Imaging-Guided Wide Local Excision

Imaging-guided wide local excision is a surgical procedure used to remove a tumor or a suspicious lesion from the body, typically from the breast, skin, or other soft tissues. The procedure combines imaging technologies with surgical techniques to ensure accurate and complete removal of the affected tissue.

Indications

The procedure is usually indicated for:

• Diagnosed or suspected cancerous tumors that are localized and have not spread to other parts of the body
• Benign (non-cancerous) tumors or lesions that are causing symptoms or pose a risk of becoming malignant
• High-risk lesions that require further examination and possible removal

Imaging Guidance

The procedure utilizes imaging modalities such as:

• Mammography: for breast lesions, to guide the surgeon during the excision
• Ultrasound: to visualize the tumor or lesion in real-time, allowing for precise removal
• Magnetic Resonance Imaging (MRI): for complex cases or when other imaging modalities are inconclusive
• Computed Tomography (CT) scans: occasionally used, especially for lesions in deeper tissues or when MRI is not feasible

Surgical Technique

The procedure typically involves:

• A small incision made in the skin to access the tumor or lesion
• Dissection and removal of the affected tissue, using imaging guidance to ensure complete excision
• Possible use of a specimen radiograph to confirm that the entire lesion has been removed
• Closure of the incision site, often with sutures or staples

Benefits and Risks

The benefits of imaging-guided wide local excision include:

• High accuracy in removing the tumor or lesion
• Potential for less invasive surgery compared to traditional methods
• Faster recovery times, depending on the location and size of the excised tissue

Risks and potential complications may include:

• Bleeding or hematoma at the surgical site
• Infection, as with any surgical procedure
• Scarring or changes in skin sensation
• Possible need for additional surgery if the lesion is found to be malignant or if margins are not clear

Post-Procedure Care and Follow-Up

After the procedure, patients typically require:

• Wound care and monitoring for signs of infection
• Pain management, as needed
• Follow-up appointments with their healthcare provider to review pathology results and discuss further treatment options, if necessary

It is essential to note that the specifics of the procedure may vary depending on individual patient needs and the preferences of the treating physician.

Frequently Asked Questions (FAQs)

What is an imaging-guided wide local excision?
A surgical procedure using imaging to remove a tumor or lesion with surrounding tissue.

Why is imaging guidance used?
To accurately locate and remove the tumor or lesion.

What types of imaging are used?
Ultrasound, MRI, or CT scans.

Is the procedure done under anesthesia?
Yes, local or general anesthesia.

How long does the procedure take?
Varies, typically 1-3 hours.

What are the benefits of wide local excision?
Removes tumor or lesion while preserving surrounding tissue.

Are there risks and complications?
Yes, infection, bleeding, and nerve damage.

Can the procedure be done on an outpatient basis?
Yes, depending on the individual case.

How long is the recovery time?
Typically several days to weeks.

Will a biopsy be performed during the procedure?
Yes, to confirm diagnosis and check for clear margins.