Preliminary experience of reverse lymphatic mapping technique using indocyanine green dye lymphangiography and patent blue dye in melanoma patients undergoing sentinel lymph node biopsies: a case series

Sentinel lymph node (SLN) biopsy is essential for staging and treatment planning in melanoma, but access to standard techniques such as preoperative radiotracer injection may be limited in resource-constrained settings. We describe a novel technique combining patent blue dye with indocyanine green (ICG)-guided reverse lymphatic mapping to identify SLN in lower extremity melanoma. This method offers a feasible alternative when radioactive isotope injection devices are unavailable. Three patients underwent this technique with successful localisation of SLN and no complications.