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AMA Journal of Ethics Apr 2018Incorporating classmates' unique one-word reflections on human anatomy and the experience of engaging with the bodies of our anatomical donors, this series captures a...
Incorporating classmates' unique one-word reflections on human anatomy and the experience of engaging with the bodies of our anatomical donors, this series captures a diverse spectrum of human emotions surrounding anatomical dissection. Grappling with the humanity of our varied reactions, we related ourselves-ethically and clinically, individually and collectively-to our first "patients" and their critical role in our education and growth as physicians.
Topics: Anatomy; Attitude to Death; Cadaver; Dissection; Gift Giving; Humans; Students, Medical; Tissue Donors
PubMed: 29671734
DOI: 10.1001/journalofethics.2018.20.4.imhl1-1804 -
Plastic and Reconstructive Surgery Nov 2018It has been two centuries since Petrus Camper identified superficial fascia and over 175 years since Sir Astley Cooper wrote his book on the anatomy of the breast. In... (Observational Study)
Observational Study
BACKGROUND
It has been two centuries since Petrus Camper identified superficial fascia and over 175 years since Sir Astley Cooper wrote his book on the anatomy of the breast. In the 1990s, Ted Lockwood taught us the importance of the superficial fascia layers in body contouring procedures he pioneered. These descriptions, however, fail to explain the three-dimensional fascial system in the breast. The authors set out to discover and describe a theory of superficial fascia structures responsible for breast shape.
METHODS
The nature of the superficial fascia system that surrounds the breast and its attachments to the chest were studied in 12 cadaver breast dissections and in clinical cases of both cosmetic and reconstructive breast procedures.
RESULTS
The authors found a three-dimensional, closed system of fascia and fat surrounding the corpus mammae, which attaches to the skin by means of specialized vertical cutaneous ligaments, or Cooper ligaments, and which attaches to the chest wall by means of a three-dimensional zone of adherence at the breast's periphery.
CONCLUSIONS
The breast is shaped by a three-dimensional, fibrofatty fascial system. Two layers of this system surround the corpus mammae and fuse together around it, and anchor it to the chest wall in a structure we have called the circummammary ligament.
Topics: Breast; Cadaver; Dissection; Fascia; Fasciotomy; Female; Humans; Medical Illustration
PubMed: 30511967
DOI: 10.1097/PRS.0000000000004948 -
Journal of Vascular Surgery May 2019
Topics: Aorta; Dissection
PubMed: 30553727
DOI: 10.1016/j.jvs.2018.07.085 -
Il Giornale Di Chirurgia 2018The Harmonic scalpel ("Focus" and the new version "Focus+") is one of the first devices for surgical simultaneous cutting and tissue coagulation which allows to obtain... (Comparative Study)
Comparative Study Randomized Controlled Trial
INTRODUCTION
The Harmonic scalpel ("Focus" and the new version "Focus+") is one of the first devices for surgical simultaneous cutting and tissue coagulation which allows to obtain dissection and hemostasis by direct application of ultrasound and allows minimally invasive surgical procedures with minimal lateral thermal spread and, thus, minimal adjacent tissue destruction. The aim of the study is to complete the previous study that we made in 2014, based on the TT performed between January 2008 and December 2013, with new data about TT performed in our Surgical Division between January 2014 and December 2016 and compare the outcome using the Ultrasonic scalpel versus the device Ligasure in term of safety, operative time, overall drainage volume, complications, hospital stay.
PATIENTS AND METHODS
250 patients were randomized into two groups: Group A where Ultracision were used and Group B where the Ligasure device was used.
RESULTS
The results of the group A and of the Group B 2014-2016 have been compared with the results of the previous study and we found that they are similar, but asymptomatic hypocalcaemia increased in the patients of the new study.
CONCLUSIONS
We found that the use of Ultrasonic scalpel and Ligasure is effective both in the hemostasis of all vessels and in dissection of tissues and confirm the results of our first study without significant difference in the rate of post-operative morbidity with these two different energy based devices used.
Topics: Adolescent; Adult; Aged; Dissection; Female; Hemostasis, Surgical; Humans; Hypocalcemia; Length of Stay; Male; Middle Aged; Operative Time; Postoperative Complications; Prospective Studies; Radiofrequency Ablation; Thyroidectomy; Ultrasonic Surgical Procedures; Vocal Cord Paralysis; Young Adult
PubMed: 29549681
DOI: 10.11138/gchir/2018.39.1.045 -
Indian Journal of Ophthalmology Sep 2022The purpose of this article is to form a basic guide for beginning the cadaver dissection training programs focused on oculoplastic surgical procedures. Ours was a... (Review)
Review
The purpose of this article is to form a basic guide for beginning the cadaver dissection training programs focused on oculoplastic surgical procedures. Ours was a collaborative study between the departments of Ophthalmology and Anatomy in a tertiary care teaching institute. We formed a step-wise approach to begin the cadaver dissection focused on the oculoplastic surgical procedures. The basics of cadaver procurement, processing, and preparation for dissections were described. The operative requirements of trainees, surgical handling of cadavers, and basic oculoplastic surgical steps were discussed. The types of embalming (cadaver preservation process) and steps have been described in detail. We have emphasized the preoperative discussion about the proposed dissections using standard teachings and skull models for easier understanding. Additional helping tools like soft embalming and injectable substances for better intra-dissection understanding (intra-arterial, intravenous and orbital injections) have been described. Post-dissection cadaver handing and soft-tissue disposal protocols have also been described. Overall, the cadaver dissections provide holistic surgical learning for the residents, specialty trainees, and practitioners. This article may act as a basic step-wise guide for starting the cadaver-based oculoplastics lab dissection in various institutes and workshops.
