Article Text
Abstract
Introduction/Background To describe and to analyze the technique steps and anatomical landmarks for the sentinel node biopsy in vulvar cancer.
Methodology Surgery remains the cornerstone in the treatment of vulvar cancer. Radical vulvectomy with inguinofemoral lymphadenectomy has been replaced by radical local excision with sentinel node procedure for early disease.
Results We perform the sentinel node biopsy using a double method: Tc99 and blue dye. However, the fluorescence substances is a feasible technique. First of all, the injection of Tc 99 is performed the day before the surgery, and during the surgery we inject the blue dye. A 3 cm insicion is performed at the Douglas arcade. A delicate dissection is performed trying to localize tha blue collector or a hot-spot area. At the time that the node is located, it is taken out and correlated with the gamma probe.
Conclusion Patients with unifocal disease, tumor size less than 4 cm, and clinically negative groins are candidates to sentinel node procedure. The learning curve of this technique can be improved with a correct knowledge of surgical anatomy of Scarpa´s triangle. The goal of this technique is the less index of morbidity, specially due to lymphedema
Disclosure Nothing to disclose