Anatomic Basis of Tumor Surgery (eBook)

Anatomic Basis of Tumor Surgery 2
Copyright Page 3
Dedication 4
Preface 5
Contents 6
Contributors 8
Chapter 1 13
Oral Cavity and Oropharynx 13
Introduction 14
Adjuvant Treatment 17
Surgical Anatomy 17
Oral Cavity 19
Tongue 19
Floor of Mouth 23
Buccal Mucosa 25
Lower Alveolar Ridge 26
Retromolar Trigone 27
Hard Palate and Upper Alveolar Ridge 27
Oropharynx 29
Soft Palate 31
Tonsil (Palatine Tonsil) 32
Base of Tongue 32
Pharyngeal Relationship to Deep Neck Spaces 33
Parapharyngeal Space (Lateral Pharyngeal Space) 33
Surgical Applications 34
Perioral Resection 34
Anterior Partial Glossectomy 35
Anterior Floor of Mouth Resection 36
Floor of Mouth Resection with Marginal Mandibulectomy 37
Soft Palate Resection 41
Tonsil Resection 42
Lip-Splitting Incision 42
Visor Flap 44
Mandibular Osteotomies 46
Lateral Mandibulotomy Approach to Tonsil Resection 48
Mandibular Swing Approach to Resection of Oropharyngeal Tumors 56
Lateral Pharyngotomy for Resection of Oropharyngeal Tumors 61
Anatomic Basis of Complications 63
Key References 64
Suggested Readings 65
Chapter 2 67
Neck 67
Anterior Neck 68
Introduction 68
Embryology of the Thyroid and Parathyroid Glands 69
Surgical Anatomy 70
Thyroid 72
Blood Supply 73
Arterial Supply 73
Venous Drainage 74
Lymphatic Drainage 76
Lymphatic Spread of Thyroid Carcinoma 77
Nerve Supply 78
Recurrent Laryngeal Nerves 78
Superior Laryngeal and Other Nerves 80
Parathyroid 83
Topography 83
Parathyroid Number and Location 83
Blood Supply 86
Surgical Applications 86
Thyroidectomy 86
Incision 87
Elevation of the Skin Flap 88
Prethyroid Muscles (Sternohyoid and Sternothyroid) 88
Middle Thyroid Vein, Recurrent Nerve, and Parathyroid Glands 88
Identification 88
Division of Superior Vessels and Identification of External Branch of Superior Laryngeal Nerve 91
Division of the Ligament of Berry and Isthmus and Parathyroid Sparing 93
Subtotal Thyroidectomy 94
Closure of Wound 95
Modifi ed Neck Dissection 95
Central Neck Dissection 96
Resection of Substernal Goiter 97
Parathyroidectomy 97
Indications and Pathology 97
Operative Techniques 99
Bilateral Neck Exploration (Traditional) 99
Minimally Invasive Parathyroid Surgery (MIPS) 102
Extent of Parathyroidectomy 103
Abnormal Parathyroid Tumor Locations 105
Anatomic Basis of Complications 105
Nerve Injuries 105
Hypoparathyroidism 107
Vascular Injuries and Hemorrhage 107
Organ Injuries 108
Key References 108
Suggested Readings 109
Lateral Neck 110
Introduction 110
Surgical Anatomy 110
Fasciae of Neck 110
Triangles of the Neck 111
Submaxillary Gland 114
Cervical Lymph Nodes 115
Level I 116
Level II 117
Level III 117
Level IV 117
Level V 117
Level VI 117
Blood Supply 117
Nerve Supply 118
Surgical Applications 118
Radical Neck Dissection 120
Sequence of Dissection 120
Surgical Exposure and Incisions 120
Submental and Submandibular Dissection: Level I 120
Upper Neck Dissection: Level II 121
Posterior Neck Dissection 122
Lower Neck Dissection 123
Wound Closure 124
Modified Neck Dissection 124
Surgical Approach 124
Fascial Dissection 124
Posterior Neck Dissection 125
Central Neck Dissection 125
Upper Neck Dissection 126
Parotid Gland 127
Parotidectomy 131
