Name of the Procedure:

Biopsy or excision of lymph node(s); open, superficial
Common name(s): Lymph node biopsy, Superficial lymph node excision

Summary

A lymph node biopsy involves the surgical removal of one or more lymph nodes, typically those close to the skin (superficial). This procedure helps doctors diagnose or rule out certain medical conditions, such as infections, autoimmune disorders, or cancer.

Purpose

The main goal is to obtain a tissue sample for microscopic examination. This helps in:

• Diagnosing infections.
• Identifying autoimmune disorders.
• Detecting cancer and determining its type, stage, and spread. The expected outcome is an accurate diagnosis that guides appropriate treatment.

Indications

• Unexplained swollen lymph nodes.
• Persistent lymphadenopathy (swollen lymph nodes) without a clear cause.
• Suspicion of cancer (e.g., lymphoma or metastasis).
• Inflammatory or infectious conditions suspected by clinical presentation.

Preparation

• Patients may need to fast for a certain period before the procedure.
• Medication adjustments might be necessary, particularly blood thinners.
• Pre-operative blood tests and imaging studies (e.g., ultrasound, CT scan) may be required to locate the lymph nodes and assess general health.

Procedure Description

1. Anesthesia: Local or general anesthesia is administered for pain control.
2. Incision: A small incision is made over the area of the targeted lymph node.
3. Excision: The lymph node is carefully dissected and removed.
4. Closure: The incision is closed with sutures or surgical glue. Tools: Scalpel, forceps, and sometimes special imaging equipment to guide the excision. The removed lymph node is sent to a pathology lab for testing.

Duration

The procedure typically takes about 30-60 minutes, depending on the complexity and number of lymph nodes being removed.

Setting

Generally performed in a hospital or outpatient surgical center.

Personnel

• Surgeon (usually a general surgeon or specialized surgical oncologist).
• Nurse(s).
• Anesthesiologist (if general anesthesia is used).

Risks and Complications

• Common risks: Pain, bleeding, infection, and scarring at the incision site.
• Rare risks: Nerve injury, seroma (fluid collection), and delayed wound healing. Management typically involves antibiotics for infection, pain control measures, and sometimes surgical intervention for more serious complications.

Benefits

• Accurate diagnosis helps in formulating an effective treatment plan.
• Early detection of serious conditions, leading to better management and outcomes. Expected benefits are usually realized within a few days to weeks after pathology results are obtained.

Recovery

• Patients may experience soreness and swelling at the incision site.
• Pain can generally be managed with over-the-counter pain relievers.
• Most patients can return to normal activities within a week, though heavy lifting and strenuous exercise should be avoided for a few days.
• Follow-up appointments are necessary to discuss pathology results and further treatment.

Alternatives

• Fine needle aspiration (FNA): Less invasive but may not provide enough information.
• Core needle biopsy: More tissue than FNA, less invasive than an open biopsy. Pros and cons depend on the specific clinical scenario, with open biopsy often offering the most comprehensive diagnostic information.

Patient Experience

Patients may feel some discomfort and pressure during the procedure if local anesthesia is used. Post-procedure, there might be mild to moderate pain, managed with prescribed medications. The care team will ensure patient comfort and provide instructions for at-home care.