Foreword 6
THE IMPORTANCE OF SURGICAL TECHNIQUE IN SURGICAL ONCOLOGY 6
Preface 10
Contents 12
List of Contributors 18
Chapter 1. Axillary Lymph Node Dissection for Breast Cancer Elisabeth A. te Velde and Emiel J. Th. Rutgers 32
INDICATIONS 32
TECHNIQUE 33
REFERENCES 36
Chapter 2. Breast Reconstructive Techniques Fabricio Brenelli, Umberto Napoli, Stefano Martella and Jean-Yves Petit 38
RECONSTRUCTION WITH PROSTHESIS 38
Breast Reconstruction with a Definitive Prosthesis 38
Breast Reconstruction with Tissue Expander 41
RECONSTRUCTION WITH LATISSIMUS DORSI FLAP (L. D.) 42
RECONSTRUCTION WITH TRAM FLAP 45
Chapter 3. Skin/Nipple-Sparing Mastectomy Leif Perbeck 50
INTRODUCTION 50
TECHNIQUE 51
DISCUSSION 54
REFERENCES 54
Chapter 4. Radio-Guided Occult Lesion Localisation of Subclinical Breast Lesions Hodigere S. J. Ramesh, Matilde M. Audisio and Riccardo A. Audisio 56
INTRODUCTION 56
EVOLUTION OF ROLL 57
GENERAL PRINCIPLES 57
PRE-OPERATIVE CONSIDERATIONS 58
Indications 58
Contraindication 58
BEFORE ANAESTHESIA 58
PATIENT POSITION 58
INCISIONS 58
HANDLING OF THE GAMMA CAMERA 60
SPECIMEN X-RAY 61
WOUND CLOSURE 61
POST-OPERATIVE CARE 61
ADVANTAGES6\u201310 61
RADIATION SAFETY 62
REFERENCES 62
Chapter 5. Technical Note on Total Parotidectomy Eberhard Stennert and Orlando Guntinas-Lichius 64
DEFINITION OF AND INDICATIONS FOR TOTAL PAROTIDECTOMY 64
STEP 1: BEDDING OF THE PATIENT 65
STEP 2: FACIAL NERVE MONITORING 65
STEP 3: SKIN INCISION AND SKIN FLAP PREPARATION 66
STEP 4: ANATOMICAL LANDMARKS FOR IDENTIFICATION OF THE FACIAL NERVE 66
STEP 5: LATERAL PAROTIDECTOMY 67
STEP 6: COMPLETION OF TOTAL PAROTIDECTOMY 67
STEP 7: DEFECT FILLING 68
STEP 8: WOUND CLOSURE 69
REFERENCES 69
Chapter 6. Total Thyroidectomy Niall O\u2019Higgins 72
REFERENCES 75
Chapter 7. Neck Dissection for Thyroid Cancer Jan Betka, Petr Luke拧, Zdenek Cada and Jaroslav Betka 76
SURGICAL MANAGEMENT AND TECHNIQUE 79
COMPLICATIONS 83
REFERENCES 84
Chapter 8. Total Laryngectomy Mohssen Ansarin, Augusto Cattaneo and Fausto Chiesa 86
INTRODUCTION 86
TECHNIQUE 87
DISCUSSION 91
REFERENCES 92
Chapter 9. Transcervical Extended Mediastinal Lymphadenectomy Jaros艂aw Kuzdza艂, Marcin Zielinski and 艁ukasz Hauer 94
INTRODUCTION 94
TECHNIQUE 96
DISCUSSION 99
REFERENCES 100
Chapter 10. Minimally Invasive Techniques for Early Lung Cancer Contardo Vergani, Luca Despini and Giancarlo Roviaro 102
BASIC CONSIDERATIONS 102
INDICATIONS 104
TECHNIQUE 104
MEDIASTINAL PHASE (FIGS. 2 AND 3) 105
FISSURAL PHASE (FIG. 4) 107
BRONCHIAL PHASE 108
LYMPHADENECTOMY 108
REFERENCES 108
Chapter 11. Resection of Superior Sulcus Cancers: Anterior Approach Marco Alifano, Salvatore Strano and Olivier Schussler 110
REFERENCES 115
Chapter 12. Surgical Staging for Lung and Mediastinal Cancers Ram贸n Rami-Porta, Sergi Call-Caja, Roser Saumench-Perramon and Mireia Serra-Mitjans 118
INTRODUCTION 118
MEDIASTINOSCOPY 118
PARASTERNAL MEDIASTINOTOMY 119
EXTENDED CERVICAL MEDIASTINOSCOPY 120
THORACOSCOPY AND VIDEO-ASSISTED THORACOSCOPIC SURGERY 122
TRANSCERVICAL MEDIASTINAL LYMPHADENECTOMY 122
REFERENCES 123
Chapter 13. Transthoracic Oesophagectomy and Lymphadenectomy Philippe Nafteux, Willy Coosemans, Herbert Decaluw茅, Georges Decker, Paul De Leyn, Dirk Van Raemdonck and Toni Lerut 126
INTRODUCTION 126
TECHNIQUES 127
Right-sided Approach 127
Left-sided approach 130
REFERENCES 133
Chapter 14. Transhiatal Esophagectomy J. Jan. B. van Lanschot, Khe T. C. Tran, Bas P. L. Wijnhoven and Hugo W. Tilanus 134
INTRODUCTION 134
