Procedures

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.

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.

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.