Preoperative Preparation 131
Surgical Exposure and Incisions 131
Identification of Facial Nerve 133
Tumor Resection 133
Postoperative Care 134
Submandibular Gland 134
Submandibular Gland Resection 134
Carotid Body Tumor 135
Preoperative Assessment 135
Carotid Body Tumor Resection 135
Complications 135
Trachea 136
Tracheostomy 136
Surgical Exposure and Incisions 136
Anatomic Basis of Complications 138
Key References 139
Suggested Readings 140
Chapter 3 141
Breast 141
Breast and Axilla 142
Surgical Anatomy 142
Topography 142
Deep Fascia 143
Nipple and Areola 143
Parenchyma 146
Axilla 147
Nerve Supply 147
Lymphatic Drainage 149
Underlying Musculature 151
Pectoralis Major Muscle 151
Nerve Supply 152
Blood Supply 152
Serratus Anterior Muscle 154
Nerve Supply 154
External ObliqueMuscle 155
Surgical Applications 155
Breast Biopsies 155
Fine-Needle Aspiration 155
Core Needle Biopsy 156
Excisional Biopsy 157
Incisional Biopsy 159
Special Considerations for Specific Benign Lesions 159
Nipple Duct Excision 159
Lactiferous Fistula Excision 160
Fibroadenoma and Phyllodes Tumor 160
Special Considerations and Procedures for Malignant Lesions 160
Lumpectomy, Segmental Resection, and Partial Mastectomy 161
Paget’s Disease 162
Sentinel Node Biopsy 163
Axillary Dissection 165
Axillary Dissection with Lumpectomy 168
Total Mastectomy 169
Skin-Sparing Mastectomy 171
Modified Radical Mastectomy (Total Mastectomy with Levels I and II Axillary Dissection) 171
Novel Procedures: Subcutaneous (Nipple Sparing) and Areolar Sparing 172
Anatomic Basis of Complications 175
Possible Causes of Lymphedema Following Axillary Dissection 176
Key References 176
Suggested Readings 177
Breast Reconstruction 178
Introduction 178
Implants and Expanders 179
Surgical Anatomy 179
Surgical Applications 180
Latissimus Dorsi Flap 184
Surgical Anatomy 185
Surgical Applications 187
Transverse Rectus Myocutaneous (TRAM) Flap 191
Surgical Anatomy 192
Surgical Applications 193
Pedicled TRAM 194
Free TRAM 196
Results 197
Anatomic Basis of Complications 199
Major 199
Minor 199
Partial Breast Reconstruction 199
Volume Displacement Procedures 200
Results 202
Volume Replacement Techniques 202
Anatomic Basis of Complications 204
Major 204
Minor 204
Key References 204
Suggested Readings 206
Chapter 4 207
Mediastinum, Thymus, Cervical and Thoracic Trachea, and Lung 207
Mediastinum 208
Surgical Anatomy 208
Divisions of Mediastinum 208
Structures and Lesions 211
Anterior Compartment 211
Middle Compartment 213
Posterior Compartment 215
Surgical Procedures 216
Diagnosis and Resection of Mediastinal Tumors 216
Anterior Compartment 216
Middle Compartment 217
Posterior Compartment 218
Anatomic Basis of Complications 220
Key References 221
Suggested Readings 221
Thymus 223
Surgical Anatomy 226
Blood Supply 227
Lymphatic Drainage 228
Surgical Applications 228
Resection of Thymic Gland Tumors 228
Anatomic Basis of Complications 231
Key References 231
Suggested Readings 232
Cervical and Thoracic Trachea 233
Surgical Anatomy 235
Blood Supply 238
Surgical Applications 239
Bronchoscopy 239
Incisions for Tracheal and Major Bronchial Resections 240
Resection and Reconstruction of Cervical Trachea 242
Resection and Reconstruction of Thoracic Trachea 244