TRANSHIATAL ESOPHAGECTOMY: TECHNICAL ASPECTS 135
Operative Technique 135
EVIDENCE IN FAVOR OF TRANSHIATAL OR TRANSTHORACIC APPROACH 137
REFERENCES 139
Chapter 15. Gastrectomy for Adenocarcinoma Hartgrink H. Hartgrink and Cornelis J. H. van de Velde 140
REFERENCES 145
Chapter 16. Stenting Gastro-Oesophageal Tumours Els M. L. Verschuur, Frank P. Vleggaar and Peter D. Siersema 148
INTRODUCTION 148
TECHNIQUE 149
Stents 149
Stent placement procedure (video) 149
DISCUSSION 154
REFERENCES 154
Chapter 17. Total Pancreatectomy Jens Werner and Markus W. B眉chler 156
INTRODUCTION 156
TECHNIQUE 157
DISCUSSION 160
Safety 160
Oncological Advantage 161
Functional Consequences 161
CONCLUSION 162
REFERENCES 162
Chapter 18. Radiofrequency Ablation in the Treatment of Liver Tumours Joris Joosten and Theo Ruers 164
INTRODUCTION 164
TECHNIQUE AND RESULTS 165
Postoperative Follow-up Imaging 166
Complications 167
Local Recurrence 167
Overall Survival 168
CONCLUSION 170
REFERENCES 170
Chapter 19. Atypical Liver Resections of Colorectal Metastases Bjarne Ardnor and Peter Naredi 172
INTRODUCTION 172
Indications 172
Resection Margin 172
Surgical Techniques 173
TECHNIQUE 173
DISCUSSION 177
REFERENCES 178
Chapter 20. Extended Hepatectomy for Primary and Metastatic Liver Lesions Ren茅 Adam, Emir Hoti, Dennis A. Wicherts and Robert J. de Haas 180
INTRODUCTION 180
TECHNIQUE 182
Preoperative Evaluation and Patient Selection 182
Surgical Procedure 182
Extended Right Hepatectomy 182
Extended Left Hepatectomy 183
Haemorrhage Control 184
DISCUSSION 185
REFERENCES 185
Chapter 21. Isolated Hepatic Perfusion: How It Should Be Done Alexander L. Vahrmeijer, Liselot B. J. van Iersel, Peter J. K. Kuppen and Cornelis J. H. van de Velde 188
INTRODUCTION 188
TECHNIQUE OF IHP 189
SAFETY 191
DISCUSSION 193
REFERENCES 194
Chapter 22. Robot-Assisted Laparoscopic Colorectal Surgery Omer Aziz and Ara W. Darzi 196
INTRODUCTION 196
ROBOT-ASSISTED LAPAROSCOPIC SURGERY 197
CONCLUSION 200
REFERENCES 200
Chapter 23. How to Make a Good Stoma Robin Phillips and Simon Phillips 202
INTRODUCTION 202
TECHNIQUE 202
The Skin and Subcutaneous Incision 203
Muscle Fascia 203
Muscle 204
Choice of Bowel for the Construction of a Stoma 204
Loop Ileostomy 206
End Colostomy 206
Loop Colostomy 207
DISCUSSION 207
REFERENCES 208
Chapter 24. Palliative Stenting for Colorectal Malignant Strictures Thomas M. Raymond, R. Bhardwaj and Mike C. Parker 210
INTRODUCTION 210
SEMSS \u2014 TYPES 211
PLACEMENT 212
Radiological Placement 213
Endoscopic/Fluoroscopic Placement 213
EFFICACY 213
SAFETY 214
COVERED VS UNCOVERED STENTS 214
COST CONSIDERATIONS 215
DISCUSSION 215
REFERENCES 215
Chapter 25. Technical Notes on TME for Rectal Cancer Bill J. Heald 218
PRE-OPERATIVE STAGING 218
SURGERY 219
OPERATIVE TECHNIQUE 219
THE INCISION \u2014 OPEN OR LAPAROSCOPIC? 220
STARTING RIGHT: THE \u201cPEDICLE PACKAGE\u201d \u2014 THE CLUE TO THE TOP OF THE \u201cHOLY PLANE\u201d 220
HIGH LIGATION OF THE INFERIOR MESENTERIC VESSELS 220
\u201cDIVISION OF CONVENIENCE\u201d OF THE SIGMOID COLON 221
PELVIC DISSECTION 221
HIGH POSTERIOR DISSECTION 221
PELVIC SIDEWALL DISSECTION 222
\u201cLATERAL LIGAMENT\u201d AREA 222
ANTERIOR DISSECTION \u2014 DENONVILLIERS SEPTUM 223
THE COLON POUCH, COLOPLASTY OR SIDE-TO-END? 224
Suggested Reading 225
Chapter 26. Total Proctocolectomy with Ileoanal Pouch Anastomosis Thomas Lehnert, Silke Sch眉le and Frank Starp 226
BOWEL PREPARATION 226
ACCESS 227
LYMPHADENECTOMY 227
