Outline of The Surgical Procedure
- An incision is made over the lymph node.
- The tissues are carefully dissected to reach the node.
- A portion or entire the node is removed for analysis.
- The wound is closed in layers with stitches.
Problems with the Lymph Glands that Require Surgery
As humans so frequently get upper respiratory tract infections, swollen glands in the neck are also very common. Normally though, these swollen glands will shrink down once the infection has passed.
Sometimes, swollen lymph glands may persist. There are very many reasons for this and most of them are quite simple and harmless. However, persistent swollen glands can suggest more serious problems somewhere in the body.
Normally, your own doctor will have watched these swollen glands for a period of time. If they do not settle down, then you may be referred to a specialist. Some times the specialist will arrange an ultrasound scan and/or a needle test to take a small biopsy from the lymph gland.
Sometimes the results of the needle test are not helpful. Sometimes the nature of the gland, or the problem, is such that a needle test will not help to give the right answer. In these situations, a formal lymph node biopsy may be suggested.
About the Operation
Sometimes dissolving stitches are used so removal is not required.
The operation may involve removal of the whole of the lymph gland if it is not too large. If it is very large, then a small portion (a bit like a slice of cake) will be removed.
This specimen is then sent to the pathologists so that a formal diagnosis can be made.
The main specific risks in this operation relate to damage to nerves passing through the neck close to the lymph gland that is biopsied.
The operation itself normally takes between 20 and 40 minutes.
A small incision is normally made over the lymph gland and the lymph gland removed in whole or in part.
At the end of the operation the incision (wound) is normally sewn up with stitches.
If a sensory nerve is damaged, this may lead to an area of numbness in the skin in the region of the incision.
There are many important blood vessels and nerves within the neck and therefore the surgeon will take great care to try and avoid damage to any of these structures.
If one of the motor nerves (movement nerves) is damaged, this may lead to some weakness in the area supplied by this nerve. Nerves that may be affected by this are as follows:-
• A branch of the facial nerve, causing some weakness at the corner of the mouth.
• The accessory nerve, causing some weakness and stiffness of the shoulder on that side.
• Damage or injury to other motor nerves is extremely uncommon. Concerns about these risks should always be discussed with your surgeon prior to the operation.
What to expect after the procedure.
Normally, after the operation, if it has been done with local anaesthetic, you should feel fairly normal with only an area of numbness where the local anaesthetic has been injected. As this wears off, you may feel some discomfort, which should respond to simple painkillers (Paracetamol or simple anti-inflammatories).
Over the next few days, there may be a little bruising and swelling around the wound.
Do I need to take time off work?
Depending on the nature of your work it may be necessary to take a few days or so off work and avoid strenuous exercise for this time. It is important to remember that you will not be able to drive or operate machinery for 48 hours after your general anaesthetic.
Will I need further appointments?
A review appointment will be arranged before you leave hospital to discuss the results.