Radial Neck Dissection
Objective
In cases of cancer of head and neck:
• Excision
of cervical lymph node and adjacent muscular and vascular structures.
Position
Supine.
Anesthesia
General.
Procedure
1. Incision (Y, double, T, parelle-transverse, Z) in the lateral neck
usually beneath the jaw to the supraclavicular region.
2. Skin flaps are mobilized.
3. The external jugular vein is severed.
4. The deep cervical fascia is incised (including
some cutaneous nerve branches).
5. The sternoclavicle origins of the
sternomastoid muscle are divided.
6. The internal jugular vein is isolated and
divided.
7. The omohyoid muscle is transected.
8. Fatty tissues bearing lymph nodes are
dissected from underlying structures in continuity.
9. The insertion of the sternomastoid muscle is
divided.
10. The
lower pole of the parotid gland removed, no injury to branches of the facial
nerve.
11. The
facial artery and vein are divided, and the submaxillary gland and proximal end
of the internal jugular vein are divided.
12. The
tissue bloc is then excised.
13. The
accessory nerve is preserved on the left, the thoracic duct is protected.
14. The
flaps are closed over suction drains.
15. A
moderate pressure dressing is applied.
Instruments
• Minor
procedure set
• Thyroid set
• Tracheostomy set
• Extra mosquito clamps (24)
• Extra towel clips (8)
• Right angle clamps (finely pointed)
• Basin set
• Marking pen
• Suction tubing
• Blades (2) No. 10 (3) No. 15
• Dissector (e.g. peanut)
• Bulb syringe (2)
• Umbilical tapes, vessel loops
• Nerve stimulator (locator)
• Suction drainage unit (e.g. Hemovac).
Any questions be sent to drmmkapur@gmail.com
All older posts are stored in archive for accessand reiew
Thosewho follow may post contributions to the site,please writo tp address above.
Thosewho follow may post contributions to the site,please writo tp address above.
To create consumer/provider enagement visit www.surginstruatlas.blogspot.co
Also available now on android & smartphones same internet address.
