Carol Morris, chief of orthopaedic oncology in the Johns Hopkins Department of Orthopaedic Surgery, summarizes her article published in Surgical Oncology called “A guide to resecting tumors of the sciatic notch” .
I'm Carol Morris, and I'm an orthopedic oncologist at Johns Hopkins Hospital. I take care of patients with bone and soft tissue tumors of the Elvis. And extremely, the pelvis can be specifically a very difficult to manage to to the surrounding complex anatomy. Lots of nearby structures such as bladder, bowel, sciatic nerve. Your order. Uh, the iliac vessels, et cetera, are in close proximity. What happens? We take care of a fairly large volume of pelvic tumors, and often these tumors involved the sciatic notch specifically. So I acknowledge tumors presented unique challenges. These tumors often span both the intra and extra pelvic anatomy, necessitating fairly extensive exposure due to the large number of site acknowledge tumors that we manage. We wrote of our collective experience and review article in the journal Surgical Oncology. Our papers summarized the various approaches that can be used, including trans abdominal and gluteal retro peritoneal, etcetera. These approaches were examined alone or in combination, and the pros and cons of each approach for discuss as it relates to psychotic notch tours. Our preferred method here is to use the extended, really ephemeral approach and specifically using a novel technique called notch plasticky in which, when you have a tumor that's socked in here in the psychic match, both expanding the extra pelvic and intra pelvic anatomy will take a high speed burr and increase the aperture here of the psychotic for Raymond, thereby allowing better visualization of the sciatic nerve of the booty. Oh, vessels, Um, improving our margin of our section around the tumor and then allowing for delivery of that you are in whichever direction it comes out easiest. This approach is particularly helpful for tumors involving the psychotic nerve for radiated tumors in which there is very little mobilization of the tumor and for tumors like recurrent chordoma. When we utilize this technique in this location, it really maximizes the safety of the reception without the excessive increased morbidity associated with it. I'm very fortunate and that I have a large multidisciplinary team with whom I can work to have to create successful outcomes in these patients. And I really believe that this collective experience that we have here leads to some of the best patient outcomes out there. Thank you very much for listening
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