Minimally invasive lymph node surgery

Minimally invasive lymph node surgery is a technique used to precisely locate and remove the sentinel lymph node, while preserving surrounding tissues as much as possible. Unlike traditional methods that rely on radioactive tracers, this approach uses fluorescent agents to allow real-time visualization of the target node.

This procedure is essential in breast cancer management, as the sentinel lymph node is the first potential site of cancer spread. Its analysis helps determine whether the disease has metastasized, guiding therapeutic strategy while avoiding unnecessary full lymph node dissection.

This approach is recommended for patients with early-stage breast cancer requiring lymph node evaluation. It is especially appropriate for women undergoing breast-conserving surgery, where tissue preservation and diagnostic accuracy are key.

It also offers a safe alternative for patients who cannot receive radioactive tracers and allows for faster recovery with a lower risk of complications.

At MIB Center Paris, sentinel lymph node detection via fluorescence follows a strict protocol.

Before the procedure

A fluorescent tracer typically indocyanine green (ICG) is injected near the tumor site. It then travels through the lymphatic system and accumulates in the sentinel node.

During the procedure

The surgeon uses an infrared camera to visualize the fluorescent signal in real time, accurately locating the sentinel node. A small incision is made to remove only the marked node, minimizing damage to other lymphatic structures.
The node is then sent for pathological analysis to determine whether cancer cells are present.

The surgery typically lasts about one hour and can be performed under general or local anesthesia, depending on the case.

After the procedure

Patients usually return home the same day or the next, and a post-operative follow-up is arranged to monitor healing and review pathology results.

One of the main benefits is improved safety for patients. Unlike radioactive tracers, fluorescent agents pose no radiation risk a particularly important factor for younger patients or those requiring multiple procedures.

Fluorescence also enables faster and more accurate detection of the sentinel node. Real-time visualization allows the surgeon to locate the node precisely, reducing false negatives and increasing the chance of early metastasis detection.

Additionally, this technique eliminates the need to handle radioactive substances, simplifying surgical logistics. Hospitals can avoid the high costs and complex infrastructure required for managing radioactivity, making the technique easier to implement.

Fluorescent tracers are also better tolerated by patients. While radioactive agents may cause allergic reactions or local complications, agents like ICG are generally safe and associated with fewer adverse effects.

The overall patient experience is also enhanced. The procedure is less invasive, requires fewer pre- and post-op precautions, and typically leads to quicker recovery and shorter hospital stays.

From a practical perspective, fluorescence-guided systems are user-friendly and require minimal training, enabling faster adoption and wider use in clinical settings.

Lastly, sentinel lymph node detection by fluorescence is fully aligned with the trend toward safer, less invasive surgeries. As a non-radioactive and highly effective alternative, it represents a major step forward in breast cancer treatment, improving the quality of care while reducing risks and associated costs.

In conclusion, fluorescence-guided sentinel lymph node detection offers numerous advantages over traditional radioactive methods. It enhances safety, precision, and procedure effectiveness, while significantly improving the experience for both patients and clinicians.