How, when, and from whom neck dissection operative technique is learned: An international survey on neck dissection education among head and neck oncologic surgeons

Hemmat, Shirin; Wang, Steven J.; Ryan, William R.

doi:10.1016/j.amjoto.2016.04.002

Cited by 3 publications

(4 citation statements)

References 7 publications

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“…We finally determined the categories that represented the fundamental surgical skills for OHNS. Twenty-one items, including technical tips and pearls for performing neck dissection, were collected in an online survey of the American Head and Neck Society, 16 and all of them could be explained by our items and categories. Since such verbalized and categorized items represent the fundamental surgical skills in an easy-to-understand manner, explaining surgery with these words can help standardize the quality of surgery by simplifying the evaluation of skills and skill transfer.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the surgeon needs to be adept at changing the surgical plan according to the tumor location and pattern of invasion into the surrounding tissue. Although performing surgery by young surgeons is the most important aspect for the improvement of their skills of OHNS, 16 the opportunity for young surgeons has declined owing to the difficulties associated with surgical technique refinement, 17 the insufficiency of basic skills training in recent otolaryngology internship, 18 and the new methods of service delivery to manage COVID-19. 19 Therefore, more efficient methods of skills transfer are required in OHNS.…”

Section: Introductionmentioning

confidence: 99%

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Verbalization, Categorization, and Evaluation of Fundamental Surgical Skills

Mitani¹,

Nishio

Kitani³

et al. 2021

Annals of Surgery Open

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Objective: This study aimed to verbalize fundamental surgical skills required for open head and neck surgery (OHNS), to organize them by categorization, and to establish a consensus among surgeons regarding the importance and difficulty of each skill. Summary Background Data: Improvement of fundamental surgical skills is the core of surgical education; however, surgical skills are not yet organized, and consensus in any surgical field remains uncertain. Methods: Fundamental surgical skills during OHNS were collected from surgical textbooks, real surgeries, and expert interviews. The items were analyzed to calculate the frequency of words and were categorized by 2 expert surgeons. After consensus on the importance and difficulty of each item was established by 15 expert surgeons using a Delphi survey, principal component (PC) analysis was performed to integrate importance and difficulty into a single parameter. Results: Sixty skills were verbalized and categorized into 7 categories: “skin flap elevation (n = 6),” “vessel management (n = 9),” “nerve preservation (n = 8),” “instrument handling (n = 11),” “counter traction (n = 7),” “tissue exposure (n = 9),” and “flow and planning (n = 10).” In the Delphi survey, expert consensus was established after 2 voting rounds (Cronbach’s α ≥ 0.80). The “counter traction” and “flow and planning” categories had high PC scores, which indicate priority in surgical education. Conclusion: Fundamental OHNS skills were verbalized, categorized, and evaluated via expert consensus. Assessment of surgeons’ skills by the structured items hereby developed will help standardize the quality of OHNS and improve patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Verbalization, Categorization, and Evaluation of Fundamental Surgical Skills

Mitani¹,

Nishio

Kitani³

et al. 2021

Annals of Surgery Open

View full text Add to dashboard Cite

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“…5 The technique of neck dissection has passed through several stages and witnessed significant evolution during the past few decades. 1 For decades, radical neck dissection remained the gold standard approach for treating node positive neck in patients with head and neck squamous cell carcinoma (SCC). [6][7][8] Owing to the significant morbidities and functional consequences of radical neck dissection, researchers developed the modified radical, functional neck dissection and subsequently the selective neck dissection.…”

Section: Discussionmentioning

confidence: 99%

“…The technique of neck dissection has passed through several stages and witnessed significant evolution during the past few decades from radical to modified radical to selective, super-selective, and lastly, the minimally invasive endoscopic and robotic approaches. 1 This evolution aimed at decreasing the surgical morbidity while maintaining the oncological safety. 2 Despite being challenging, END provides excellent visualization of the surgical field together with better cosmetic outcome.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Cervical Lymph Node Dissection Using the Extra-cervical Anterior Chest Wall Approach: A New Technique

et al. 2021

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Introduction This study aims to demonstrate the safety, surgical feasibility, and esthetic features of total endoscopic neck dissection (END) through anterior chest wall approach (ACWA) without creation of any neck incisions. Resection of their primary tumors followed by selective total END through ACWA using 3 ports (one 10-mm port for the camera and two 5-mm ports for the working instruments). Methods From January 2020 to August 2020, 6 patients with a biopsy proven head and neck carcinoma underwent resection of their primary tumors followed by selective total END through ACWA using 3 ports (one 10-mm port for the camera and two 5-mm ports for the working instruments). Results The selective neck dissection was successfully performed endoscopically in all cases with no conversion to open approach and with good visualization of the major neurovascular structures. The operative time for the END ranged from 120 to 170 minutes, with 10–50 mL estimated blood loss. No significant perioperative complications were encountered. The mean total number of cervical LN retrieved was 13.67 + 2.42, and the mean LNR was .01 + .13. All patients were discharged in the third postoperative day, and they were satisfied with the cosmetic outcome. Conclusion Selective total END through ACWA is technically feasible and safe with satisfactory cosmetic results. The absence of neck scars and magnification of the important neurovascular structures are the most obvious advantages of this innovative technique. It may be a valid alternative to conventional surgery when performed in selected patients. However, further research with longer follow up is needed to clarify the oncological safety and the real benefits of END in head and neck cancer patients.

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Mixed reality技術によるホログラムを利用したハイブリッドカダバートレーニング

et al. 2021

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Virtual reality is a rapidly developing technology in the field of computer science and can contribute to surgical care. The mixed reality (MR) technique is the merging of real and virtual worlds and provides the user with a hologram in the real world. Here, we report a new cadaver training technique with holograms called hybrid cadaver training. The MR technique makes it possible to show teaching materials as holograms during cadaver training. The application for the MR was developed by the faculty of engineering, Ehime University. Four otolaryngology-head and neck surgery residents participated in the hybrid cadaver training and answered a questionnaire. All participants rated the usefulness of the training as 5 points out of 5. The hybrid cadaver training with holograms may be a new promising simulation training for otolaryngology-head and neck surgery residents.

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How, when, and from whom neck dissection operative technique is learned: An international survey on neck dissection education among head and neck oncologic surgeons

Cited by 3 publications

References 7 publications

Verbalization, Categorization, and Evaluation of Fundamental Surgical Skills

Verbalization, Categorization, and Evaluation of Fundamental Surgical Skills

Endoscopic Cervical Lymph Node Dissection Using the Extra-cervical Anterior Chest Wall Approach: A New Technique

Mixed reality技術によるホログラムを利用したハイブリッドカダバートレーニング

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