Tag Archives: lymph node dissection

PUBLISHED: Left Lateral Neck Dissection for Metastatic Papillary Thyroid Carcinoma

Left Lateral Neck Dissection for Metastatic Papillary Thyroid Carcinoma
Sarah A. Brownlee, MDAllison S. Letica-Kriegel, MD, MScAntonia E. Stephen, MD
Massachusetts General Hospital

Papillary thyroid carcinoma frequently metastasizes to lateral neck lymph nodes, necessitating compartment-based lymph node dissection following initial thyroidectomy. Surgical education videos provide valuable resources for training surgeons in complex neck dissection techniques. A detailed surgical procedure was documented in a patient with biopsy-proven metastatic papillary thyroid carcinoma in level IV lymph nodes following prior total thyroidectomy and central neck dissection. A compartment-based dissection of levels IIb, III, and IV was performed with preservation of vital neurovascular structures. The procedure was successfully completed with removal of metastatic lymph nodes while preserving the critically important physiological structures throughout the dissection.

PREPRINT RELEASE: Distal Gastrectomy (Open)

Distal Gastrectomy (Open)
John T. Mullen, MD
Director, General Surgery Resident Program
Massachusetts General Hospital

 

An 80-year-old patient with anemia undergoes an upper endoscopy that reveals inflammation in the distal stomach. Biopsies identify it as an early intramucosal adenocarcinoma while an endoscopic ultrasound shows the tumor invading the muscle of the stomach. Given that there are no signs of metastasis, the patient presents for a potentially curative gastrectomy where Dr. John Mullen removes the distal two-thirds of the stomach, performs a D1 lymph node dissection and a partial D2 lymph node dissection, and reconstructs in a Billroth II fashion.