Reconstruction After Carinal Resection 245
Anatomic Basis of Complications 246
Key References 246
Suggested Readings 246
Lung 248
Staging of Lung Cancer 249
Stage-Based Treatment of Lung Cancer 253
Surgical Anatomy 254
Bronchopulmonary Segments 254
Right Hilum 256
Left Hilum 257
Blood Supply and Nerve Supply 257
Surgical Applications 258
Posterolateral Thoracotomy 258
Limited or Muscle-Sparing Thoracotomy 259
Median Sternotomy Incision 259
Video-Assisted Thoracic Surgery (VATS) 260
Pulmonary Resection 263
Right Upper Lobectomy 264
Right Middle Lobectomy 265
Right Lower Lobectomy 266
Left Upper Lobectomy 267
Left Lower Lobectomy 268
VATS Lobectomy 269
Right and Left Pneumonectomy 270
Mediastinal Lymph-Node Dissection 272
Anatomic Basis of Complications 274
Key References 275
Suggested Readings 276
Chapter 5 277
Esophagus and Diaphragm 277
Esophagus 278
Surgical Anatomy 278
Blood Supply 281
Lymphatic Drainage 282
Nerve Supply 283
Carcinoma of the Esophagus 284
Surgical Applications 286
Esophagectomy Through Right Thoracotomy and Laparotomy (Ivor-Lewis Approach) 286
Three-Hole (McKeown) Esophagectomy and Transhiatal Esophagectomy 293
Trans-Hiatal (Blunt) Esophagectomy 294
Esophagectomy Through Left Thoracotomy 295
Esophagectomy Without Thoracotomy 298
Minimally Invasive Esophagectomy 298
Postoperative Management 301
Results 302
Benign Tumors of the Esophagus 302
Benign Tumor Resection 302
Anatomic Basis of Complications 304
Major 304
Minor 304
Key References 305
Suggested Readings 305
Diaphragm 307
Surgical Anatomy 307
Carcinoma of the Diaphragm 308
Surgical Applications 308
Resection and Reconstruction 308
Key References 309
Suggested Readings 309
Chapter 6 310
Stomach and Abdominal Wall 310
Stomach 311
Surgical Anatomy 314
Topography 314
Curvatures and Surfaces 315
Peritoneal Relations 316
Structure 316
Blood Supply 317
Celiac Trunk 317
Left Gastric Artery 318
Right Gastric and Right Gastroepiploic Arteries 318
Left Gastroepiploic Artery 319
Veins 319
Lymphatic Drainage 320
Nerve Supply 321
Surgical Applications 322
Gastrostomy 322
Resection of Smooth Muscle Tumors 324
Palliative Gastrojejunos tomy 327
Subtotal Gastrectomy 328
Radical Lymphadenectomy 336
Total Gastrectomy 339
Extended Gastrectomy 343
Anatomic Basis of Complications 346
Key References 346
Suggested Readings 347
Abdominal Wall 348
Surgical Anatomy 348
Topography 348
Landmarks 348
Abdominal Regions 348
Structure of Abdominal Wall 349
Anterior and Lateral Abdominal Wall 349
Skin 349
Superfi cial Fascia 350
Muscles of Anterior and Leteral Abdominal Walls 350
External Oblique 350
Internal Oblique 351
Transversus 351
Rectus Abdominis 352
Rectus Sheath 352
Transversalis Fascia 353
Extraperitoneal Fat 353
Peritoneum 353
Blood Supply 353
Lymphatic Drainage 355
Nerve Supply 355
Surgical Applications 356
Incisions 356
Upper Midline Incision 357
Lower Midline Incision 357
Transverse Abdominal Incision 358
Diagnostic Laparoscopy 360
Laparoscopic Jejunostomy and Gastrostomy 361
Laparoscopic Ileostomy and Colostomy 364
Anatomic Basis of Complications 367
Major 367
Minor 367
Key References 367
Suggested Readings 368
Chapter 7 369
Small Bowel and Mesentery 369
