tag:blogger.com,1999:blog-37286253.post8516531686963770148..comments2024-03-09T11:08:34.910+02:00Comments on other things amanzi: the sentinelBongihttp://www.blogger.com/profile/12918640034313468627noreply@blogger.comBlogger7125tag:blogger.com,1999:blog-37286253.post-33403786447499883662010-09-22T12:55:40.616+02:002010-09-22T12:55:40.616+02:00I had a terrifying IVC moment a couple of weeks ag...I had a terrifying IVC moment a couple of weeks ago. There was a retroperitoneal lymph node dissection for metastatic cancer and on the scan you could see a node between the aorta and the IVC. The boss was operating - I was just holding retractors, sucking, and buzzing, and we got that node out. I thought we were home and hosed but having a feel the boss says that he can feel another node <i>behind</i> the IVC. so I get the job of retracting the IVC while he dissects the node out. there was a bit of bleeding but those were only little feeding arterioles - thankfully we escaped with nothing major needing to be repaired.DHShttps://www.blogger.com/profile/00251680600047999918noreply@blogger.comtag:blogger.com,1999:blog-37286253.post-81020110145533531262010-09-13T23:59:47.237+02:002010-09-13T23:59:47.237+02:00As a spine surgeon who does a lot of these, I woul...As a spine surgeon who does a lot of these, I would recommend a retroperitoneal approach. This way you can usually mobilize the whole bifurcation to the patient's right side, exposing the entire L4-5 disc. The L4-5 level is notoriously the most difficult anterior exposure; L5-S1 is easier, because you just need to mobilize the iliacs.gcs15noreply@blogger.comtag:blogger.com,1999:blog-37286253.post-8089244695828171592010-09-12T14:13:28.101+02:002010-09-12T14:13:28.101+02:00anonymous, a retroperitoneal approach might have b...anonymous, a retroperitoneal approach might have been better. that way you get in under the iliac.<br /><br />still i'm much more confident transperitoneally, and it worked, so i might do it the same again anyway.Bongihttps://www.blogger.com/profile/12918640034313468627noreply@blogger.comtag:blogger.com,1999:blog-37286253.post-56441191925906898332010-09-12T10:53:19.177+02:002010-09-12T10:53:19.177+02:00bongi what approach would you take if you were doi...bongi what approach would you take if you were doing it again?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-37286253.post-17138358044802194512010-09-11T19:42:43.500+02:002010-09-11T19:42:43.500+02:00Bongi 3, ivc 0....or is there a story I am forgett...Bongi 3, ivc 0....or is there a story I am forgetting?annehttps://www.blogger.com/profile/12697085927133582429noreply@blogger.comtag:blogger.com,1999:blog-37286253.post-27776513031353293732010-09-11T14:40:48.657+02:002010-09-11T14:40:48.657+02:00I love your IVC stories. :)I love your IVC stories. :)rlbateshttps://www.blogger.com/profile/15236331355857884458noreply@blogger.comtag:blogger.com,1999:blog-37286253.post-72945067973691182362010-09-11T14:07:21.867+02:002010-09-11T14:07:21.867+02:00Apparently a little panic is good for the soul. I...Apparently a little panic is good for the soul. I remain unconvinced. Great story though.Jabulanihttps://www.blogger.com/profile/12847825459654555235noreply@blogger.com