38525 Biopsy or excision of lymph node(s); open, deep axillary node(s)

Name of the Procedure:

Biopsy or excision of lymph node(s); open, deep axillary node(s)

Summary

This surgical procedure involves removing one or more lymph nodes from the deep tissues of the armpit. It helps diagnose or treat conditions affecting the lymph nodes, such as infections, cancer, or unexplained swelling.

Purpose

The procedure addresses issues such as unexplained swelling of the lymph nodes, suspected or confirmed cancer spread, and infections. The goal is to obtain tissue samples for diagnosis or to remove affected lymph nodes.

Indications

• Unexplained lymph node enlargement
• Suspected malignancy or cancer staging
• Persistent infection or inflammation
• Abnormal findings on imaging studies

Preparation

• Fasting typically required for 6-8 hours before the procedure.
• Review and adjustment of current medications, particularly blood thinners.
• Pre-procedure imaging tests like ultrasound or MRI.
• Possible pre-operative blood tests to check overall health and readiness.

Procedure Description

1. The procedure is usually done under general anesthesia.
2. An incision is made in the armpit to access the deep axillary lymph nodes.
3. The surgeon carefully dissects and removes one or more lymph nodes for examination.
4. The incision is then closed with sutures and dressed.
5. The removed lymph nodes are sent to a lab for pathological analysis.

Duration

The procedure typically takes 1 to 2 hours.

Setting

Conducted in a hospital operating room or surgical center.

Personnel

• Surgeon
• Operating room nurse
• Anesthesiologist
• Surgical technician

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma
• Nerve injury causing numbness or weakness in the arm
• Seroma (fluid accumulation)
• Lymphedema (swelling due to lymph fluid buildup)
• Reactions to anesthesia

Benefits

• Accurate diagnosis of lymph node-related conditions
• Effective removal of diseased lymph nodes
• Helps in staging and planning treatment for cancer
• Provides symptomatic relief from painful or swollen nodes

Recovery

• Brief hospital stay, often same-day discharge
• Pain management with prescribed medications
• Instructions to keep the incision area clean and dry
• Avoid heavy lifting or strenuous activity for a few weeks
• Follow-up appointment for wound check and review of pathology results
• Full recovery usually within 2-4 weeks

Alternatives

• Needle biopsy (less invasive but may provide less tissue for analysis)
• Imaging studies alone (non-diagnostic but useful for monitoring)
• Watchful waiting in cases of non-urgent swelling
• Chemotherapy or radiation therapy if the nodes are cancerous and in case of inoperable conditions

Patient Experience

• During the procedure, the patient will be under general anesthesia and will not feel pain.
• Postoperatively, some discomfort and pain at the incision site can be expected.
• Pain can be managed with medications.
• Mild swelling and bruising are normal.
• The patient may feel tired for a few days after the surgery.

The patient will receive detailed post-procedure care instructions to facilitate a smooth recovery.