Female pelvic lymphadenectomy

Lymph node dissection is begun by sharply and bluntly mobilizing the tissue lateral to the external iliac artery and vein and moving this tissue until the external iliac artery can be identified. The dissection should be kept close to the artery to facilitate the resection. Using Metzenbaum scissors and forceps, the lymphatic tissue is then sharply dissected off the surface of the external and common iliac arteries and reflected medially. With lateral traction at this time, the external iliac vein and obturator fossa can be identified.