Small Bowel and Mesentery 370
Surgical Anatomy 370
Topography 370
Blood Supply 371
Nerve Supply 373
Lymphatic Drainage 373
Small Bowel Lymphatic Pathways 373
Neoplasms 373
Comparison of Jejunum and Ileum 374
Intussusception and Its Relationship to Neoplasia 379
Surgical Applications 379
Resection of Small Bowel 380
Resection of the Duodenum 380
Resection of Jejunum and Ileum 380
Anastomosis 381
Resection of Mesentery 384
Anatomic Basis of Complications 384
Vascular Injury 384
Organ Injury 385
Key References 385
Suggested Readings 386
Chapter 8 387
Colon and Appendix 387
Introduction 388
Colon 388
Surgical Anatomy 388
Topography 388
Cecum 389
Ascending Colon 389
Transverse Colon 390
Descending Colon 391
Sigmoid Colon 391
Blood Supply 391
Arteries 391
Veins 393
Lymphatic Drainage 393
Nerve Supply 393
Surgical Applications 394
Right Hemicolectomy 395
Laparoscopic Approach to Right Hemicolectomy 400
Left Hemicolectomy 401
Rectosigmoid Colectomy 404
Laparoscopic Left and Sigmoid Colectomy 407
Subtotal Colectomy 409
Laparoscopic-Assisted Subtotal Colectomy 410
Appendix 411
Surgical Anatomy 411
Topography 411
Blood Supply 411
Nerve Supply 412
Lymphatic Drainage 412
Surgical Applications 412
Incision for Appendectomy 412
Appendectomy 413
Laparoscopic Appendectomy 414
Anatomic Basis of Complications 415
Key References 416
Suggested Rfeadings 417
Chapter 9 418
Rectum 418
Introduction 419
Surgical Anatomy 419
Blood Supply 421
Lymphatic Drainage 423
Nerve Supply 423
Fascial Support 426
Surgical Applications 427
Low Anterior Resection 432
Coloanal Resection 438
Abdominoperineal Resection 440
Total Pelvic Exenteration 443
Transanal Excision 444
Transphincteric Approach 447
Kraske’s Approach 447
Anatomic Basis of Complications 449
Key References 450
Suggested Readings 451
Chapter 10 452
Pelvis 452
Introduction 453
Surgical Anatomy 453
Topography 453
Blood Supply 454
Nerve Supply 455
Lymphatic Drainage 456
Bony Pelvis 456
Ligaments 457
Musculature 457
Ureter 457
Surgical Applications 458
Biopsy 458
Fine-Needle Aspiration Biopsy 460
Core Needle Biopsy 461
Open Biopsy 463
Incisional Biopsy 464
Excisional Biopsy 466
Hemipelvectomy 466
Posterior Flap Hemipelvectomy 467
Anterior Dissection 468
Posterior Dissection 470
Anterior Flap Hemipelvectomy 474
Partial Pelvic Resection 479
Internal Hemipelvectomy 483
Reconstruction Following Internal Hemipelvectomy 487
Anatomic Basis of Complications 487
Key References 488
Suggested Readings 489
Chapter 11 492
Liver, Biliary Tree, and Gallbladder 492
Introduction 493
Surgical Anatomy 493
Topography 493
Functional Hepatic Anatomy 494
Portal Anatomy 497
Blood Supply 498
Portal Vein 501
Hepatic Veins 501
Surgical Applications 502
Right Hepatic Lobectomy 503
Incision and Exposure 504
Mobilization and Assessment of Resectability 505
Hilar Dissection 506
Venous Dissection 507
Parenchymal Transection 509
Incision and Exposure 512
Mobilization and Assessment of Resectability 512
Hilar Dissection 513
Venous Dissection 513
Parenchymal Transection 514
Resection of RightHepatic Lobe Plus Medial Segment (IV) of Left Lobe (Extended Right Hepatectomy) 516
Incision and Exposure 516
Mobilization and Assessment of Resectability 516
Hilar Dissection 516