LENGTHENING OF THE MESENTERY 228
RECTAL MUCOSECTOMY AND ILEOANAL ANASTOMOSIS 229
POUCH FORMATION 232
PROTECTIVE ILEOSTOMY 233
REFERENCES 233
Chapter 27. Pouches and Coloanal Anastomosis Sylvain Kirzin, Guillaume Portier and Franck Lazorthes 234
INTRODUCTION 234
Is a Pouch Necessary? 234
What Kind of Pouch? 235
TECHNIQUE 236
REFERENCES 239
Chapter 28. Pelvic Exenteration for Rectal Cancer Klaas Havenga and Theo Wiggers 240
INTRODUCTION 240
SURGICAL ANATOMY 241
SURGICAL TECHNIQUE FOR TOTAL PELVIC EXENTERATION 241
CONCLUSION 245
REFERENCES 245
Chapter 29. Reconstruction of the Perineum by Gluteal Fold Flap Niri S. Niranjan 246
INTRODUCTION 246
GLUTEAL FOLD FLAP 247
OPERATIVE TECHNIQUE 247
REFERENCES 249
Chapter 30. Local Treatment for Primary Melanoma Omgo E. Nieweg 250
REFERENCES 252
Chapter 31. Ilioinguinal Dissection for Melanoma Alessandro Testori and Mark Zonta 254
INTRODUCTION 254
TECHNIQUE 254
DISCUSSION 259
REFERENCES 259
Chapter 32. Surgical Treatment of Peritoneal Carcinomatosis Marcello Deraco, Dario Baratti, Barbara Laterza, Domenico Sabia and Shigeki Kusamura 260
INTRODUCTION 260
TECHNIQUE 261
HIPEC 263
DISCUSSION 264
REFERENCES 266
Chapter 33. Laparoscopic Management of Adnexal Tumours Liselotte Mettler, Ivo Meinhold-Heerlein and Andreas G. Schmutzler 268
REFERENCES 273
Chapter 34. Excision of Intra-Abdominal Sarcomas: Technical Notes on Surgical Procedures Beate Rau and Peter M. Schlag 276
INTRODUCTION 276
OPERATIVE TECHNIQUE 277
DISCUSSION 278
REFERENCES 281
Chapter 35. Laparoscopic Adrenalectomy for Tumours in the Adrenal Glands Berg镁贸r Bj枚rnsson, Gu冒j贸n Birgisson and Margr茅t Oddsd贸ttir 284
INTRODUCTION 284
TECHNIQUE 285
Left Adrenalectomy 286
Right Adrenalectomy 287
DISCUSSION 288
REFERENCES 289
Chapter 36. Isolated Limb Perfusion Harald J. Hoekstra 290
INTRODUCTION 290
PERFUSION LEVEL 290
PERFUSION TECHNIQUE 291
CYTOSTATIC AGENTS 293
TREATMENT TOXICITY 295
SUMMARY 295
REFERENCES 296
Chapter 37. Cone and Wedge Resection in Renal Cell Carcinoma Frederik C. Roos and Joachim W. Th眉roff 298
INTRODUCTION 298
INTRAOPERATIVE PROCEDURE 299
COMPLICATION MANAGEMENT 303
REFERENCES 303
Chapter 38. Transperitoneal Laparoscopic Radical Nephrectomy Hugh F. O\u2019Kane, Alex MacLeod, Christopher Hagan and Thiagarajan Nambirajan 306
INTRODUCTION 306
TECHNIQUE 307
Pre-Operative Workup 307
Transperitoneal Approach 307
DISCUSSION 310
REFERENCES 311
Chapter 39. Radical Prostatectomy for Locally Advanced Prostate Cancer Marc Claessens, Steven Joniau and Hendrik Van Poppel 312
INTRODUCTION 312
TECHNIQUE 313
General Preparation and Positioning of the Patient 313
Incision and Exposure of the Pelvis 313
Pelvic Lymph Node Dissection (Fig. 1) 313
Incision of the Endopelvic Fascia and Lateral Dissection 314
Division of the Puboprostatic Ligaments 314
Control of the Dorsal Vein Complex 314
Dissection of the Apex and Neurovascular Bundles and Division of the Urethra 315
Posterior Release 315
Resection of the Neurovascular Bundles and Division of the Pedicles 316
Resection of the Seminal Vesicles 316
Bladder Neck Dissection 316
Anastomosis 317
DISCUSSION 318
REFERENCES 318
Chapter 40. Flap Technology and Reconstructive Techniques in Urology Milomir Ninkovic and Gustavo Sturtz 320
PELVIC FLOOR RECONSTRUCTION 321
VAGINAL RECONSTRUCTION 323
VESICOVAGINAL FISTULA REPAIR 323
RECTOURETHRAL FISTULA REPAIR 324
PENILE AND URETHRAL RECONSTRUCTION 326
FUNCTIONAL BLADDER AND ABDOMINAL WALL RECONSTRUCTION 327
CONCLUSION 328
REFERENCES 328
Index 332