Core procedures Preoperative imaging Intraoperative imaging Postoperative imaging Non-invasive evaluation of the heart is an essential part of the assessment of patients undergoing cardiac surgery. Echocardiography is the commonly used non-invasive imaging modality. Preoperatively, it is an essential part of…
Core procedures Pericardiectomy Pericardiocentesis Pericardial harvesting, e.g. closure of atrial septal defect Thoracoscopic pericardial window creation Relief of pericardial tamponade post-cardiotomy Pericardial biopsy Surgical surface anatomy The surface projections of an average adult heart are modified by age, sex, stature,…
Core Procedures Thymectomy Clinical anatomy The thymus is an encapsulated soft, bilobed organ; the two lobes are joined in the midline by connective tissue that merges with the capsule of each lobe. It is usually located in the anterior mediastinum.…
Core Procedures Tracheal resection: segmental resection Bronchoscopy: assessment Mediastinoscopy: assessment Wedge resection: non-anatomical wedge Segmentectomy: segment or multiple segments Lobectomy: lobe Sleeve lobectomy: lobe with segment of bronchus or pulmonary artery Pneumonectomy: whole lung Trachea Clinical anatomy The adult trachea…
Core procedures Pleural biopsy, pleural drainage, pleural debridement Spontaneous pneumothorax surgery, parietal pleurectomy Decortication of empyema Pleurectomy/decortication (extended) for mesothelioma Excision of solitary pleural tumour Thoracic sympathectomy, facial flushing, axillary and palmar hyperhidrosis, angina, splanchnicectomy Surgical surface anatomy of the…
Core Procedures Transthoracic oesophagectomy Minimally invasive oesophagectomy (MIO) Thoracic lymphadenectomy Embryology The oesophagus develops from the primitive foregut, a ventral diverticulum caudal to the fifth pharyngeal pouch in the third week of gestation. It is initially a single common gastrointestinal…
Core Procedures Surgical Repair of Aortic Arch Proximal aortic arch (so-called hemiarch) Distal aortic arch (so-called reverse hemiarch) Total aortic arch (involves at least one epi-aortic vessel) Total aortic arch and elephant trunk: conventional elephant trunk; reverse elephant trunk; frozen…
Core procedures Mastectomy: simple; skin-sparing; nipple-sparing, skin-sparing Wide local excision of breast lesion Wire-localized wide local excision Sentinel lymph node biopsy Microdochectomy Development Developmentally, the breast is a modified and highly specialized apocrine gland, composed of glandular tissue and ducts…
Core Procedures Chest drain (tube) insertion Sternotomy Three-port thoracoscopic approach Posterolateral thoracotomy Anterolateral thoracotomy Left anterior thoracotomy Left thoraco-abdominal incision Right anterior mini-thoracotomy and minimally invasive approach to the mitral valve Hemi-sternotomy and minimally invasive approach to the aortic valve…
Core Procedures Dorsal and palmar approaches to the wrist, e.g. for access to joints, fractures; for tendon, ligament and nerve repair (see Table 41.1 ) TABLE 41.1 Core procedures: wrist Region Approach Indication Dorsal Arthroscopic Triangulo-fibro-cartilaginous complex (TFCC) injuries, synovectomy,…