Venous Dissection 517
Parenchymal Transection 517
Resection of Left Hepatic Lobe Plus Anterior Segment (V–VIII) of Right Lobe (Extended Left Hepatectomy) 518
Central Hepatectomy (Excision of Segments IV,V, VIII or Left Medial Plus Right Anterior Sectionectomies) 518
Incision and Exposure 518
Mobilization and Assessment of Resectability 518
Hilar Dissection 518
Venous Dissection 519
Parenchymal Transection 519
Isolated Resection of Each Section of the Liver 520
Isolated Resection of Each Segment of the Liver 521
Laparoscopic approach 522
Anatomic Basis of Complications 522
Biliary Tree and Gallbladder 523
Surgical Anatomy 525
Topography 525
Blood Supply 529
Lymphatic Drainage 532
Surgical Applications 533
Preoperative Evaluation of Cholangiocarcinomas and Carcinoma of Gallbladder 533
Potential Contraindications to Surgical Resection 535
Resection of Hilar Cholangiocarcinoma With Extended Right Hepatectomy (and Caudate Lobectomy) 535
Incision and Exposure 535
Mobilization and Assessment of Resectability 536
Further Proximal Portal Dissection 538
Biliary Enteric Reconstruction 541
Resection of Hilar Cholangiocarcinoma with Left Hepatectomy (and Caudate Lobectomy) 544
Incision and Exposure 544
Mobilization and Assessment of Resectability 545
Further Proximal Portal Dissection and Left Hepatic Lobectomy 545
Biliary Enteric Reconstruction 549
Palliation of Proximal Cholangiocarcinoma by Transhepatic Stenting and Hepaticojejunostomy 549
Resection of Gallbladder Fossa with Portal Lymphadenectomy 550
Incision and Exposure 550
(Liver) Resection of Gallbladder Fossa 550
Regional Portal Lymphadenectomy 552
Extension of the Resective Procedure 553
Anatomic Basis of Complications 553
Key References 555
Suggested Readings 556
Chapter 12 557
Pancreas and Duodenum 557
Introduction 558
Surgical Anatomy 560
Topography 560
Duodenum 560
Pancreas 562
Pancreatic Ducts 563
Ampulla of Vater 563
Major Duodenal Papilla 564
Minor Duodenal Papilla 565
Blood Supply 566
Arteries 566
Veins 567
Lymphatic Drainage 569
Nerve Supply 569
Surgical Applications 571
Incisions 571
Exposure of the Pancreas 572
Cattell-Brasch Maneuver 572
Kocher Maneuver 573
Transduodenal Biopsy of the Pancreas 576
Intraoperative Celiac Plexus Block 577
Pancreaticoduodenectomy with Hemigastrectomy (Whipple Procedure) 578
Pancreaticoduodenectomy with Pylorus Preservation 589
Left (Distal) Pancreatectomy with Splenectomy 591
Left (distal) Pancreatectomy with Splenic Preservation 597
Central (Middle) Pancreatectomy 599
Enucleation of Insulinoma 600
Local Excision of Ampullary Tumor 602
Management of non-Ampullary Duodenal Tumor 606
Benign Tumors 606
Malignant Tumors 607
Duodenal Resection 607
Resection of Third or Fourth Portion of the Duodenum 607
Anatomic Basis of the Complications of Pancreaticoduodenectomy 608
Major 608
Minor 608
Key References 608
Selected Readings 609
Chapter 13 610
Spleen 610
Introduction 611
Surgical Anatomy 612
Topography 612
Shape, Surfaces, and Borders 613
Peritomeum and Ligaments 615
Gastrosplenic Ligament 617
Splenorenal Ligament 617
Minor Ligaments 618
Blood Supply 619
Segmental Anatomy 619
Splenic Artery 620
Branches of Splenic Artery 621
Collateral Circulation 621
Venous Drainage 623
