Procedures
Sentinel Lymph Node Biopsy (SLNB)
This minimally invasive staging procedure can determine potential microscopic spread from a melanoma to the draining lymph node(s) and is used to guide further preventive (=adjuvant) systemic therapy, such as immunotherapy. Please ask about this procedure if you think you might be eligible.
Wide Local Excision (WLE)
Even though an initial biopsy often removes all the recognisable melanoma, wide local re-excision is usually recommended to further reduce the risk of the melanoma recurring. This involves removing the melanocytes adjacent to the melanoma that may be susceptible to turning into melanoma themselves.
A wide local excision usually removes a 1-2cm margin around the site of the original melanoma, however this amount varies depending on the depth of the tumour and how far it has spread into the lower layers of the skin. Most wide local excisions are closed with stitches, however larger excisions may require skin grafts or skin flaps.
Lymph Node Dissections
A lymph node dissection may be performed in select cases. This may happen at the same time as the wide local excision or as a subsequent surgery. Your surgeon will talk to you about the benefits of undergoing a lymph node dissection. Lymph node dissection is conducted under a general anaesthetic and will require you to stay in hospital for up to seven days.
There are three main types of lymph node dissection:
- Axillary dissection removes all the lymph nodes and possible tumour-containing tissue from the armpit region. See our Axillary dissection patient information leaflet
- Groin dissection removes all the lymph nodes from the groin (inguinal lymph node dissection) or all the lymph nodes from the groin and pelvis (ilio-inguinal lymph node dissection). See our Groin dissection patient information leaflet
- Neck dissection (also known as cervical lymph node dissection) removes affected lymph nodes in the neck region. The extent of node clearance is determined by the location of the original melanoma and how far it has spread.