Topics: Cadaver; Dissection; Embalming; Humans; Learning
PubMed: 36018092
DOI: 10.4103/ijo.IJO_3037_21 -
The Journal of Thoracic and... Mar 2021
Topics: Aortic Dissection; Dissection; Humans; Replantation; Research
PubMed: 33353750
DOI: 10.1016/j.jtcvs.2020.11.084 -
Fertility and Sterility Feb 2018To study the safety and feasibility of robotic dissection of deep pelvic vessels as applied to the robotic harvesting of a uterus from live transplant donor.
OBJECTIVE
To study the safety and feasibility of robotic dissection of deep pelvic vessels as applied to the robotic harvesting of a uterus from live transplant donor.
DESIGN
Surgical video.
SETTING
Gynecologic oncology practice of a tertiary community cancer center.
PATIENT(S)
Two patients undergoing robotic nerve-sparing radical hysterectomy for International Federation of Gynecology and Obstetrics (FIGO) stage Ib1 cervical cancer.
INTERVENTION(S)
Application of robotic platform to precise dissection of internal iliac artery and vein, their branches, including the superficial and deep uterine artery and vein. The robotic technique for deep pelvic dissection in gynecologic oncology demonstrated here provides superior outcomes compared with the open technique. In our settings, a typical robotic nerve-sparing radical hysterectomy takes 3 hours from completion of the pelvic lymphadenectomy to the moment when the patient leaves the operating room.
MAIN OUTCOME MEASURE(S)
Safety and adequacy of robotic dissection of deep pelvic vessels. The procedure's modification to the current technique demonstrated improved transplant blood supply and outflow. Demonstration of modification to current technique, that has potential to improve transplant blood supply and outflow.
RESULT(S)
Using the robotic technique for nerve-sparing radical hysterectomy, the pelvic vessels can be dissected with superior precision, hemostasis, efficiency, and clinical outcomes. Due to its difficulty, nerve-sparing radical hysterectomy is not even performed via a laparotomy approach in the United States. Robotic dissection allows for better exposure of the pelvic vessels, which may allow for harvesting intact uterine vessels with internal iliac artery and vein patches, thus facilitating wider vascular anastomosis and superior blood supply and outflow of the transplant.
CONCLUSION(S)
Uterine harvesting from a live donor is currently being performed via a laparotomy technique, resulting in long procedures associated with significant morbidity. Based on our gynecologic oncology experience, a robotic approach to deep pelvic dissection is superior to laparotomy. Robotic nerve-sparing radical hysterectomy is a difficult procedure that requires knowledge of deep pelvic vessels' anatomy, precise dissection techniques, and repetition. Robotic harvesting of the uterus for transplantation from a live donor may provide better results in terms of transplant survival and donor outcomes. This type of procedure should be attempted by a robotic team that has experience in working with deep and large pelvic vessels.
Topics: Clinical Competence; Dissection; Feasibility Studies; Female; Fertility Preservation; Humans; Hysterectomy; Living Donors; Neoplasm Staging; Operative Time; Patient Care Team; Robotic Surgical Procedures; Surgeons; Tissue and Organ Harvesting; Treatment Outcome; Uterine Cervical Neoplasms; Uterus
PubMed: 29246556
DOI: 10.1016/j.fertnstert.2017.10.038 -
The Journal of Thoracic and... Sep 2019
Topics: Arteries; Axilla; Axillary Artery; Catheterization; Dissection
PubMed: 30660410
DOI: 10.1016/j.jtcvs.2018.12.019 -
International Journal of Legal Medicine Nov 2023During autopsies, weighing the heart is a standard procedure. In addition to myocardial pathologies, heart size, and ventricular wall thickness, heart weight is a common...
During autopsies, weighing the heart is a standard procedure. In addition to myocardial pathologies, heart size, and ventricular wall thickness, heart weight is a common parameter to describe cardiac pathology and should be recorded as accurately as possible. To date, there exists no standard for recording heart weight at autopsy, although some authors recommend weighing the heart after dissection and removal of blood and blood clots. In the study presented, the hearts of 58 decedents were weighed after being dissected out of the pericardial sac (a), after dissection using the short-axis or inflow-outflow method with manual removal of blood and blood clots (b), and after rinsing and drying (c). Depending on the dissection method, the heart weight was 7.8% lower for the inflow-outflow method and 11.6% lower for the short-axis method after dissection compared to before and correspondingly 2.9% to 5% lower again after rinsing and drying respectively. Accordingly, the heart should be dissected, blood and blood clots removed, rinsed with water, and dried with a surgical towel after dissection, before weighing.
Topics: Humans; Autopsy; Female; Male; Organ Size; Middle Aged; Aged; Adult; Myocardium; Dissection; Heart; Aged, 80 and over; Forensic Pathology
PubMed: 37723344
DOI: 10.1007/s00414-023-03089-9 -
The Journal of Thoracic and... Jul 2018
Topics: Aorta; Artifacts; Dissection; Tomography, X-Ray Computed
PubMed: 29779645
DOI: 10.1016/j.jtcvs.2018.02.003