Axillary Lymph Node Dissection

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  • Positive sentinel lymph node
  • Contraindication to sentinel lymph node detection (e.g., pregnancy)
  • Clinically palpable nodes
  • Inflammatory breast cancer
  • Patients with previous ALND
  • Inability to abduct the arm
  • Scalpel
  • Electrocautery
  • Star self retractor
  • S retractors
  • Appendiceal retractors
  • Long fine tonsils
  • Long sponge sticks
  • Allis clamps
  • 19F Blake drain
  • 3.0 nonabsorbable suture
  • 4.0 Vicryl running stitch

Surgical anatomy of the axilla from the axillary view

Sample excerpt does not include step-by-step text instructions for performing this procedure
The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
  • Clinical pearls providing practical clinical tips from medical experts
  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures

  • The patient usually requires at least an overnight hospital stay.
  • The patient should be instructed to keep her elbow at her side. The drain should be removed after 7 days if the drainage is less than 30 mL and should be left in no longer than 10 days. Consider prophylactic antibiotics.
  • Hematoma
  • Seromas
  • Injury to the thoracodorsal or long thoracic nerve
  • Numbness or dysesthesia in the posterior medial arm
  • Injury to the thoracodorsal vessels
  • Injury to the lymphatics
  • Nerve injuries
  • Postoperative chronic shoulder bursitis
  • Frozen shoulder
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