Nerve Supply 624
Lymphatic Drainage 625
Surgical Applications Open Splenectomy 626
Incisions 626
Indications for Splenectomy 627
Splenectomy for Enlarged Spleen 627
Splenectomy for Staging Hodgkin's Disease 630
Anatomic Basis of Complications 631
Key References 631
Suggested Readings 632
Laparoscopic Splenectomy 633
Preoperative Preparation 634
Operative Technique 635
Opstoperative Care 641
Anatomic Basis of Complications 641
Key References 641
Suggested Readings 642
Chapter 14 643
Female Genital System 643
Introduction 644
Clinical Anatomy 644
Topography 644
Corpus/Cervix 644
Fallopian Tube 645
Ovary 645
Pelvic Suspension 646
Omentum 646
Vagina 646
Vulva 647
Blood Supply 648
Lymphatic Drainage 650
Nerve Supply 651
Types of Malignancies 652
Cervical Carcinoma 652
Uterine Carcinoma 655
Uterine Sarcomas 655
Epithelial Ovarian Carcinomas 658
Second-Look Laparotomy 658
Vuluar Carcinoma 660
Surgical Applications 662
Simple Extrafascial Total Abdominal Hysterectomy With or without Bilateral Salpingo-oophorectomy 662
Laparoscopic Hysterectomy 665
Radical Hysterectomy 665
Pelvic Lymphadenectomy 672
Periaortic Lymph Node Dissection 674
Supraclavicular Lymph Node Biopsy 676
Omentectomy 677
Radical Vulvectomy With Inguinal Femoral Lymphadenectomy 678
Anatomic Basis of Complications 682
Major 682
Minor 683
Key References 683
Suggested Readings 684
Uterine Cancer 684
Cervical Cancer 685
Ovarian Cancer 685
Vulvar Cancer 686
Chapter 15 687
Male Genital System 687
Introduction 688
Prostate Gland 688
Anatomy 688
Surgical Applications 690
Transrectal Ultrasound Guided Needle Biopsy 690
Pelvic Lymph Node Dissection 692
Radical Retropubic Prostatectomy 693
Robotic Prostatectomy 697
Perineal Prostatectomy 698
Testis 701
Anatomy 701
Surgical Applications 703
Radical Orchiectomy 703
Retroperitoneal Lymph Node Dissection 705
Laparoscopic RPLND 707
Penis 707
Surgical Anatomy 708
Topography 708
Surgical Applications 710
Total Radical Penectomy 710
Partial Penectomy 712
Inguinal Node Dissection 714
Anatomic Basis of Complications 715
Pelvic Lymph Node Dissection 715
Radical Retropubic Prostatectomy 716
Radical Perineal Prostatectomy 716
Inguinal Orchiectomy 716
Retroperitoneal Lymph Node Dissection 716
Key References 716
Suggested Readings 718
Chapter 16 719
Retroperitoeum 719
Introduction 720
Surgical Anatomy 721
General Considerations 721
Lymphatics 723
Nerve Supply 725
Surgical Applications 726
Biopsy 727
Resection of Left-Sided Retroperitoneal Sarcomas 728
Resection of Right-Sided Retroperitoneal Sarcoma 729
Minimally Invasive Surgical Techniques 731
Anatomic Basis of Complications 735
Key References 735
Suggested Readings 736
Chapter 17 738
Adrenal Glands 738
Open Adrenalectomy 739
Surgical Embryology 739
Surgical Anatomy 741
Topography 741
Blood Supply 743
Lymphatic Drainage 744
Nerve Supply 745
Surgical Applications 745
Anterior Approach 746
Exposure and Mobilization of the Left Adrenal Gland 746
Anatomic Basis of Complications 748
Vascular Injury 748
Organ Injury 749
Exposure and Mobilization of the Right Adrenal Gland 749
Anatomic Basis of Complications 751
Vascular Injury 751
Organ Injury 751
Posterior Approach 751
Exposure and Mobilization of the Adrenal Gland 751
