38520 Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad

Name of the Procedure:

Biopsy or Excision of Lymph Node(s); Open, Deep Cervical Node(s) with Excision Scalene Fat Pad

Common Names:

• Deep Cervical Lymph Node Biopsy
• Cervical Lymph Node Excision

Summary

This is a surgical procedure where a sample of lymph node tissue is removed from the deep cervical (neck) area for examination. Additionally, tissue from the scalene fat pad is also excised to aid in diagnosis.

Purpose

This procedure helps diagnose conditions such as infections, lymphoma, and other types of cancer in the lymph nodes. The goal is to obtain tissue for pathological examination to determine the presence of disease.

Indications

• Unexplained swelling of lymph nodes
• Persistent or unexplained neck lumps
• Suspicion of cancer or lymphoma
• Diagnostic clarification following imaging or blood tests

Preparation

• Patients might need to fast for several hours before the surgery.
• Discontinue certain medications as directed by the doctor.
• Pre-surgical assessments including blood tests and imaging studies (e.g., ultrasound, CT scan).

Procedure Description

1. The patient is positioned comfortably, usually under general anesthesia.
2. An incision is made in the neck to access the deep cervical lymph nodes and surrounding tissue.
3. The surgeon carefully dissects to reach the targeted lymph nodes and scalene fat pad.
4. Specimens are removed for pathological examination.
5. The incision is then closed with sutures, and a bandage is applied.

Tools used include surgical scalpels, forceps, and possibly electrocautery devices.

Duration

Approximately 1 to 2 hours.

Setting

This procedure is typically performed in a hospital's operating room or a specialized surgical center.

Personnel

• Surgeon
• Anesthesiologist
• Surgical Nurse
• Pathologist (later examination of the biopsy)

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma
• Nerve injury causing numbness or weakness
• Adverse reaction to anesthesia
• Scarring

Benefits

• Accurate diagnosis of lymphatic or systemic diseases
• Facilitation of appropriate treatment planning
• Early detection of malignancies

Recovery

• Monitoring in a recovery room until anesthesia wears off
• Pain management with prescribed medications
• Instructions for wound care and activity restrictions
• Follow-up appointments for pathology results and wound check
• Full recovery typically takes a few weeks

Alternatives

• Needle biopsy (less invasive but may not be as comprehensive)
• Imaging studies (non-invasive but not as definitive)
• Observation and repeat imaging (active surveillance)

Patient Experience

• The patient will be under general anesthesia and will not feel the procedure.
• Some post-operative pain and swelling in the neck area are expected.
• Pain relief measures and postoperative care to ensure comfort.
• Gradual resumption of normal activities based on the doctor's advice.