Procedure Information Sheet

Name: Kim Kunzman

Date: Feb 5, 2015
Hospital: Aurora Kenosha
Specialty: General
Procedure: Bilateral Mastectomy with sentinel node biopsy
Probable Preoperative Diagnosis: Cancer on one side, tumors/nodes on the
other
New Equipment Used During This Procedure: no
Student Comments: First time Ive been in a case like this. It went very well. I
really enjoyed working with Dr. Needle.
Instructor Comments:
Instructor Initials:
Position of Patient: supine

Incision Site:

Position Aids / Tables Attachments

Used: sandbags, pillows, doughnut,
stirrups, leg holder, arm holder,
arm board, other:

Special Equipment Used: cautery,

suction, laser, c-arm, arm table,
microscope, ortho table, power
fiber optic light, tourniquet, cellsaver, monitors, endoscopic
equipment, other: cautery, gamma
probe

arm board on the cancer side with

sentinel node. arm holder on the other.
Special Instruments Used:

Sutures / Needles Used:

Peritoneum:
Fascia:
Muscle:
Sub Q: absorbable stapler
Skin: stapler and 3-0 vicryl sh
Free Needles:
Other: 2-0 silk for labeling
specimen,

Drains Used: Jackson Pratt drain

Implants: NO

Clinical Interventions 1 2 3 4

Dressings: telfa, 4x4s and chest

binder

Surgical Technology Program

Procedure Information Sheet

Summary (in your own words) of the Procedure: Resource Used: Page
Numbers:
Alexanders pg 322-325
Sentinel Node Biopsy
Isosulfan blue dye is injected into the tumor mass
Rule of 5s is followed. 5-mL of dye, at 5 sites spanning a 5-cm
diameter and the site massaged for 5 minutes.
Axillary dissection occurs
stained nodes are identified and excised. Each node placed separately
in their own specimen container and numbered with their own pathological
requests
Surgeon will continue with the procedure once results are returned.

Mastectomy (simple)
***IF BILATERAL, AND ONE SIDE IS CANCER FREE, MOST OF THE TIME,
THE CLEAN SIDE IS DONE FIRST***
Transverse elliptic incision. (eye shaped)
10 blade is passed
lahey retractors are used. (have at least 10 ready in case of large
breast)
Cautery begins.
Debakey is passed
Dissection takes place until the pectoral fascia is found.
Breast tissue is removed.
Bleeding vessels are clamped with hemostat and cauterized.
Once closing begins, ASK FOR LAP COUNT
Closed side is cleaned and a sterile towel is placed on the first side.
Surgeon, PA, Mayo Stand and Back Table are shifted to the other side.
***IF YOU HAVE FRESH INSTRUMENTS, USE THEM ON THE SECOND
SIDE FIRST INCLUDING BLADES***
Repeat on second side.

Clinical Interventions 1 2 3 4

Surgical Technology Program