Surgical Techniques for operating on Large Adherent Cervical Nodal Metastases from Thyroid Cancer causing Severe Neck Pain and Compression Effects and encasing Major Vessels

ABSTRACT Aim We aim to refine and define surgical techniques for doing difficult adherent bulky cervical nodal metastases from thyroid cancer to help surgeons do dissections with better curability and lesser morbidity. Background Patients with thyroid cancer with large nodal metastases presenting with severe neck pain due to compression effects and encasing carotid artery and other major vessels pose a challenge to surgeons to do complete resections while preserving important structures in the neck. Materials and methods We define surgical planning and road map to dissect difficult bulky adherent cervical nodes encasing carotid artery and jugular vein by splaying the plane over carotid sheath by doing adventitial level dissection and dissecting medial and lateral to carotid sheath the large nodal mass adherent to adjacent structures preserving the major vessels and nerve plexus. Conclusion By appropriate surgical planning and meticulous dissection techniques, we can do major neck dissections with complete resections and same time preserving important structures in the neck minimizing morbidity. Clinical significance: By doing neck dissections with complete oncological resections and saving vital structures in the neck, we aim to offer best possible chance of cure to the patient along with reduced morbidity at same time. How to cite this article Ramakant P, Singh KR, Rana C, Mishra AK. Surgical Techniques for operating on Large Adherent Cervical Nodal Metastases from Thyroid Cancer causing Severe Neck Pain and Compression Effects and encasing Major Vessels. World J Endoc Surg 2016;8(3):217-219.

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Postendarterectomy Common Carotid Artery Pseudoaneurysm

Vascular ◽

10.2310/6670.2006.00032 ◽

2006 ◽

Vol 14 (3) ◽

pp. 177-180 ◽

Cited By ~ 12

Author(s):

Nenad S. Ilijevski ◽

Predrag Gajin ◽

Vojislava Neskovic ◽

Jovo Kolar ◽

Djordje Radak

Keyword(s):

Carotid Artery ◽

Endovascular Treatment ◽

Carotid Endarterectomy ◽

Common Carotid Artery ◽

Carotid Surgery ◽

Artery Pseudoaneurysm ◽

Adjacent Structures ◽

Uncommon Complication

Pseudoaneurysm (PSA) formation is an uncommon complication in carotid surgery. PSA of the carotid artery requires surgical or endovascular treatment to prevent PSA thrombosis, embolization from the thrombotic material within the PSA, hemorrhage after rupture, or compression on the adjacent structures. We present a case of a symptomatic common carotid PSA that occurred 14 months after routinely performed eversion carotid endarterectomy.

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Surgical treatment of internal carotid artery restenosis following eversion endarterectomy

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1210577r ◽

2012 ◽

Vol 140 (9-10) ◽

pp. 577-582

Author(s):

Djordje Radak ◽

Slobodan Tanaskovic ◽

Miloje Vukotic ◽

Srdjan Babic ◽

Nikola Aleksic ◽

...

Keyword(s):

Surgical Treatment ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Surgical Techniques ◽

Minor Stroke ◽

Graft Occlusion ◽

Redo Surgery ◽

Eversion Endarterectomy ◽

Late Morbidity

Introduction. Carotid angioplasty and internal carotid artery stenting is the therapeutic method of choice in the treatment of carotid restenosis, but when it is not technically feasible (expressed tortuosity of supraaortic branches, calcifications, presence of pathological elongation of very long lesions) a redo surgery is indicated. Objective. The aim of our study was to examine the benefits and risks of redo surgery in patients with symptomatic and asymptomatic significant internal carotid artery restenosis and its impact on early and late morbidity and mortality. Methods. The study included 45 patients who were surgically treated for a hemodynamically significant internal carotid artery restenosis from January 2000 to December 2009. Surgical techniques included redo endarterectomy with direct suture, redo anderectomy with a patch plastic and resection with Dacron tubular graft interposition. The patients were followed for postoperative neurological ischemic events (transient ischemic attack (TIA), stroke), local surgical complications and lethal outcome after one month, six months, one year and after two years). Results. In the early postoperative period (up to 30 days) there were no lethal outcomes. TIA was diagnosed in four patients (8.8%), minor stroke in one patient (2.2%) and one patient (2.2%) also had cranial nerve injury. After two years two patients died (4.4%) due to fatal myocardial infarction, three patients (6.5%) had ipsilateral stroke and one patient developed graft occlusion (2%). Conclusion. In the case of symptomatic and asymptomatic carotid restenosis that cannot be treated by carotid percutaneous angioplasty, redo surgical treatment is therapeutic option with an acceptable rate of early and late postoperative complications.

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Mitral commissural prolapse

10.22541/au.160653791.18592665/v1 ◽

2020 ◽

Author(s):

EVA PAPADIMITRAKI ◽

Alexandros Patrianakos ◽

Antonis Pitsis ◽

Maria Marketou ◽

Aggeliki Zacharaki ◽

...