Anatomic Basis of Complications 752
Vascular Injury 752
Organ Injury 753
Posterolateral Extraperitoneal Approach 753
Thoracoabdominal Approach 755
Thoracolumbar Approach 756
Key References 758
Suggested Readings 758
Laparoscopic Adrenalectomy 759
Surgical Applications 760
Lateral Transabdominal Adrenalecomty 760
Left Adrenalectomy 761
Right Adrenalectomy 766
Retroperitoneoscopic Adrenalectomy 769
Postoperative Care 769
Special Considerations 770
Bilateral Adrenalectomy 770
Incidentaloma 770
Complications and Outcomes 770
Key References 771
Suggested Readings 772
Chapter 18 773
Kidneys, Ureters, and Bladder 773
Upper Urinary Tract 774
Surgical Anatomy 774
Kidneys 774
Topography 774
Gerota's Fascia 774
Anatomic Relationships 775
Renal Parencyma 777
Blood supply 778
Lymphatic Drainage 780
Nerve Supply 781
Ureters 781
Topography 781
Blood Supply 782
Lymphatic Drainage 783
Nerve Supply 783
Surgical Applications 783
Lumbar Subcostal Approach 783
Transcostal Approach 785
Supracostal Approach 785
Downward Extension of Lumbar Incision 786
Thoracoabdominal Approach 787
Anterior Midline Approach 788
Anterior Paramedian Approach 788
Anterior Subcostal Approach 789
Kidney Tumors 789
Radical Nephrectomy 789
Indications 789
Preoperative Evaluation 790
Incision 790
Right Radical Nephrectomy 791
Left Radical Nephrectomy 793
Management of Tumor Extension in the Vena Cava 794
Lymphadenectomy 795
Nephroureterectomy 796
Partial Nephrectomy 796
Polar Nephrectomy 797
Wedge Resection 798
Laparoscopic Nephrectomy 799
Transperitoneal Approach 799
Retroperitoneal Approach 799
Hand-Assisted Approach 799
Laparoscopic Partial Nephrectomy 800
Renal Cryoablation and RadioFrequency Ablation 800
Laparoscopic Cryoablation 802
Laparoscopic Radiofrequency Ablation 802
Robotic-Assisted Laparoscopy 803
Ureteral Tumors 803
Preoperative Evaluation 803
Endoscopic Treatment 803
Partial Ureterectomy 804
Indications 804
Incision 804
Technique 804
Open and Laparoscopic Nephroureterectomy 805
Urinary Bladder 805
Surgical Anatomy 805
Topography 805
Blood Supply 808
Lymphatic Drainage 809
Nerve Supply 809
Surgical Applications 809
Radical Cystectomy 809
Indications 809
Preoperative Evaluation 810
Technique in Male Patients 810
Technique in Female Patients 814
Partial Cystectomy 815
Indications 815
Technique 816
Extraperitoneal Partial Cystectomy 816
Intraperitoneal Partial Cystectomy 818
Laparoscopic and Robotic Radical Cystectomy 818
Key References 819
Suggested Readings 820
Chapter 19 822
Tumors of the Skin 822
Introduction 823
Biology of Skin Cancers 823
Basal Cell Carcinoma 823
Squamous Cell Carcinoma 824
Merkel Cell Carcinoma 825
Melanoma 826
Summary 827
Surgical Considerations in Primary Lesions 828
General Concepts 828
Biopsy Technique 828
Incision Planning 828
Surgical Excision 828
Wound Closure 830
Aatomic Considerations 830
Treatment by Disease Type 831
Basal Cell Carcinoma 831
Squamous Cell Carcinoma 833
Merkel Cell Carcinoma 833
Melanoma 833
Special Situations 834
Face 834
Scalp 834
Hand 835
Ear 836
Methods 836
Flaps 837
Surgical Considerations in Sentinel Lymph Node Biopsy 838
Anatomic Basis of Complications 839
Summary 840
Key References 840
Suggested Readings 841
Index 842