Type of Surgery
Information

Last updated: 02/17/2009
Although the specific surgical procedure may differ according to which lymph nodes are to be removed, some steps are common among all lymphadenectomies. General anesthesia is usually administered for the duration of surgery; this ensures that the patient...
remain unconscious and relaxed, and awaken with no memory of the procedure.
First, an incision is made into the skin and through the subcutaneous layers in the area where the lymph nodes are to be removed. The lymph nodes are identified and isolated. They are then carefully taken out from surrounding tissues (that is, muscles, blood vessels, and nerves). In the case of axillary node dissection, the pad of fat under the skin of the armpit is removed; generally, about 10 to 20 lymph nodes are embedded in the fat and separately removed. The incision is sutured (stitched) closed with a drain left in place to remove excess fluid from the surgical site.
Alternatively, laparoscopy may be used as a less invasive method of removing lymph nodes. The laparoscope is a thin, lighted tube that is inserted into the abdominal cavity through a small incision. Images taken by the laparoscope may be seen on a video monitor connected to the scope. Certain lymph nodes, such as the pelvic and aortic lymph nodes, may be removed using this technology.
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Other Information
Lymphadenectomy consists of the surgical removal of one or more groups of lymph nodes. It is almost always performed as part of the surgical management of cancer.
This is usually done because many types of cancer have a marked tendency to produce lymph node metastasis early on in their natural history. This is particularly true of melanoma, head and neck cancer, differentiated thyroid cancer, breast cancer, lung cancer, gastric cancer and colorectal cancer. Famed British surgeon Sir Berkeley Moynihan once remarked that "the surgery of cancer is not the surgery of organs; it is the surgery of the lymphatic system".
The better known examples of lymphadenectomy are axillary lymph node dissection for breast cancer; radical neck dissection for head and neck cancer and thyroid cancer; D2 lymphadenectomy for gastric cancer; and total mesorectal excision for rectal cancer.
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