Table 2.
Task analysis
| Sequence of tasks | Generic task | Sub-tasks |
|---|---|---|
| 1 |
Find the MM nerve |
1.1 Use landmarks |
| 1.2 Cut parallel to nerve with scalpel | ||
| 1.3 Trace retrograde | ||
| 2 |
Dissect external jugular vein from anterior border of SCM |
|
| 3 |
Unwrap the SCM |
3.1 Grasp SCM in nondominant hand, retracting laterally |
| 3.2 Run monopolar along edge of SCM | ||
| 3.3 Roll SCM laterally | ||
| 4 |
Identify CN XI |
|
| 5 |
Identify posterior belly of digastric |
5.1 Identify posterior edge of submandibular gland |
| 5.2 Identify digastric tendon using army navy and dental | ||
| 5.3 Dissect superficial to the muscle in posterior direction | ||
| 6 |
Skeletonize CN XI |
|
| 7 |
Expose carpet/floor of neck |
7.1 Identify IJV |
| 7.2 Dissect superior aspect of IJV | ||
| 7.3 Find carpet in the lateral posterior border of jugular vein | ||
| 8 |
Release level IIb |
8.1 Monopolar or bipolar scissors to remove fibrofatty tissue from level IIB |
| 8.2 Dunk under CN XI | ||
| 9 |
Free nodal packet from IJV inferiorly |
9.1 Identify the IJV |
| 9.2 Dissect nodal packet free off IJV | ||
| 9.3 Cut fascia posterior to jugular vein | ||
| 9.4 Use dentals to sweep nodal packet superiorly | ||
| 9.5 Identify phrenic | ||
| 9.6 Cut omohyoid as goes into level V of neck | ||
| 10 |
Dissect out and preserve cervical rootlets |
10.1 Use 15blade and run parallel to posterior SCM |
| 10.2 Identify cervical rootlets | ||
| 10.3 Change to plane medial to rootlets | ||
| 11 |
Identify the vagus nerve |
11.1 Identify carotid sheath |
| 11.2 Identify vagus nerve | ||
| 11.3 Cut on vagus in a parallel plane | ||
| 12 |
Free the IJV |
12.1 Incise sheath over IJV |
| 12.2 Cut parallel to “white line” | ||
| 12.3 Identify and preserve any branches of IJV | ||
| 13 |
Hypoglossal nerve |
13.1 Identify hypoglossal nerve with blunt dissection or dental anterior to jugular vein |
| 13.2 Release nodal pack superior to inferior preserving lingual vein and hypoglossal nerve | ||
| 14 |
Dissect down to strap muscles |
14.1 Identify ansa |
| 14.2 Cut medial to ansa | ||
| 14.3 Identify and preserve superior thyroid artery and veins | ||
| 14.4 Continue and identify strap muscles | ||
| 15 | Free nodal package from straps and digastric | 15.1 use monopolar cautery to free up |