawn reaching the near-center of the
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Incision through skin and subdermal tissue
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When reaching the axillary fat, self-holding retractors may be helpfull to view of the axillary content.
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Small bleeding vessels are closed using bipolar diathermia. The lymphnode is dissected very close to the capsule using the bipolar diathermia, thereby ensuring no harm to nerves or larger vessels.
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The Lymphnode is removed using a combination of metzenbaum scissors and bipolar diathermia. Keep the dissection close to the capsule of the lymphnode. Use retractors to obtain a better view. Use forceps to handle the lymphnode, holding in the capsule, without damaging it.
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The lymphnode is succesfully removed. The capsule is intact, this ensures no lymphoma cells or cancer cells left behind in the operative field.
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The lymphnode measures 4x3x3 cm in size. The capsule is intact. Some minor fatty tissue is left in the capsule.
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Gently and thoroughly hemostasis is always important
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The patient had the skin further closed/secured using micropore plaster. Compression was applied to the axilla using gauze and mefix plaster. The patient was discharged later the same day. No active sports to be performed for 2 weeks.
How to cite this article
Roskilde. Case 8 (2023): Removal of an axillary lymphnode. Journal of Plastic, Breast & Reconstructive Surgery. 2023.
Open access. © 2023 The Author(s). Published by the Journal of Plastic, Breast & Reconstructive Surgery. Copyright to this case is shared between the author(s) and the journal; authors may reuse their own case for education, presentations and social media.
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