• Title/Summary/Keyword: Cadaveric dissection

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High-Fidelity Perforator Visualization for Cadaver Dissection in Surgical Training

  • AllenWei Jiat Wong;Yee Onn Kok;Khong Yik Chew;Bien Keem Tan
    • Archives of Plastic Surgery
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    • v.50 no.6
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    • pp.621-626
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    • 2023
  • In the first half of the third century B.C., Herophilus and Erasistratus performed the first systematic dissection of the human body. For subsequent centuries, these cadaveric dissections were key to the advancement of anatomical knowledge and surgical techniques. To this day, despite various instructional methods, cadaver dissection remained the best way for surgical training. To improve the quality of education and research through cadaveric dissection, our institution has developed a unique method of perforator-preserving cadaver injection, allowing us to achieve high-fidelity perforator visualization for dissection studies, at low cost and high efficacy. Ten full body cadavers were sectioned through the base of neck, bilateral shoulder, and hip joints. The key was to dissect multiple perfusing arteries and draining veins for each section, to increase "capture" of vascular territories. The vessels were carefully flushed, insufflated, and then filled with latex dye. Our injection dye comprised of liquid latex, formalin, and acrylic paint in the ratio of 1:2:1. Different endpoints were used to assess adequacy of injection, such as reconstitution of eyeball volume, skin turgor, visible dye in subcutaneous veins, and seepage of dye through stab incisions in digital pulps. Dissections demonstrated the effectiveness of the dye, outlining even the small osseous perforators of the medial femoral condyle flap and subconjunctival plexuses. Our technique emphasized atraumatic preparation, recreation of luminal space through insufflation, and finally careful injection of latex dye with adequate curing. This has allowed high-fidelity perforator visualization for dissection studies.

Surgical Anatomy of Lateral Extracavitary Approach to the Thoracolumar Spine - Cadaveric Study - (흉요추부 외측 강외 접근법(Lateral Extracavitary Approach)의 수술해부학적 구조 - 사체해부실험 -)

  • Kim, Sang-Don;Suh, Jung-Keun;Ha, Sung-Kon;Kim, Joo-Han;Cho, Tae-Hyung;Park, Jung-Yul;Kim, Hyun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.10
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    • pp.1187-1192
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    • 2001
  • Objective : The lateral extracavitary approach(LECA) to the thoracolumbar spine is known as one of procedure which allows not only direct vision of pathologic lesion, but also ventral decompression, and dorsal fixation of the spine through the same incision. However, some drawbacks of LECA, including the technically- demanding, time-consuming, unfamiliar surgical anatomy and excessive blood loss, make surgeons to hesitate to use this approach. This study is to provide the surgical anatomy of LECA using cadavers, for detailed informations when LECA is considered for the surgery. Methods : We performed the 10 cadaveric studies, 7 male and 3 female, and careful dissection was carried out on right side of thoracolumbar region, except one for thoracic region. The photographs with micro-lens were taken to depict the close-up findings and for demonstrating detailed anatomy. Results : The photographs and hand-drawings demonstrated the relationships among the musculature, segmental vessels and nerve roots seen during each dissection plane. The lateral branches of dorsal rami of spinal nerve and the transverse process were confirmed to be the most important landmark of this approach. Conclusion : We concluded that detailed anatomical findings for LECA through this step-by-step dissection would be useful during operative intervention to reduce the intraoperative complications in LECA.

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The Unusual Origin of the Sternocleidomastoid Artery from the Lingual Artery

  • Kim, Tae-Hong;Chung, Seung-Eun;Hwang, Yong-Soon;Park, Sang-Keun
    • Journal of Korean Neurosurgical Society
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    • v.51 no.1
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    • pp.44-46
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    • 2012
  • The sternocleidomastoid (SCM) artery supplying blood to the SCM muscle has different origins according to its anatomical segment. The authors performed cadaveric neck dissection to review the surgical anatomy of neurovascular structures surrounding the carotid artery in the neck. During the dissection, an unusual finding was cited in which the SCM artery supplying the middle part of the SCM muscle originated from the lingual artery (LA); it was also noted that it crossed over the hypoglossal nerve (HN). There have been extremely rare reports citing the SCM artery originated from the LA. Though the elevation of the HN over the internal carotid artery was relatively high, the vascular loop crossing over the HN was very close to the carotid bifurcation. Special anatomical consideration is required to avoid the injury of the HN during carotid artery surgery.

