What is a radical neck dissection? when is it done?

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What is a radical neck dissection? The surgeon removes a block of tissue from the collarbone to the jaw and from the front to the back of the neck. The large muscle on the side of the neck that is used for rotating, flexing or extending the neck is also taken out, along with the major vein on the side of the neck. Sometimes, a less drastic operation, called a supraomohyoid neck dissection is done. This takes out only the lymph nodes, the tissue surrounding the nodes and a muscle at the front of the neck. Another technique, called a functional neck dissection, saves the muscles of the neck, taking out only the lymph nodes and tissues surrounding them.
What kind of incision is made with a radical neck dissection? The incision depends upon what the surgery is for. It can run from below the ear to the collarbone. Everything in the front of the neck on one side or on both sides may be removed. This may include the lymph nodes, blood vessels, nerves, and the salivary gland under the jawbone.

What is a ( colonoscope,laparoscope,peritoneoscope,bronchoscope and proctosigmoidoscope)

What is a colposcope examination, and how is it done? 

The colposcope is basically a microscope on a stand which gives a lighted, magnified view of the vulva, vagina, and cervix an area which previously could not be seen without major surgery. It allows the doctor to look through a microscopic eyepiece into the area. No part of the instrument is inserted into the vagina.

Is the laparoscope used as a diagnostic tool? 

Yes, the laparoscope is used to examine a woman's reproductive system for diagnosing disease as well as in performing a quick, relatively painless operation for sterilization. With the laparoscope, the doctor can inspect the uterus, the ovaries, the fallopian tubes, and even the appendix if the other organs are moved aside. He can sometimes use it to differentiate fibroid tumors from ovarian cancers and various other pelvic problems by looking inside the abdominal cavity. A small slit is made in the abdominal cavity near the navel. This procedure is usually done under general anesthesia in the hospital. Normally you can leave the hospital the same day. Sometimes the laparoscope is used for detecting liver lesions, either alone or in conjunction with an ultrasonic probe.

What is a peritoneoscope? 

A peritoneoscope allows the doctor to decide whether or not to operate without making an incision in the abdomen; it is used instead of exploratory laparotomy in some cases. Liver metastases can be seen and biopsied with a peritoneoscope. It is used for people with lung, gastric, and pancreatic cancer, whose disease might have spread, and for people with lymphoma and with ovarian cancer. Depending on the location, either local or general anesthesia is used.

When is a bronchoscope used? 

A bronchoscope is a slender, tubular instrument, that may be rigid or flexible, inserted into the patient's nose or mouth and threaded into the larger breathing passages. Its light at the far end allows the doctor to look directly into your bronchi. The doctor normally sprays anesthetic into the throat and bronchial tubes so that they are numb. Since it is inserted into only one bronchus at a time, you should have no trouble breathing normally during a bronchoscopy. The fiberoptic bronchoscope is a more flexible instrument which allows viewing of less accessible parts of the respiratory tract to locate early lesions.

What is a proctosigmoidoscope? 

This is a lighted instrument that can be inserted to a maximum of 10 inches into the colon. It can be used for viewing the lower interior portion of the colon. Two-thirds of all cancers of the colon and rectum are accessible to detection by this means.

What is a colonoscope? 

The colonoscope allows the doctor to examine the entire length of the colon. It is used to detect cancers which sometimes are not seen in x-ray studies. It is a highly flexible, four directional instrument, no thicker than a finger, that can be maneuvered through the curves and around the bends of the colon. It gives off brilliant rays of light and gives the doctor an excellent view of any damage or abnormality in the tissue. The colonoscope permits tiny tissue samples, or biopsies, to be taken. Since the delicate walls of the colon can be penetrated by this instrument, a skilled physician is required to perform this test. Colonoscopy is often done in conjunction with a fluoroscope to help the doctor follow the course of the tube. It is usually performed under light anesthesia on an outpatient basis.

If the doctor sees polyps (cherrylike growths on the intestinal wall), he can sometimes remove them entirely, safely, and easily through working channels in the colonoscope which allow a variety of instruments to be inserted.

What are esophagoscopy, gasrroscopy, and duodenoscopy? 

These three procedures use flexible fiberoptic instruments to examine several parts of the gastrointestinal tract. A doctor can look at the esophagus (esophagoscopy), see problems in the stomach (gastroscopy) or in the pancreas (duodenoscopy). These instruments permit photography, biopsy, and collection of cytological materials. Several different models of instruments are available in varying lengths. They have working channels through which various tools can be inserted, and they have controls for air, water, and suction. Some anesthesia is used, especially in the area of the throat, to allow painless swallowing of the tube.

What kind of doctor should do these examinations? 

Several of the new instruments require doctors who are qualified, trained specialists to perform the tests and to understand what is being seen by these tools. They can be dangerous in the hands of untrained practitioners. In most cases the average general practitioner has not had enough experience unless he has undergone special training. Make sure a trained proctologist, internist, or surgeon will be doing your tests.

What is involved in a barium enema with air contrast examination? 

This method uses a contrast medium to visualize the lower bowel. By carefully x-raying the colon, small and large lesions overlooked by other tests (such as palpation, proctosigmoidoscopy, or colonoscopy) may be seen. Sometimes if a barium enema exam is negative, but suspicious signs and symptoms continue, the exam is repeated.


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