1. Elasticated retraction Electrical dissection Knotless sutures Rod Mountain Dundee

2. 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)

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

4. Single operator Neck dissection ? Exposure Bleeding Wound closure

5. Single operator Neck dissection ? Exposure Bleeding Wound closure

6. Single operator Neck dissection ? Exposure Bleeding Wound closure

7. “Traditional” Exposure Skin Subcutaneous Platysma Fascia Muscle Neural Vascular

8. “Elasticated” Exposure Skin Subcutaneous Platysma Fascia Muscle Neural Vascular

9. “Elasticated” Exposure Skin Subcutaneous Platysma Fascia Muscle Neural Vascular

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

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

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

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

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

15. Skin / Platysma “ Lateral + Multidirectional Retraction” 1 2 34

16. Fascia / Muscle “ Elevation and Eversion” 1 2 34

17. Superficial to Deep

18. Wide exposure with elevation

19. Skin / Platysma

20. Fascia / Muscle retraction

21. 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

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

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

24. 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

25. 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 }

26. 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

27. 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

28. Haemostatic dissection

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

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

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

33. Tracheostomy