Intraoperative identification (eg, mapping) of sentinel lymph node(s) includes injection of non-radioactive dye, when performed (List separately in addition to code for primary procedure)
CPT4 code
Name of the Procedure:
Intraoperative Identification (Mapping) of Sentinel Lymph Nodes
Common Name: Sentinel Lymph Node Mapping
Summary
Sentinel lymph node mapping is a surgical procedure used to identify the first lymph node(s) to which cancer cells are likely to spread from a primary tumor. During the procedure, a non-radioactive dye is injected to help locate these sentinel lymph nodes.
Purpose
The primary goal of this procedure is to determine the spread of cancer. By identifying sentinel lymph nodes, doctors can assess whether cancer has metastasized to the lymphatic system.
Indications
- Diagnosed with certain types of cancer such as breast cancer or melanoma.
- Need to evaluate the extent of cancer spread.
- Planned surgical excision of a primary tumor.
Preparation
- Follow fasting instructions as advised by your doctor, usually starting the night before the procedure.
- Inform your doctor of any medications you are taking; adjustments may be needed.
- Pre-procedure tests such as blood work or imaging studies may be required.
Procedure Description
- Anesthesia is administered (local, regional, or general, depending on the case).
- A non-radioactive dye is injected near the tumor site.
- The surgeon tracks the dye as it travels to the sentinel lymph nodes.
- Identified lymph nodes are surgically removed for pathological examination.
Duration
The procedure typically takes about 1-2 hours but may vary based on individual circumstances and the complexity.
Setting
Sentinel lymph node mapping is usually performed in a hospital's surgical suite or an outpatient surgical center.
Personnel
- Surgeon
- Surgical nurse
- Anesthesiologist (if general anesthesia is used)
- Pathologist (for examination of the lymph nodes)
Risks and Complications
- Infection at the injection or surgical sites
- Bleeding or hematoma formation
- Allergic reaction to the dye
- Nerve or tissue damage
- In rare cases, failure to accurately identify sentinel lymph nodes
Benefits
- Provides crucial information about cancer spread.
- Helps to avoid more extensive lymph node surgeries.
- Results are often available soon after the procedure, aiding in prompt decision-making for further treatment.
Recovery
- Monitoring in a recovery room until anesthesia effects wear off.
- Post-procedure pain management with prescribed medications.
- Instructions on wound care and activity restrictions.
- Follow-up appointments to discuss pathology results and subsequent treatment plans.
Alternatives
- Comprehensive lymph node dissection
- Pros: Can provide more extensive information about cancer spread.
- Cons: Higher risk of complications such as lymphedema.
- Non-surgical imaging techniques (e.g., MRI, CT scans)
- Pros: Non-invasive.
- Cons: May not be as precise in detecting lymph node involvement.
Patient Experience
- You may feel some discomfort at the injection site for the dye.
- Post-surgery, mild to moderate pain can be expected, manageable with medications.
- Full recovery typically occurs within a few days, but strenuous activities may need to be avoided for a couple of weeks.
By understanding this procedure's details, patients can make informed decisions and feel more comfortable with their treatment plan.