Lateral Nasal Artery Perforator Flaps: Anatomic Study and Clinical Applications

  • Lombardo, Giuseppe AG;Tamburino, Serena;Tracia, Luciano;Tarico, Maria Stella;Perrotta, Rosario Emanuele
    • Archives of Plastic Surgery
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    • v.43 no.1
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    • pp.77-83
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    • 2016
  • Background Previous studies have investigated facial artery perforators, but have reported inconsistent results regarding lateral nasal artery (LNA) perforators. Although several authors have described the use of LNA perforators for ala nasi and nasal sidewall reconstruction, the literature contains little information regarding the cadaveric dissection of LNA perforators, and most previously published studies have focused on facial artery perforators. Methods Sixteen hemifaces from eight fresh cadavers were dissected to study the LNA perforators. After the dissection was performed, the total length and diameter of the LNA and its perforators were measured. The quantity and the distribution of the LNA perforators supplying the overlying skin were then assessed. LNA perforator flaps were used for reconstruction in 10 nasal and perinasal defects. Results The mean total lengths of the LNA and its perforators were 49.37 mm and 16.06 mm, respectively. The mean diameters of the LNA and its perforators were 2.08 mm and 0.91 mm, respectively. Based on our findings, we mapped the face to indicate zones with a higher probability of finding perforators. No infection, hematoma, or complete flap necrosis were observed after the procedures. Conclusions Nasal reconstruction is a challenging procedure, and LNA propeller/V-Y perforator flaps are an excellent reconstructive option in certain cases. Based on our cadaveric study, we were able to identify an area in the upper third of the nasolabial groove with a high density of perforators.

A Morphological Analysis of the Facial Nerve in Korean Fetuses and Stillborn Infants

  • Lee, Won-Tae;Chung, Youn-Young;Kim, Seok-Won
    • Journal of Korean Neurosurgical Society
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    • v.40 no.6
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    • pp.445-449
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    • 2006
  • Objective : The accurate anatomy of the facial nerve is essential for successful surgical outcome. The purpose of the present study is to know such information on the facial nerve from a series of specimens. Methods : This study is based on cadaveric dissection of 41 Korean fetus and stillborn infant and describes anatomical variations of the peripheral branches of the facial nerve that pose a importance in a number of neruosurgical procedure. Results : The branching patterns were classified into six types according to modified Davis classification : the frequencies of occurrence were : type I, 4.9%; type II, 24.4%; type III, 34.1%; type IV, 19.5%; type V, 12.2%; and type VI, 4.9%. Types II, III and IV together accounted for almost 80% of the specimens. Conclusion : Compared to previous adult and western stillborn fetus cadaveric studies, there was no significant difference in the percentage of the types between the subjects in the present study, similar pattern and anatomic distribution.

A Cadaveric Study of Thread Cubital Tunnel Release with Newly Developed Threads

  • Kang, Minsuk;Nam, Yong Seok;Kim, In Jong;Park, Hae-Yeon;Ham, Jung Ryul;Kim, Jae Min
    • Journal of Korean Neurosurgical Society
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    • v.65 no.2
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    • pp.307-314
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    • 2022
  • Objective : The percutaneous thread transection technique is a surgical dissecting method using a dissecting thread inserted through a needle under ultrasound guidance without skin incision. As the new dissecting threads were developed domestically, this cadaver study was conducted to compare the effectiveness and safety between the new threads (ultra V sswire and smartwire-01) and a pre-existing commercial dissecting thread (loop & shear) by demonstrating a modified looped thread cubital tunnel release. Methods : The percutaneous cubital tunnel release procedure was performed on 29 fresh cadaveric upper extremities. The pre-existing commercial thread was used in 5 upper extremities. The two newly developed threads were used in 24 upper extremities. Two practitioners performed the procedures separately. After the modified looped thread cubital release, anatomical and histological analyses were performed by a blinded anatomist. The presence of the dissected cubital tunnel and damaged adjacent soft tissue was assessed. Results : Out of the 29 cadaveric upper extremities, 27 specimens showed complete dissection of the Osborne ligament and the proximal fascia of the flexor carpi ulnaris muscle. One specimen was incompletely dissected in each of the ultra V sswire and smartwire-01 groups. There were no injuries of adjacent structures including the ulnar nerve, ulnar artery, medial antebrachial cutaneous nerve, or flexor tendon with either the commercial thread or the newly developed threads. The anatomical analysis revealed clear and sharp incisional margins of the cubital tunnel in the Smartwire-01 and loop & shear groups. All three kinds of threads maintained proper linear elasticity for easy handling during the procedure. The smartwire-01 provided higher visibility in ultrasound than the other threads. Conclusion : The newly developed threads were effective and safe for use in the thread cubital tunnel release procedure.

