Elasticated retraction Electrical dissection Knotless sutures Rod Mountain Dundee

Innovations in Head and Neck Surgical technique Exposure (Incisions / Retraction / Counter traction) Bleeding (Adr / Mono/Bipolar / Coblation/ Ties/Clips) Closure (Sutures / Clips / Tissue glues / Strips)

Single operator Neck dissection ? Exposure ? Bleeding ? Wound closure ?

Single operator Neck dissection ? Exposure Bleeding Wound closure

Single operator Neck dissection ? Exposure Bleeding Wound closure

Single operator Neck dissection ? Exposure Bleeding Wound closure

“Traditional” Exposure Skin Subcutaneous Platysma Fascia Muscle Neural Vascular

“Elasticated” Exposure Skin Subcutaneous Platysma Fascia Muscle Neural Vascular

“Elasticated” Exposure Skin Subcutaneous Platysma Fascia Muscle Neural Vascular

Elasticated retraction Principles Lateral retraction Elevation Eversion Controlled force Multi-directional Adjustable Skin / Fascia / Muscle

Elasticated retraction Principles Lateral retraction Elevation Eversion Controlled force Multi-directional Adjustable Skin / Fascia / Muscle

Elasticated retraction Principles Lateral retraction Elevation Eversion Controlled force Multi-directional Adjustable Skin / Fascia / Muscle

Elasticated retraction Principles Lateral retraction Elevation Eversion Controlled force Multi-directional Adjustable force / angle Skin / Fascia / Muscle

Elasticated retraction Principles Lateral retraction Elevation Eversion Controlled force Multi-directional Adjustable Skin Fascia / Muscle

Skin / Platysma “ Lateral + Multidirectional Retraction”

Fascia / Muscle “ Elevation and Eversion”

Superficial to Deep

Wide exposure with elevation

Skin / Platysma

Fascia / Muscle retraction

Benefits of Elasticated retraction Constant / Controlled field of exposure Wider / Circumferential field Elevation / fascia / muscle retraction Improved visual / technical field Reduced tissue trauma Enhanced assistant / training roles Single operator Safer operating

Benefits of Elasticated retraction Constant / Controlled field of exposure Wider / Circumferential field Elevation / fascia / muscle retraction Improved visual / technical field

Benefits of Elasticated retraction Constant / Controlled field of exposure Wider / Circumferential field Elevation / fascia / muscle retraction Improved visual / technical field Reduced tissue trauma

Benefits of Elasticated retraction Constant / Controlled field of exposure Wider / Circumferential field Elevation / fascia / muscle retraction Improved visual / technical field Reduced tissue trauma Enhanced assistant / training roles

Benefits of Elasticated retraction Constant / Controlled field of exposure Wider / Circumferential field Elevation / fascia / muscle retraction Improved visual / technical field Reduced tissue trauma Enhanced assistant / training roles Single operator - { Minor to major }

Benefits of Elasticated retraction Constant / Controlled field of exposure Wider / Circumferential field Elevation / fascia / muscle retraction Improved visual / technical field Reduced tissue trauma Enhanced assistant / training roles Single operator - { Minor to major } Safer operating

Haemostatic dissection Vessel sealers and dividers Integrated cutting mechanism Seal up to 7 mm arteries 2 to 4 seconds Reduce operating time Reduce bleeding Single operator Reduced drainage

Haemostatic dissection

Knotless Sutures “Barbed” suture technology Looped suture end to start No knot at end Platysma and Skin

Knotless Sutures Barbed suture technology “Looped”suture end to start No knot at end Platysma and Skin

Knotless Sutures Barbed suture technology Looped suture end to start “No knot” at end Platysma and Subcutaneous Skin

Tracheostomy