scholarly journals Pelvic Lymphadenectomy in Gynecologic Oncology—Significance of Anatomical Variations

Diagnostics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 89
Author(s):  
Stoyan Kostov ◽  
Yavor Kornovski ◽  
Stanislav Slavchev ◽  
Yonka Ivanova ◽  
Deyan Dzhenkov ◽  
...  
Keyword(s):  
Spinal Surgery ◽  
Medical Literature ◽  
Gynecologic Oncology ◽  
Anatomical Variations ◽  
Pelvic Lymphadenectomy ◽  
Pelvic Lymph Node Dissection ◽  
Surgical Approaches ◽  
Anatomical Landmarks ◽  
Gynecological Surgery ◽  
Pelvic Anatomy

Pelvic lymphadenectomy is a common surgical procedure in gynecologic oncology. Pelvic lymph node dissection is performed for all types of gynecological malignancies to evaluate the extent of a disease and facilitate further treatment planning. Most studies examine the lymphatic spread, the prognostic, and therapeutic significance of the lymph nodes. However, there are very few studies describing the possible surgical approaches and the anatomical variations. Moreover, a correlation between anatomical variations and lymphadenectomy in the pelvic region has never been discussed in medical literature. The present article aims to expand the limited knowledge of the anatomical variations in the pelvis. Anatomical variations of the ureters, pelvic vessels, and nerves and their significance to pelvic lymphadenectomy are summarized, explained, and illustrated. Surgeons should be familiar with pelvic anatomy and its variations to safely perform a pelvic lymphadenectomy. Learning the proper lymphadenectomy technique relating to anatomical landmarks and variations may decrease morbidity and mortality. Furthermore, accurate description and analysis of the majority of pelvic anatomical variations may impact not only gynecological surgery, but also spinal surgery, urology, and orthopedics.

scholarly journals Minimally Invasive Surgery in Gynecologic Oncology

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
Kristina M. Mori ◽  
Nikki L. Neubauer
Keyword(s):  
Ovarian Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Gynecologic Oncology ◽  
Laparoscopic Hysterectomy ◽  
Modern Medicine ◽  
Pelvic Lymphadenectomy ◽  
Surgical Approaches ◽  
Operative Laparoscopy

Minimally invasive surgery has been utilized in the field of obstetrics and gynecology as far back as the 1940s when culdoscopy was first introduced as a visualization tool. Gynecologists then began to employ minimally invasive surgery for adhesiolysis and obtaining biopsies but then expanded its use to include procedures such as tubal sterilization (Clyman (1963), L. E. Smale and M. L. Smale (1973), Thompson and Wheeless (1971), Peterson and Behrman (1971)). With advances in instrumentation, the first laparoscopic hysterectomy was successfully performed in 1989 by Reich et al. At the same time, minimally invasive surgery in gynecologic oncology was being developed alongside its benign counterpart. In the 1975s, Rosenoff et al. reported using peritoneoscopy for pretreatment evaluation in ovarian cancer, and Spinelli et al. reported on using laparoscopy for the staging of ovarian cancer. In 1993, Nichols used operative laparoscopy to perform pelvic lymphadenectomy in cervical cancer patients. The initial goals of minimally invasive surgery, not dissimilar to those of modern medicine, were to decrease the morbidity and mortality associated with surgery and therefore improve patient outcomes and patient satisfaction. This review will summarize the history and use of minimally invasive surgery in gynecologic oncology and also highlight new minimally invasive surgical approaches currently in development.

scholarly journals Role of Minimally Invasive Surgery in Gynecologic Oncology: An Updated Survey of Members of the Society of Gynecologic Oncology

2015 ◽  
Vol 25 (6) ◽  
pp. 1121-1127 ◽  
Author(s):  
Lesley B. Conrad ◽  
Pedro T. Ramirez ◽  
William Burke ◽  
R. Wendel Naumann ◽  
Kari L. Ring ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Endometrial Cancer ◽  
Minimally Invasive Surgery ◽  
Robotic Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Single Port ◽  
Gynecologic Oncology ◽  
Pelvic Lymphadenectomy ◽  
Single Port Laparoscopy

