Cervical Injection of Methylene Blue for Identification of Sentinel Lymph Nodes in Cervical Cancer

This is a step-by-step illustration of methylene blue injection into cervix for sentinel lymph node identification. The patient was a 34-year-old Hispanic woman who was diagnosed with stage IB1 squamous cell carcinoma of the cervix. She was taken to the OR for robotic-assisted radical hysterectomy and sentinel lymph node dissection. By utilizing the ultra-short injection protocol, 4 ml of methylene blue was injected at 3 and 9 o’clock positions of cervix. Sentinel lymph node dissection was started approximately 20 minutes after the injection. Bilateral pelvic dissection was performed and sentinel lymph nodes were identified at the most common topographic location: Between external and internal iliac vessels. Sentinel lymph node in the para-aortic area was also identified and removed.