Convergence of Explanation Meeting in Cadaveric Dissection with Communication Skill : Correlation between Self-evaluation Factor and Academic Achievement of Medical Students (의사소통 기술과 해부학 실습 설명의 융합 : 의과대학 학생들의 자기평가 요소와 학문적 성취감의 상관관계)

  • Park, Jeong-Hyun;Im, Hee-Kyung;Kim, Jee-Hee
    • Journal of Digital Convergence
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    • v.14 no.8
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    • pp.363-370
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    • 2016
  • This study aimed to evaluate correlation between self-evaluation factors and academic achievement of medical students according to introduction of explanation meeting in cadaveric dissection. The students explained cadaveric structure to health allied sciences students and discussed with each other. Just after the meeting, 102 medical students filled out a self-reported questionnaire on impact of self-evaluation factors and communication. The data were analyzed by frequency analysis, t-test and analysis of variance. Regardless of their gender, age, previous experience, the majority of the students gave high scores in all of self-evaluation factors. Among them, linkage with major and verbal communication factor were closely related to their academic achievement(p<0.05). The verbal and non-verbal communication factors also had a high correlation of 0.580(p<0.01). The explanation meeting provided a chance to learn further with positive attitude to medical students and motivated them academically.

Correlation between Self-evaluation Factor and Academic Achievement of Medical Students according to Introduction of Explanation Meeting in Cadaveric Dissection (해부설명회의 도입에 따른 의학전문대학원생들의 자기 평가 요인과 학업성취도 상관관계 분석)

  • Park, Jeong-Hyun;Kim, Jee-Hee;Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.7
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    • pp.2475-2482
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    • 2010
  • This study aimed to evaluate correlation between self-evaluation factors(satisfaction, linkage with major, suitability of management, verbal and non-verbal communication) and academic achievement of medical students according to introduction of explanation meeting in cadaveric dissection. The study was carried out that medical students(n=57) explained cadaveric structure to health allied sciences students and discussed with each other. Just after the meeting,, medical students filled out a questionnaire on impact of self-evaluation factors and communication. We analyzed these factors and their scores using frequency analysis, T-test and analysis of variance. Regardless of their gender, age, previous experience, the majority of the students gave high scores in all of self-evaluation factors. Among them, only verbal communication factor was closely related to their academic achievement(p<0.05). The verbal and non-verbal communication also had a high correlation of 0.673(p<0.01). The explanation meeting provided chance to learn further with positive attitude to medical students and motivated them academically. Additionally, they realized that communication skill played a key role in transmitting medical knowledge to others. Therefore, introduction of communication-based explanation meeting would be very useful tool in improving educational efficiency.

Microsurgical Anatomy in Transoral Odontoidectomy (경구강 치상돌기제거술의 수술해부학)

  • Park, Kwan;Lee, Sang Koo;Cho, Tae Goo;Nam, Do-Hyun;Lee, Jung-Il;Kim, Jong-Soo;Hong, Seung-Chyul;Shin, Hyung-Jin;Eoh, Whan;Kim, Jong-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.309-316
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    • 2000
  • Objective :The transoral approach allows direct view of the ventral craniovertebral junction and provides useful management of the various lesions of this area. We present a step by step guide to the performance of the transoral excision of the odontoid process in the cadaveric model. Methods : Ten cadaver heads were used in fixed or unfixed state. We describe the relevant surgical anatomy in the cadaveric dissection and surgical technique of transoral transpharyngeal odontoidectomy. Results : The surgical procedure of transoral odontoidectomy was categorized by six steps;soft palate, posterior pharyngeal wall, muscular structures, osseous structures, odontoid process and ligaments, cruciate ligament and dura. Conclusion : With anatomical knowledge of these regions neurosurgeons can deal with wide variety of lesions in the ventral craniovertebral junction.

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Robot-Assisted Transoral Odontoidectomy : Experiment in New Minimally Invasive Technology, a Cadaveric Study

  • Yang, Moon-Sul;Yoon, Tae-Ho;Yoon, Do-Heum;Kim, Keung-Nyun;Pennant, William;Ha, Yoon
    • Journal of Korean Neurosurgical Society
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    • v.49 no.4
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    • pp.248-251
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    • 2011
  • Objective : In the field of spinal surgery, a few laboratory results or clinical cases about robotic spinal surgery have been reported. In vivo trials and development of related surgical instruments for spinal surgery are required before its clinical application. We investigated the use of the da $Vinci^{(R)}$ Surgical System in spinal surgery at the craniovertebral junction in a human cadaver to demonstrate the efficacy and pitfalls of robotic surgery. Methods : Dissection of pharyngeal wall to the exposure of C1 and odontoid process was performed with full robotic procedure. Although assistance of another surgeon was necessary for drilling and removal of odontoid process due to the lack of appropriate end-effectors, successful robotic procedures for dural sutures and exposing spinal cord proved its safety and dexterity. Results : Robot-assisted odontoidectomy was successfully performed in a human cadaver using the da $Vinci^{(R)}$ Surgical System with few robotic arm collisions and minimal soft tissue damages. Da $Vinci^{(R)}$ Surgical System manifested more dexterous movement than human hands in the deep and narrow oral cavity. Furthermore, sutures with robotic procedure in the oral cavity demonstrated the advantage over conventional procedure. Conclusion : Presenting cadaveric study proved the probability of robot-assisted transoral approach. However, the development of robotic instruments specific to spinal surgery must first precede its clinical application.