A model for teaching sentinel lymph node mapping and excision and axillary lymph node dissection

Abstract

Background: The surgical skills laboratory increasingly provides opportunities for training and practice in basic surgical procedures.

Study design: This article describes a new method for teaching trainees sentinel lymph node mapping and excision and level I/level II axillary dissection. The training session uses cadaver head and torso segments through T6 implanted with radioactive discs to simulate the sentinel node. This model is the first described to provide trainees the opportunity to practice mapping of the sentinel node and excision of the node once identified.

Results: A group of PGY2 and PGY3 residents participated in this laboratory experience with defined objectives, syllabus material, and training session. All participants successfully harvested the sentinel node and completed a level I/level II axillary dissection with faculty supervision and feedback. The residents rated the experience as outstanding and felt that it increased their confidence in their ability to perform the procedure in the operating room.

Conclusions: Use of cadavers for surgical skills training is only one of a variety of options currently available to provide practice for surgical housestaff in the surgical skills laboratory. Such a model might well have application in training courses for surgeons in practice and courses accompanying clinical trials for sentinel lymph node mapping and excision.