-
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 -
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 -
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 Cochrane Database of Systematic... Mar 2011This is an update of a Cochrane Review first published in The Cochrane Library in Issue 4, 2001 and previously updated in 2003.Tonsillectomy is a commonly performed... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
This is an update of a Cochrane Review first published in The Cochrane Library in Issue 4, 2001 and previously updated in 2003.Tonsillectomy is a commonly performed surgical procedure. There are several operative methods currently in use, but the superiority of one over another has not been clearly demonstrated.
OBJECTIVES
To compare the morbidity associated with tonsillectomy by two different techniques - dissection and diathermy.
SEARCH STRATEGY
We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 3), PubMed, EMBASE, CINAHL, Web of Science, BIOSIS Previews, ISRCTN and additional sources for published and unpublished trials. The date of the most recent search was 1 October 2010, following a previous update search in 2003.
SELECTION CRITERIA
Randomised controlled trials of children and adults undergoing tonsillectomy or adenotonsillectomy by dissection or diathermy techniques.
DATA COLLECTION AND ANALYSIS
Two review authors selected studies, extracted data and assessed risk of bias independently.
MAIN RESULTS
Two studies (254 participants) are included in the review. The overall risk of bias in the included studies was low, although we excluded pain data from one study due to unclear risk of bias. One study compared monopolar dissection diathermy with conventional cold dissection in children and the other compared microscopic bipolar dissection with cold dissection in children and adults. These studies demonstrate reduced intraoperative bleeding, but increased pain in the diathermy group. There was no difference in the rate of secondary bleeding overall, although the power of both studies to detect a small difference was insufficient.
AUTHORS' CONCLUSIONS
There are insufficient data to show that one method of tonsillectomy is superior. There is evidence that pain may be greater after monopolar dissection. Large, well designed randomised controlled trials are necessary to determine the optimum method for tonsillectomy.
Topics: Adult; Child; Diathermy; Dissection; Humans; Pain, Postoperative; Randomized Controlled Trials as Topic; Tonsillectomy
PubMed: 21412878
DOI: 10.1002/14651858.CD002211.pub2 -
The Journal of Thoracic and... Sep 2019
Topics: Arteries; Axilla; Axillary Artery; Catheterization; Dissection
PubMed: 30660410
DOI: 10.1016/j.jtcvs.2018.12.019 -
Advances in Physiology Education Sep 2023In the field of anatomy education, the debate over the superiority of learning with or without human donors is decades long and ongoing. Arguments for or against the use... (Review)
Review
In the field of anatomy education, the debate over the superiority of learning with or without human donors is decades long and ongoing. Arguments for or against the use of human donors in anatomy education vary, depending on the healthcare discipline. Physical therapy programs have been particularly resistant to the trend away from the use of human donors. In this personal view, I present my history of anatomy education and how my perspectives on teaching and learning anatomy have changed dramatically throughout my teaching experiences. The purpose of this article is to support instructors who are creating anatomy courses for all healthcare trainees without donors, inspire those teaching with donors to incorporate other methods of instruction and evaluation, challenge educators to examine their own biases surrounding anatomy education, and provide recommendations for developing an anatomy course without human donors. Included in this article is the perspective of a practicing physical therapist who learned through human dissection and has assisted me in the development and management of the human anatomy course in our physical therapy curriculum. This article provides an overview of how to design an anatomy course without anatomical donors for doctor of physical therapy students and includes recommendations for instructors who need to reduce or eliminate anatomical donors from their anatomy curriculum.
Topics: Humans; Anatomists; Anatomy; Cadaver; Curriculum; Dissection; Education, Medical, Undergraduate; Educational Status; Learning; Students, Medical; Teaching
PubMed: 37141435
DOI: 10.1152/advan.00004.2023 -
Anatomical Record (Hoboken, N.J. : 2007) Apr 2022Present day scenario regarding epistemological methods in anatomy is in sharp contrast to the situation during ancient period. This study aimed to explore the evolution...
Present day scenario regarding epistemological methods in anatomy is in sharp contrast to the situation during ancient period. This study aimed to explore the evolution of epistemological methodologies in anatomy across centuries. In ancient times Egyptian embalmers acquired anatomical knowledge from handling human bodies and likewise anatomical studies in India involved human dissection. Ancient Greeks used theological principles-based methods, animal dissection and human dissection in practice of anatomy. Human dissection was also practiced in ancient China for gaining anatomical knowledge. Prohibition of human dissection led to use of animal dissection in ancient Rome and the trend continued in Europe through Middle Ages. Epistemological methods used by Muslim scholars during Middle Ages are not clearly chronicled. Human dissection returned as primary epistemological method in Renaissance Europe and empirical methods were reinstated after ancient period in human dissection during 16th century. The situation further improved with introduction of pragmatic experiment based approach during 17th century and autopsy-based methods during 18th century. Advances in anatomical knowledge continued with advent of microscope-based methods and emergence of anatomical sections in practice of human dissection in 19th century. Introduction of human observational studies, medical imaging, and molecular methods presented more options in terms of epistemological methods for investigating the human body during 20th century. Onset of 21st century has witnessed dominance of technology-based methods in anatomy. Limited emphasis on ethics in epistemological methodologies since antiquity is a dark aspect of otherwise an eventful evolutionary journey but recent developments are in positive direction.
Topics: Anatomy; Animals; China; Dissection; Europe; History, 15th Century; History, 18th Century; History, 19th Century; History, 20th Century; History, Ancient; History, Medieval; Human Body; Humans; Knowledge
PubMed: 34558798
DOI: 10.1002/ar.24781 -
BMJ (Clinical Research Ed.) Dec 2004
Topics: Adenolymphoma; Adenoma, Pleomorphic; Dissection; Humans; Parotid Neoplasms
PubMed: 15576716
DOI: 10.1136/bmj.329.7478.1299 -
Journal of Anatomy Jul 2016This brief history of topographical anatomy begins with Egyptian medical papyri and the works known collectively as the Greco-Arabian canon, the time line then moves on... (Review)
Review
This brief history of topographical anatomy begins with Egyptian medical papyri and the works known collectively as the Greco-Arabian canon, the time line then moves on to the excitement of discovery that characterised the Renaissance, the increasing regulatory and legislative frameworks introduced in the 18th and 19th centuries, and ends with a consideration of the impact of technology that epitomises the period from the late 19th century to the present day. This paper is based on a lecture I gave at the Winter Meeting of the Anatomical Society in Cambridge in December 2015, when I was awarded the Anatomical Society Medal.
Topics: Anatomy; Cadaver; Dissection; History, 15th Century; History, 16th Century; History, 17th Century; History, 18th Century; History, 19th Century; History, Ancient; History, Medieval
PubMed: 27278889
DOI: 10.1111/joa.12473