General Surgery · Breast

Axillary Lymph Node Dissection (Level I-II)

OPERATION: Axillary Lymph Node Dissection (Level I-II) — Completion ALND
ANAESTHETIC: General anaesthesia. Long-acting muscle relaxants avoided.
ANTIBIOTICS: IV prophylaxis at induction.
POSITION: Supine. Soft roll placed longitudinally beneath the shoulder and flank to displace the axilla anteriorly. Arm positioned at slightly <90° to the trunk on an arm board.

INDICATION:
Metastatic breast carcinoma in the axilla — [positive sentinel lymph node biopsy requiring completion dissection / clinically palpable nodal disease]. [Pre-operative axillary USS and FNAC or core biopsy confirmed node-positive disease]. Lymphoscintigraphy performed pre-operatively if uncertainty about drainage pattern.

PROCEDURE:
WHO Checklist performed. Axilla prepared and draped. Ipsilateral arm prepped into field to allow manipulation.