Sentinel lymph node biopsy
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Revision as of 06:32, 15 February 2024 by Peter Tryphonopoulos (talk | contribs)
Sentinel lymph node biopsy
Anesthesia type |
GA, local with sedation |
---|---|
Airway |
LMA |
Lines and access |
PIV sufficient |
Monitors |
standard |
Primary anesthetic considerations | |
Preoperative |
Cancer considerations. Radioisotope tagging beforehand means that cancelling "elective" cases is discouraged once they have been tagged. |
Intraoperative |
avoid BP cuff on ipsilateral arm. |
Postoperative |
PONV (breast surgery). With local infilitration, pain is usually minimal. |
Article quality | |
Editor rating | |
User likes | 0 |
Provide a brief summary here.
Overview
Indications
- The sentinel lymph node is the first node or group of lymph nodes that drains from the primary cancer. Thus, it is used to check for metastastic breast cancer.
Surgical procedure
- Carried out in conjunction with radioisotope tagging beforehand. The nodes with the highest degree of activity are removed.
- Involves incision in axilla to excise corresponding nodes.
Preoperative management
Patient evaluation
System | Considerations |
---|---|
Airway | |
Neurologic | |
Cardiovascular | |
Pulmonary | |
Gastrointestinal | |
Hematologic | |
Renal | |
Endocrine | |
Other |
Labs and studies
Operating room setup
Patient preparation and premedication
Regional and neuraxial techniques
Intraoperative management
Monitoring and access
- Standard monitors
- PIV sufficient
Induction and airway management
- If GA - standard induction. Usually a fairly healthy population.
- If MAC - propofol infusion +/- narcotic prn
Positioning
- Supine. Arms out
Maintenance and surgical considerations
Emergence
Postoperative management
Disposition
- Day procedure
Pain management
- Usually small incision. Local infilitration +/- prn narcotic, multimodals sufficient.
Potential complications
Procedure variants
Variant 1 | Variant 2 | |
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Unique considerations | ||
Indications | ||
Position | ||
Surgical time | ||
EBL | ||
Postoperative disposition | ||
Pain management | ||
Potential complications |