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Title
1. Introduction
2. Surgical Approach
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a. Position Patient
b. Mark for Incision
3. Formation of Subplatysmal Flaps
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a. Incision and Collection of Scar Revision Specimen
b. Dissect Through Platysma
c. Identify Greater Auricular Nerve
d. Finalize Subplatysmal Flaps
4. Dissection to Internal Jugular Vein (IJV)
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a. Identify Accessory Nerve
b. Ligate External Jugular Vein
c. Mobilize and Isolate Sternocleidomastoid (SCM)
d. Mobilize Omohyoid Muscle
e. Evaluate Tumor Spread
f. Resect Omohyoid Muscle
5. Isolate and Mobilize IJV
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a. Place Vessel Loop around IJV
b. Identify Digastric Muscle and Hypoglossal Nerve
c. Dissect Following Carotid
d. Identify Vagus Nerve
e. Follow IJV Inferiorly
6. Resection of Tumor
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a. Lateral to Medial Tumor Mobilization
b. Ligate Internal Jugular Vein
c. Separate Vagus Nerve and Collect Marginal Specimen
d. Resect Bulk of Tumor
e. Resect Residual Tumor
7. Left Side Summary and Inspection
8. Right Side - Subplatysmal Flaps
9. Dissection to IJV
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a. Dissect out External Jugular
b. Isolate and Mobilize SCM
c. Isolate and Inspect Omohyoid Muscle
10. Isolation of IJV and Vagus Nerve
11. Resection of Tumor
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a. Resect Level II Specimen
b. Follow IJV
c. Lateral to Medial Mobilization of Tumor
d. Resect Bulk of Tumor
12. Right Side Summary and Inspection
13. Placement of Drains
14. Closure
15. Post-op Remarks
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Bilateral Modified Radical Neck Dissection for Metastatic Papillary Thyroid Carcinoma
Courtney Gibson, MD, MS, FACS
;
Tobias Carling, MD, PhD, FACS
Yale School of Medicine
Tags:
General Surgery
Otolaryngology
Main Text
Procedure Outline
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Authors
Courtney Gibson, MD, MS, FACS
Tobias Carling, MD, PhD, FACS
Filmed At:
Smilow Cancer Hospital at Yale New Haven
Article Information
Publication Date
11/27/2024
Article ID
238
Production ID
0238
Volume
2024
Issue
238
DOI
https://doi.org/10.24296/jomi/238