Cautery Burns: Prevention Better than Cure! Abstract The electrocautery is an integral part of head and neck surgeries both for the primary lesion as well as for neck dissection. However, it is fraught with dangers of inadvertent burns to unintended areas, especially by the proximal end of the diathermy blade while working in deep narrow spaces. We devised a simple, cost effective, and easily reproducible method to eliminate this risk.

Unusual Complication After TTE: a Simple Management

A Pioneer of Surgical Oncology in India—a Tribute to Dr Mrs Mehta

Editorial

Oophorectomy as a Hormonal Ablation Therapy in Metastatic and Recurrent Breast Cancer: Current Indications and Results Abstract Breast cancer is the commonest malignancy affecting females. Hormone-positive cancers carry a better prognosis. Many adjuvant and palliative endocrine therapies are in use, including surgical ablation. We retrospectively studied seventy-four patients who did bilateral salpingo-oophorectomy (BSO)/bilateral oophorectomy (BO) for factors affecting survival and prognosis. BSO was superior in overall and progression-free survival. Incidental ovarian metastasis carried a grave prognosis. Surgical hormonal ablation is a viable option with laparoscopic BSO as the approach of choice.

Cannula-Assisted Port Placement during Video Endoscopic Inguinal Lymphadenectomy (VEIL)—a Novel and Safe Technique Abstract To present our novel technique for subsequent port placement during video endoscopic inguinal lymphadenectomy (VEIL) surgery. VEIL has provided positive results in terms of reduction of pain, early recovery, and better cosmesis. Ten patients who underwent VEIL procedure during 2012–2015 were included in this study to assess feasibility, safety, and advantages of port placement by our new technique which include placement of subsequent ports with the help cannula of the first port. The size of incision, time taken for port placement, leakage of pneumo, any complication(s), and potential learning curve or special instrument requirements were noted in these patients. Median incision size was 10 mm and 5 mm for their respective sized ports with this new technique. Pneumo leakage was not seen in any patient. Median time taken for subsequent port placement was 2 min ± 15 s. No complication was noted to patients or the operating surgeon. The technique proved to be feasible and needed no special equipment or training. We report technical feasibility, safety, and advantages of a new technique for port placement during VEIL surgery emphasising its potential to become a standard technique in the near future.

Cutaneous Metastasis of Laryngeal Neuroendocrine Carcinoma: a Case Report

Massive Bilateral Maxillary Osteosarcoma: a Dramatic Clinical Presentation and a Reconstructive Challenge

Comparison of Continuous Epidural Analgesia and Intravenous Patient-Controlled Analgesia with Opioids in Terms of Postoperative Pain and Their Complications in Mega-Prosthesis Total Knee Arthroplasty for Bone Cancers Abstract Total knee arthroplasty with mega-prosthesis in oncologic patients is a painful surgery and may be associated with nerve injury. Epidural analgesia (EA) with local anaesthetics (LA) is routinely used for pain relief in these patients. At our institute, we came across a high incidence of motor weakness in these patients compelling to shift to patient-controlled analgesia (PCA) with intravenous opioids. We retrospectively analysed our data to find the incidence and reasons for motor weakness and also to compare the efficacy of EA and PCA as analgesics. Over a period of 15 months, 68 patients were operated; out of these, 41 were in EA and 27 in PCA. Demographic details, level of epidural placement, drug used, pain scores, degree of motor weakness, measures taken to relieve the motor weakness and the improvement in symptoms after treatment were recorded. In the IV PCA group, details of drug used, dose of bolus, pain and sedation scores were analysed. Groups were comparable demographically. Motor weaknesses were present in 9 (22%) and 0 patients in EA and IV PCA groups respectively (p = 0.009). Average and maximum pain scores were significantly higher on day 1 in the IV PCA group (p of 0.00 and 0.001 respectively). Maximum pain scores were also significantly higher in the IV PCA group on day 2 (p = 0.010). Two patients out of 27 in IV PCA were found drowsy. Motor weakness is known with EA but can be managed effectively using a lower concentration of LA or by stopping the infusion of LA.

Infrahyoid Myofasciocutaneous Flap for Reconstruction of Tongue Defects: Our Experience and Perspective