How I do it: Simple and effortless approach to identify thoracodorsal nerve on ­axillary clearance procedure

T Zin,1 M Maw,1 SM Oo,1 DR Pai,1 RB Paijan,2 and M Kyi2

1 Department of Surgery, Melaka Manipal Medical College, Melaka, Malaysia 2 Department of Surgery, Hospital Pakar Sultanah Fatimah, Muar, Johor, Malaysia

Correspondence to: Thant Zin. Email: [email protected]

Abstract

Breast cancer surgery frequently involves an axillary clearance procedure for nodal metastases. Injury to the thoracodorsal nerve is one of the complications related to the axillary dissection. The thoracodorsal nerve innervates the latissimus dorsi muscle which facilitates in certain movements of the arm. Moreover, it can be used as a nerve graft in long thoracic nerve injury whether in trauma or surgery. ­Understanding the anatomy structures and good surgical technique in the axillary clearance procedure can identify and prevent such an injury to the thoracodorsal nerve. Here, we demonstrate a simple and effortless technique for identification of the thoracodorsal nerve during axillary surgery.

Keywords: thoracodorsal nerve, axilla, axillary clearance Short Communication

Published: 28/05/2012 Received: 27/04/2012 ecancer 2012, 6:255 DOI: 10.3332/ecancer.2012.255

Copyright: © the authors; licensee ecancermedicalscience. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Short Communication thoracodorsal nerve(C),subscapularvein(D), neurovascularbundle(E)andlongthoracicnerve(F). 2: Figure ­thoracodorsal nerve(C),subscapularvein(D)andneurovascularbundle(E). 1: Figure Operative view of left axillary clearance procedure showing axillary vein (A), cut end of the lateral thoracic vein (B), vein thoracic lateral the of end cut (A), vein axillary showing procedure clearance axillary left of view Operative prtv ve o lf ailr cerne rcdr soig xlay en A, u ed f aea toai vi (B), vein thoracic lateral of end cut (A), vein axillary showing procedure clearance axillary left of view Operative 3 e cancer www.ecancer.org 2012, 6 :255

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