SKIN / SOFT TISSUE

Question 1

Inguinal node disection for melanoma

Answer 1

Lazy S incision meal to anterior superior iliacs fine extending to a point one cm below the apex of the femoral triangle

And… Skin over the palpable masses included in the resection

Flaps arrays lateral to the sartorius muscle and medial to the abductor longus

Mints notes are excised from 
over the femoral nerve
Femoral artery
Femoral vein
 external oblique aponeurosis

Is coquette’s lymph node is at the level of the inguinal ligament

Deep dissection:
Separate incision in the external oblique aponeurosis
(or by dividing the inguinal ligament)

Peritoneum is retracted immediately to expose the iliac fossa

The iliac lymph nodes are dissected off of the common and external iliac vessels

The obturator nodes are dissected off of the posterior surface of the external iliac vein

Deep drain is placed

Sartorius muscle is mobilized and transposed over the exposed femoral vessels

Superficial drain is placed

Careful of:
Spermatic cord structures and contents
Unexpected hernia
Injury to theater
Injury to the vessels
Bleeding from the obturator and iliac veins

Question 2

Where is level III node found in the axilla in relation to pectoralis minor muscle

Answer 2

MEDIAL to pec minor

Question 3

Do you perform resection of lung met for melanoma

Answer 3

IF:
SINGLE
Proven NO other dz

then yes