The removal of all the lymph node bearing tissue in the iliac and femoral area is performed for various malignant diseases of the lower extremities or perineum. Because of frequent complications after the standard surgical techniques, a different approach was developed, utilizing two oblique and parallel incisions to gain exposure of the retroperitoneal and groin lymph nodes. There were 50 patients with melanomas of the lower extremities who underwent this procedure in addition to a hindquarter regional perfusion. Eleven patients had major wound problems. The new technique appears to represent an improvement without compromising adequate exposure and thorough removal of the regional nodes.