Endocrine and Neuroendocrine Surgery

 

Description:

 

This book brings together recognized experts in the field to describe their current techniques for the surgical treatment of diseased thyroid, parathyroid, and adrenal glands, as well as neuroendocrine tumors of small bowel, pancreas, liver, and skin. For each procedure, indications, operative steps, potential pitfalls and complications, and postoperative management are presented. The clear descriptions coupled with informative and beautiful illustrations will give the reader new perspectives and insights into the anatomy and conduct of these procedures. Endocrine surgery has been an area of special interest to surgeons for well over a century, while the increasing incidence of neuroendocrine tumors has more recently led to greater attention to these neoplasms. Significant advances have been made in a variety of areas, the most recent being the introduction of minimally invasive methods of removing diseased glands, and the improved understanding of the natural history of neuroendocrine tumors.

Table of Contents:

Preface

Acknowledgments

Contents

Contributors

Part I: Parathyroid

1: Radioguided Parathyroidectomy

1.1 Introduction

1.2 Technique

1.3 Discussion

1.3.1 Sestamibi-Negative Patients

1.3.2 Ectopic Glands

1.3.3 Familial Primary Hyperparathyroidism

1.3.4 Secondary and Tertiary Hyperparathyroidism

1.3.5 Pediatric Patients

1.3.6 Reoperative Surgery

1.4 Summary

Suggested Reading

2: Minimally Invasive Parathyroidectomy with Intraoperative PTH Testing

2.1 Introduction

2.2 Technique

2.2.1 Preoperative Imaging

2.2.2 Surgical Procedures

2.2.3 Measurement of PTH Levels

2.2.4 Closure and Postoperative Care

2.3 Discussion

2.3.1 Complex Findings on Preoperative Imaging

2.3.2 Failure of IOPTH to Fall Appropriately

2.3.3 Other Methods of MIP

References

3: Subtotal Parathyroidectomy for Parathyroid Hyperplasia

3.1 Introduction

3.2 Techniques of Subtotal Parathyroidectomy

3.2.1 Positioning of the Patient and Skin Incision

3.2.2 Normal Parathyroid Anatomy

3.2.3 Fascial Layers

3.2.4 Exposure of Parathyroid Glands

3.2.5 Superior Glands

3.2.6 Inferior Glands

3.2.7 Supernumerary Glands

3.2.8 Subtotal Parathyroidectomy: Resection and Verification

3.3 Results and Conclusions

References

4: Parathyroid Transplantation

4.1 Introduction

4.2 Surgical Technique

4.3 Results and Conclusions

References

5: Mediastinal/Thoracoscopic Parathyroidectomy

5.1 Introduction

5.2 Preoperative Workup and Imaging

5.3 Intraoperative Localization and PTH Monitoring

5.4 Mediastinal Anatomy

5.5 Parathyroidectomy Using Video-�Assisted Thoracoscopic Surgery (VATS)

5.6 Anterior Mediastinotomy (Chamberlain Procedure)

5.7 Complications

References

Part II: Thyroid

6: Thyroid Lobectomy and Total Thyroidectomy

6.1 Indications for Surgery

6.2 Preoperative Work-Up

6.3 Preoperative Discussion and Consultation

6.4 Anesthesia

6.5 Position of the Patient and the Incision

6.6 Surgical Procedure

6.7 Wound Closure

6.8 Intraoperative Decisions

6.9 Postoperative Management

References

7: Central Neck Dissection for Medullary Thyroid Carcinoma

7.1 Introduction

7.2 Preoperative Workup

7.3 Surgical Procedure

7.3.1 Positioning and Incision

7.3.2 Initial Dissection

7.3.3 Thyroidectomy and Tumor Specimen Mobilization

7.3.4 Contralateral Thyroidectomy and Node Dissection

7.3.5 Parathyroid Autotransplantation

7.3.6 Drains and Closure

7.4 Complications

7.5 Results and Conclusions

References

8: Substernal Goiter

8.1 Introduction

8.2 Operative Technique

8.2.1 Cervical Approach

8.2.2 Mediastinal Extension

8.3 Complications of Substernal Goiter Surgery

References

9: Modified Neck Dissection for Differentiated Thyroid Cancer

9.1 Introduction

9.2 Modified Neck Dissection for Lateral Cervical Lymphadenectomy

9.2.1 Incision Planning

9.2.2 Raising Skin Flaps

9.2.3 Selective Neck Dissection of Levels IIa, III, IV, and Vb

9.2.4 Comprehensive Neck Dissection of Levels I Through V

9.3 Discussion

9.4 Conclusions

References

Part III: Adrenal

10: Open Transabdominal Adrenalectomy for Malignant Neoplasms

10.1 Introduction

10.2 Surgical Technique

10.3 Results and Conclusions

References

11: Posterior Adrenalectomy

11.1 Introduction

11.2 Needs and Indications

11.3 Surgical Technique

11.4 Results and Conclusions

References

12: Laparoscopic Transabdominal Lateral Adrenalectomy

12.1 Introduction

12.2 Surgical Technique

12.2.1 Laparoscopic Right Adrenalectomy

12.2.2 Laparoscopic Left Adrenalectomy

12.3 Postoperative Management

12.4 Complications

References