ObjectivesTo evaluate the current patterns of use of minimally invasive surgical procedures, including traditional, robotic-assisted, and single-port laparoscopy, by Society of Gynecologic Oncology (SGO) members and to compare the results to those of our 2004 and 2007 surveys.MethodsThe Society of Gynecologic Oncology members were surveyed through an online or mailed-paper survey. Data were analyzed and compared with results of our prior surveys.ResultsFour hundred six (32%) of 1279 SGO members responded. Eighty-three percent of respondents (n = 337) performed traditional laparoscopic surgery (compared with 84% in 2004 and 91% in 2007). Ninety-seven percent of respondents performed robotic surgery (compared with 27% in 2007). When respondents were asked to indicate procedures that they performed with the robot but not with traditional laparoscopy, 75% indicated radical hysterectomy and pelvic lymphadenectomy for cervical cancer. Overall, 70% of respondents indicated that hysterectomy and staging for uterine cancer was the procedure they most commonly performed with a minimally invasive approach. Only 17% of respondents who performed minimally invasive surgery performed single-port laparoscopy, and only 5% of respondents indicated that single-port laparoscopy has an important or very important role in the field.ConclusionsSince our prior surveys, we found a significant increase in the overall use and indications for robotic surgery. Radical hysterectomy or trachelectomy and pelvic lymphadenectomy for cervical cancer and total hysterectomy and staging for endometrial cancer were procedures found to be significantly more appropriate for the robotic platform in comparison to traditional laparoscopy. The indications for laparoscopy have expanded beyond endometrial cancer staging to include surgical management of early-stage cervical and ovarian cancers, but the use of single-port laparoscopy remains limited.

scholarly journals Non-recurrent inferior laryngeal nerve: a case report

2020 ◽  
Vol 7 (10) ◽  
pp. 3469
Author(s):  
Shah Urvin Manish ◽  
Boopathi Subbarayan ◽  
Saravanakumar Subbaraj ◽  
Tirou Aroul Tirougnanassambandamourty ◽  
S. Robinson Smile
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nodular Goiter ◽  
Anatomical Variations ◽  
Laryngeal Nerve ◽  
Anatomical Landmarks ◽  
Inferior Laryngeal Nerve ◽  
Nonrecurrent Inferior Laryngeal Nerve ◽  
Aged Woman ◽  
Middle Aged Woman ◽  
The Right

The incidence of Non-recurrent laryngeal nerve (NRLN) is reported to be 0.6%-0.8% on the right side and in 0.004% on the left side. Damage to this nerve during thyroidectomy may lead to vocal cord complications and should therefore be prevented. A middle-aged woman with a nodular goiter who underwent subtotal thyroidectomy for multinodular colloid goiter. We encountered a non-recurrent laryngeal nerve on the right side in a patient during surgery. We were not able to find the inferior laryngeal nerve in its usual position using the customary anatomical landmarks. Instead, it was emerging directly from the right vagus nerve at a right angle and entering the larynx as a unique non-bifurcating nerve. Nonrecurrent inferior laryngeal nerve incidence is very rare, but when present, increases the risk of damage during thyroidectomy. Hence, it is very important to be aware of the anatomical variations of the inguinal lymph node (ILN) and the use of safe meticulous dissection while looking for the nerve during thyroidectomy. The use of Intra-operative neuro-monitoring (IONM) if available in thyroid surgery allows the surgeon to recognize and differentiate branches of the inferior laryngeal nerve (ILN) from sympathetic anastomoses, as well as NRLN during surgery.

scholarly journals P138 PREPERITONEAL ENDOSCOPIC GROIN HERNIA SURGERY - REASSESSMENT OF TOPOGRAPHIC ANATOMY AS A BASIS FOR STANDARDIZED DESCRIPTION OF SURGICAL STEPS

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Marvin Heimke ◽  
Tilmann Heinze ◽  
Andreas Kuthe ◽  
Thilo Wedel ◽  
Christoph W Strey
Keyword(s):  
Abdominal Wall ◽  
Groin Hernia ◽  
Histological Study ◽  
Learning Curves ◽  
Surgical Approaches ◽  
Anatomical Landmarks ◽  
Hernia Surgery ◽  
Mesh Placement ◽  
Topographic Anatomy ◽  
Total Extraperitoneal

Abstract Aim Fascial groin anatomy remains a conundrum. In particular, a clear anatomical allocation of the correct extraperitoneal dissection planes and spaces in total extraperitoneal endoscopic hernia surgery (TEP) has not yet agreed upon. The differing anatomical concepts are reflected by the variability of surgical approaches, the considerably long learning curves and subsequent complications. Thus, the aim of this study was to reassess the topographic anatomy of the groin region providing a basis to standardize the surgical steps of TEP according to clearly defined anatomical landmarks. Material and Methods Video analysis of intraoperative surgical anatomy of groin hernia patients was correlated with the findings retrieved by macroscopic anatomical studies. The groin region of formalin fixed body donors was subjected to a stepwise dissection exposing the fascial system of the abdominal wall layer-by-layer and via different angles. Selected areas of interest were processed for histological study. Surgically relevant anatomical landmarks were defined and termed according to the most appropriate anatomical nomenclature. Results The essential surgical dissection steps during TEP could be related to specific anatomical landmarks extending within the extraperitoneal space of the ventral and dorsolateral abdominal wall. The definition of fascial structures and interfaces and the identification of structures at risk allowed the identification of correct dissection planes for mesh placement. Conclusions Our study helps to clarify the definition and nomenclature of anatomical key structures required for a standardized description of TEP in a simplified model. The data may contribute to reduce complications and improve surgical teaching and training.