Keyword(s):

Risk Factor ◽

Surgical Planning ◽

3D Imaging ◽

Correct Diagnosis ◽

Surgical Techniques ◽

Valve Repair ◽

Accurate Identification ◽

2D Echocardiography ◽

2D And 3D ◽

Echocardiographic Findings

Mitral commissural prolapse or flail, either isolated or combined with more extensive degenerative valve disease imposes several challenges both on its diagnosis and management whilst being a risk factor for valve reoperation after mitral valve repair. Accurate identification of the prolapsing segment is often not feasible with transthoracic 2D echocardiography, with transesophageal 3D imaging then required for correct diagnosis and surgical planning. Various surgical techniques employed alone or in combination, have yielded good results in the repair of commissural prolapse. Herein, we analyze the specific characteristics of commissural disease focusing our attention on 2D and 3D echocardiographic findings and we briefly comment on techniques employed for surgical correction of the disease.

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Karakteristik radiograf kista dentigerous dengan menggunakan CBCT-scan

Jurnal Radiologi Dentomaksilofasial Indonesia ◽

10.32793/jrdi.v4i2.519 ◽

2020 ◽

Vol 4 (2) ◽

pp. 15

Author(s):

Berty Pramatika ◽

Aga Satria Nurrachman ◽

Eha Renwi Astuti

Keyword(s):

Case Report ◽

Surgical Planning ◽

Dentigerous Cyst ◽

Three Dimensional ◽

Case Series ◽

Impacted Tooth ◽

Adjacent Structures

Objectives: The aim of this report which contains three case series is to describe the radiographic characteristic of dentigerous cyst using CBCT. Case Report: In the case presented here, all of the three patients had dentigerous cyst developing in impacted tooth, but did not have the same symptoms. CBCT radiography examination was carried out to find out the margin of the cortical extension, the diameter of the lesion, and the relations between the lesion and adjacent structures. The result of CBCT examination shows there is a variation of radiograph characteristics of dentigerous cyst among the three patients. Conclusion: CBCT is a very useful complementary tool for diagnosis and surgical planning in cases of dentigerous cyst, because three-dimensional viewing of the structures offers greater accuracy in lesion identification.

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Immersive 3-Dimensional Virtual Reality Modeling for Case-Specific Presurgical Discussions in Cerebrovascular Neurosurgery

Operative Neurosurgery ◽

10.1093/ons/opaa335 ◽

2020 ◽

Cited By ~ 1

Author(s):

Taku Sugiyama ◽

Tod Clapp ◽

Jordan Nelson ◽

Chad Eitel ◽

Hiroaki Motegi ◽

...

Keyword(s):

Virtual Reality ◽

Surgical Planning ◽

Objective Assessment ◽

Surgical Techniques ◽

Patient Specific ◽

Decision Making Process ◽

3 Dimensional ◽

Head Mounted Display ◽

Precise Understanding ◽

Cerebrovascular Surgery

Abstract BACKGROUND Adequate surgical planning includes a precise understanding of patient-specific anatomy and is a necessity for neurosurgeons. Although the use of virtual reality (VR) technology is emerging in surgical planning and education, few studies have examined the effectiveness of immersive VR during surgical planning using a modern head-mounted display. OBJECTIVE To investigate if and how immersive VR aids presurgical discussions of cerebrovascular surgery. METHODS A multiuser immersive VR system, BananaVisionTM, was developed and used during presurgical discussions in a prospective patient cohort undergoing cerebrovascular surgery. A questionnaire/interview was administered to multiple surgeons after the surgeries to evaluate the effectiveness of the VR system compared to conventional imaging modalities. An objective assessment of the surgeon's knowledge of patient-specific anatomy was also conducted by rating surgeons’ hand-drawn presurgical illustrations. RESULTS The VR session effectively enhanced surgeons’ understanding of patient-specific anatomy in the majority of cases (83.3%). An objective assessment of surgeons’ presurgical illustrations was consistent with this result. The VR session also effectively improved the decision-making process regarding minor surgical techniques in 61.1% of cases and even aided surgeons in making critical surgical decisions about cases involving complex and challenging anatomy. The utility of the VR system was rated significantly higher by trainees than by experts. CONCLUSION Although rated as more useful by trainees than by experts, immersive 3D VR modeling increased surgeons’ understanding of patient-specific anatomy and improved surgical strategy in certain cases involving challenging anatomy.

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Why Evolution is Better than Revolution

The American Journal of Cosmetic Surgery ◽

10.1177/074880689701400203 ◽

1997 ◽

Vol 14 (2) ◽

pp. 109-112

Author(s):

Russell Knudsen

Keyword(s):

Surgical Planning ◽

Gradual Increase ◽

Surgical Techniques ◽

Staff Skills ◽

Better Than

In the main, the development of modern hair restoration surgical techniques has involved a few revolutions and a number of small evolutions. These evolutions have improved upon earlier techniques after carefully analyzing both the benefits and shortcomings of these pioneer techniques. Longer-term shortcomings in surgical planning have equally demonstrated the potential dangers of aggressive radical technique changes. Modern megasessions require a gradual increase in graft numbers to accommodate the need for development of staff skills unique to these procedures. Innovation is important, but it is more safely expressed in gradual improvements to existing techniques.

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