13: Posterior Retroperitoneoscopic Adrenalectomy

13.1 Introduction

13.2 Surgical Technique

13.2.1 Patient Positioning and Trocar Placement

13.2.2 Creation of Working Space and Identification of Critical Landmarks

13.2.3 Adrenal Gland Dissection: Operative Strategy

13.2.4 Identification and Division of the Adrenal Vein

13.3 Robot-Assisted Retroperitoneoscopic Adrenalectomy (RAPRA)

13.4 Results and Conclusions

References

Part IV: Stomach and Duodenum

14: Surgery for Duodenal and Gastric Neuroendocrine Tumors

14.1 Duodenal Neuroendocrine Tumors

14.1.1 Introduction

14.1.2 Surgery

14.2 Gastric Neuroendocrine Tumors (Carcinoid Tumors)

14.2.1 Introduction

14.2.2 Treatment and Surgery

14.2.2.1 Surveillance and Local Resection

14.2.2.2 Operative Technique for Subtotal or Total Gastrectomy with D2 Lymph Node Dissection

Suggested Reading

Part V: Pancreas

15: Pancreaticoduodenectomy for Neuroendocrine Tumors

15.1 Introduction

15.2 Surgical Technique

15.2.1 Step 1: Exposure of the Infrapancreatic Superior Mesenteric Vein (SMV)

15.2.2 Step 2: Extended Kocher Maneuver

15.2.3 Step 3: Dissection of the Porta Hepatis, Hepatic Artery Exposure, Cholecystectomy, and Bi

15.2.4 Step 4: Transection of the Gastric Antrum (or the Duodenum, if Pylorus Preservation Is Pl

15.2.5 Step 5: Transection of the Jejunum

15.2.6 Step 6: Transection of the Pancreas and Completion of the Retroperitoneal Dissection

15.2.7 Step 7: Vascular Resection and Reconstruction

15.2.8 Step 8: SMV Reconstruction When Tumor Involvement Is Limited to the SMV

15.2.9 Step 9: Pancreatic Reconstruction

15.2.10 Step 10: Biliary Reconstruction

15.2.11 Step 11: Gastric or Duodenal Reconstruction

15.3 Results and Conclusions

References

16: Open Distal Pancreatectomy

16.1 Introduction

16.2 Procedure

16.2.1 Step 1: Incision

16.2.2 Step 2: Isolation of the Splenic Artery and Identification of the Portal Vein

16.2.3 Step 3: Exposure of the Lesser Sac and Division of the Short Gastric Vascular Arcade

16.2.4 Step 4: Dropping the Splenic Flexure of the Colon

16.2.5 Step 5: Dissection of the Pancreatic Body and Exposure of the Superior Mesenteric Vein

16.2.6 Step 6: Developing the Portal Vein Canal and Portosplenic Confluence.

16.2.7 Step 7: Transection of the Pancreatic Neck and Ligation of the Vasculature

16.2.8 Step 8: Retrograde Removal of the Distal Pancreas and Spleen

16.2.9 Step 9: Final Considerations

16.2.10 Technical Variations

16.3 Discussion

References

17: Laparoscopic Distal Pancreatectomy

17.1 Introduction

17.2 Laparoscopic Distal Pancreatectomy with Splenectomy

17.2.1 Patient Positioning and Port Placement

17.2.2 Dissection of Peripancreatic Structures

17.2.3 Division of the Pancreas and Vascular Structures

17.3 Laparoscopic Distal Pancreatectomy with Splenic Preservation

17.4 Hand-Assisted Laparoscopic Distal Pancreatectomy

17.5 Pearls and Pitfalls

17.6 Results and Conclusions

References

18: Pancreatic Enucleation

18.1 Introduction

18.2 Indications

18.3 Diagnostic Imaging

18.4 Patient Preparation

18.5 Operative Technique

18.5.1 Open Pancreatic Enucleation

18.5.1.1 Exposure of the Pancreas (Body and Tail)

18.5.1.2 Exposure of the Pancreas (Head and Uncinate)

18.5.1.3 Mobilization of the Pancreas

18.5.1.4 Bimanual Palpation and Ultrasound

18.5.1.5 Enucleation of Pancreatic Tumor

18.5.2 Laparoscopic Pancreatic Enucleation

18.5.2.1 Positioning and Port Placement

18.5.2.2 Exposure and Mobilization of the Pancreas

18.5.2.3 Enucleation

18.6 Results

18.7 Conclusions

References

Part VI: Other Neuroendocrine

19: Small Bowel Resection and Lymphadenectomy for Jejunoileal Neuroendocrine Tumors

19.1 Introduction

19.2 Operative Technique

19.2.1 Approach

19.2.2 Exploring the Abdomen

19.2.3 Small Bowel Resection and Lymphadenectomy

19.2.4 Special Considerations for Lymphadenectomy

19.2.5 Other Considerations

19.3 Complications

19.4 Results

References

20: Liver Surgery for Neuroendocrine Tumors

20.1 Introduction

20.2 Radiofrequency Ablation and Microwave Ablation

20.3 Irreversible Electroporation

20.4 Tumor Enucleation

20.5 Segmental and Lobar Resections

20.6 Central Hepatectomy: Surgical Technique

20.7 Discussion

References

21: Wide Excision and Sentinel Node Mapping for Merkel Cell Carcinoma

21.1 Introduction

21.2 Operative Details

21.2.1 Wide Local Excision

21.2.2 Local Flaps

21.2.3 Sentinel Lymph Node Biopsy

21.3 Results and Follow-Up

References

An aparitie	15 Aug 2018
Autor	James R. Howe
Dimensiuni	210 x 279 mm
Editura	Springer
Format	Paperback
ISBN	9783662571781
Limba	Engleza
Nr pag	344