scholarly journals Principles of Protection of the Eye and Vision in Orbital Surgery

2020 ◽  
Vol 81 (04) ◽  
pp. 381-384
Author(s):  
Jenny C. Dohlman ◽  
Michael K. Yoon
Keyword(s):  
Vision Loss ◽  
Anatomical Variations ◽  
Individual Risk ◽  
Surgical Approaches ◽  
Orbital Surgery ◽  
Risk Of Injury ◽  
Direct Injury ◽  
Different Types ◽  
Individual Risk Factors ◽  
Ischemic Events

AbstractOrbital surgery can result in damage to ocular and orbital structures, leading to a range of structural and visual sequelae, including corneal abrasions, globe malposition, diplopia, and blindness. Vision loss in particular is the most feared and devastating complication, occurs with an overall incidence of 0.84%, and can occur secondary to direct injury, optic nerve compression, or ischemic events. Different types of orbital surgery and surgical approaches carry their own hazards, and it is important to be mindful of these risks in addition to having a thorough understanding of individual risk factors and anatomical variations for each patient. Although universal guidelines for preserving vision in orbital surgery do not yet exist, there are concrete steps that every surgeon can take at the preoperative, intraoperative, and postoperative stages to minimize the risk of injury and maximize the likelihood of preserving the eye and visual function.

Intraoperative anatomical studies in patients with aneurysms of the anterior communicating artery complex

1992 ◽  
Vol 76 (4) ◽  
pp. 629-634 ◽  
Author(s):  
Edgar Nathal ◽  
Nobuyuki Yasui ◽  
Takeshi Sampei ◽  
Akifumi Suzuki
Keyword(s):  
Surgical Approach ◽  
Radical Surgery ◽  
Anatomical Variations ◽  
Surgical Approaches ◽  
Anterior Communicating Artery ◽  
Anatomical Studies ◽  
Content Type ◽  
Number Of Patients ◽  
Vascular Elements ◽  
Fine Print

✓ The intraoperative anatomical findings of the anterior communicating artery (ACoA) complex in 46 patients with anatomical variations were compared to those in an equal number of patients without variations in order to determine the visualization of the elements of the vascular complex. All patients underwent radical surgery for an ACoA aneurysm by one of three different surgical approaches: transsylvian, anterior interhemispheric, or basal interhemispheric. Visualization of the vascular elements was similar in patients with or without anatomical variations. The differences observed were dependent on the surgical approach selected and on the projection of the aneurysm. It was found that, even when the intraoperative anatomical field and the number of vascular elements visualized are different from those obtained in autopsy studies, the vascular microanatomical characteristics can be confirmed with each surgical approach to the extent necessary to ensure safe clipping of aneurysms in patients both with and without anatomical variations.

Complications of pelvic Lymph Node Dissection: Laparoscopy vs Open Surgery

1993 ◽  
Vol 60 (3) ◽  
pp. 248-250
Author(s):  
M. Moroni ◽  
G. Muto
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Laparoscopic Approach ◽  
Laparoscopic Group ◽  
Pelvic Lymphadenectomy ◽  
Pelvic Lymph Node Dissection ◽  
Pelvic Lymph Node ◽  
Node Dissection ◽  
Group 2 ◽  
Laparoscopic Pelvic Lymphadenectomy

Intraoperative and postoperative complications were assessed in 44 patients undergoing pelvic lymph node dissection for staging of prostatic cancer. In 24 cases an open surgical lymphadenectomy was performed and in the other 20 cases the lymphadenectomy was by laparoscopic approach. Complications in the surgical group were 3 (12%), more or less the same as those of the laparoscopic group (2 cases, 10%). In our opinion with experience of laparoscopic surgical principles, the risk of complications may be minimized so that laparoscopic pelvic lymphadenectomy offers a reliable and minimally invasive alternative to open dissection in selected patients.

scholarly journals Anatomical landmarks to locate the junction between transverse and sigmoid sinuses in translabyrinthine and retrosigmoid open surgical approaches

2018 ◽  
Vol 36 (2) ◽  
pp. 8
Author(s):  
Y Mathangasinghe ◽  
UMJE Samaranayake ◽  
SSA Silva ◽  
HC Prematilaka ◽  
MHS Perera ◽  
...  
Keyword(s):  
Surgical Approaches ◽  
Anatomical Landmarks
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