Removal (ablatio) of the breast and sentinel node
In this patiënt a malignant tumour was removed at an earlier intervention above the right areola (1). Unfortunately further surgical treatment proved to be necessary meaning removal of the breast. Below follows the description of this procedure, in which also the sentinel node is removed.
1
2
3
4
5
6
Previously radioactive material has been injected at the cicatrice and the place of the radioactive sentinel node has been indicated with a sign. During the intervention also a blue dye is injected , which piles up itself in the sentinel node, so that this can be found easier during the operation. The place of the incision is indicated with a sterile marker and with a probe the place of the sentinel node is checked (2-6).
7
8
9
10
The incision is made here with a surgical knife and continued with an electric knife. The breastgland is in this way freed just underneath the skin (7-10)
11
12
13
14
15
16
17
For hemostasis a gauze under one skinflap is left behind whereas the other flap is freed. As both flaps are ready the breastgland is freed from the underlying muscle (11-17)
18
19
20
21
22
With the probe the sentinel node is localized and when the meanwhile blue discoloured gland is reached this is removed and checked for radioactivity (18-22)
23
24
25
26
27
The breast is removed and the wound is checked on haemorrhages. Drains are left behind on the muscle and in the armpit (23-27)
Hereafter the wound is closed, in this example only the skin, subcutaneous, with a soluble suture. Wound plasters are applied. Dismissal from the hospital follows within a number of days, depending on when the drains can be removed and on the patients wish (28-31).
