Virchow technique (removal of the viscera one by one) for:
Lungs, spleen, kidneys, adrenals and gonads. |
Rokitansky's technique (opening and examination in situ of viscera and apparatus) for:
Heart (before removing it), thorax large blood vessels, stomach, epiploon's cavity and pancreas, duodenum, large bowel, ureters, prostate, bladder and the retroperitoneal large blood vessel. |
Ghon technique (evisceration en bloc) for:
Brain, tongue, organs of the neck and posterior mediastinum, liver and gallbladder, small bowel. |
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Letulle's evisceration technique (evisceration en masse) not performed to minimize the leak of blood, feces and biological fluids from the body |
Special notes:
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A.
To be able to eviscerate the tongue, the sublingual salivary glands and part of the hypopharynx in continuity with the trachea, it is important that the incision of the skin and subcutaneous planes starts bilaterally from the most posterior part of the acromion and not from the anterior surface of the shoulder.
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B.
The tongue is extracted by sectioning the frenulum and the floor below the mandibular arch after lifting the skin and subcutaneous planes of the neck and upper chest, and turning the tip over on the anterior laryngeal surface. The whole block of the tongue and viscera of the neck and the posterior mediastinum is mobilized from the vertebral plane by cutting the main vessels of the neck and dissecting the esophagus after performing an obstructive ligature in correspondence with its overdiaphragmatic tract.
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C.
To open the thoracic cage, dissect as far as possible the ribs at the level of their cartilage tract, to avoid producing bone spicules that may sting the operator; then disarticulate bilaterally the sternum-clavicular joint and thus remove the sternum and the anterior tract of the ribs. To increase the space of maneuver inside the chest, it is advisable to dissect the muscles of the intercostal spaces.
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D.
Removal of liver-gallbladder block cutting the hilar structures, the liver ligaments, freeing the quadrate lobe and by removing the part of the phrenic muscle corresponding to the bare area of the right lobe of the liver.
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E.
When you need to open the bladder to remove the prostate or uterus, you need to turn it; in this case, the bladder wall must be pulled upwards, making a small full-thickness hole in it from which it will be inserted a suction cannula that will empty it.
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