Robert C Wright, MD, PS – Puyallup, Washington
Informed Consent – Lymphadenectomy or
Lymph Node Biopsy
We have determined that you have a problem in your lymph nodes requiring their partial or total removal in a
specific area. A lymphadenectomy is an operation that removes all of the lymph nodes in a specific area,
whereas a lymph node biopsy is performed to remove only the enlarged lymph nodes. The indications for
this operation are several. You may have abnormal lymph nodes that we can feel; we would remove those
lymph nodes in order to diagnose the cause for the enlarged lymph node(s). You also may have a known
cancer that has a high incidence of spread to lymph nodes, and the lymph nodes would be removed as a part
of staging and treatment of the cancer.
Description of the Procedure
Lymph nodes may be removed in the neck (cervical nodes), armpit (axillary nodes) or groin (superficial
and/or deep inguinal nodes). An incision is placed over the lymph nodes to be removed, and the lymph
nodes are carefully removed from the nerves and blood vessels that accompany the nodes. Drains are often
placed if multiple lymph nodes were taken, or if a full lymphadenectomy was performed.
Additional Procedures that may be done while in Surgery
If a tumor or mass is being resected at the time of the lymphadenectomy or lymph node biopsy, a separate
consent will be completed for that portion of the operation.
Alternatives for Treatment
Alternative treatments will depend on the nature of the disease undergoing treatment. A lymph node biopsy,
and often a lymphadenectomy, are performed for diagnostic reasons rather than curative reasons.
Risks/Complications of Treatment
In any medical treatment, it is impossible to predict all the things that could go wrong. Fortunately,
complications are the exception rather than the rule. Every reasonable effort is made to avoid complications.
The most common possible complications are:
Possible complications of major surgery
1. Bleeding – this is a problem that could happen any time the skin is cut. The need for a blood
transfusion is rare.
2. Infection – we take special care to prevent an infection, but it is always a possibility. An infection
may require prolonged hospitalization and treatment to resolve.
3. Reactions to medications – this could be many things from a minor rash to possible death.
4. Reactions to anesthesia and surgery – this could show up as a heart attack, blood clots, pneumonia,
sore throat, or potential death, in rare cases.
5. Poor wound healing – breakdown of the incision.
Possible complications of a lymphadenectomy or lymph node dissection
1. Injury to associated nerves or blood vessels – The lymph nodes sit next to and surround nerves and
blood vessels. An injury to the blood vessels will be repaired in surgery. An injury to nerves may
lead to either prolonged numbness or weakness.
2. Swelling – (lymphedema) in the extremity or region where the lymph nodes are being removed.
3. Increased risk of bad infections in the extremity being operated on.
4. Seroma – a collection of fluid beneath the wound.
5. Recurrence of the cancer – this could occur within the area where the cancerous lymph nodes are
being removed, or elsewhere in the body. Cure cannot be guaranteed.
(see other side)
Anticipated Recovery/Expected Rehabilitation
Recovery is quite variable, depending on the individual and the disease being treated. Hospitalization
typically extends from one to four days. You will usually be sent home with suction drains in place.
Recovery to return to full preoperative function of the extremity usually takes one or two months or more.
Most people can return to light duty in two or three weeks. You will be instructed in exercises to perform to
regain full use of the extremity following surgery. A simple lymph node biopsy is usually an outpatient
procedure with minimal time off work.
Further treatment of a cancer (should you have one) may be required, including chemotherapy and
possible radiation therapy. You may also require further surgery to treat the cancer. The final pathology
report after surgery will influence this decision.
Consent for Treatment
I understand my need for a lymphadenectomy or lymph node biopsy. I have read and understand the
above explanation of the procedure being proposed. My surgeon has answered my questions, and I
choose to proceed with surgery.
I understand that every operation may yield unexpected finding. I give the surgeon permission to act
on his best judgment in deciding to remove or biopsy tissues that appear to be diseased, understanding
that complications may arise from that action.
I understand that while most people receiving a lymphadenectomy or lymph node biopsy benefit from
the operation, I may not. My condition may not improve, and it may worsen. No absolute guarantee
can be made.
HIPPA: Before and after surgery, unless otherwise requested in writing by you, visitors whom you
invite to attend the surgery will be informed of the surgical finding, your surgical status, and
anticipated recovery issues for effectiveness of communications. Because of the anesthetic, you may or
may not remember these important details.
PRINT NAME OF PATIENT __________________________________________________________________
SIGNATURE __________________________________________________________ DATE _________________
WITNESS ____________________________________________________________ DATE _________________
SURGEON ____________________________________________________________ DATE _________________
RELATIONSHIP TO PATIENT IF SIGNATURE OF LEGAL GUARDIAN ___________________________________
I waive the right to read this form, and do not want to be educated and informed of treatment risks;
nonetheless, I understand the need for this surgery and grant permission to the surgeon to proceed on
my behalf.
SIGNATURE _____________________________________________________ DATE _________________
04/04 rev