The Rolle of Surgery in Oncology

Henry Naland Oncologist Surgeon

Surgery Departement Medical Faculty Ukrida University

Malignant Tumors

2 types of malignant Tumors: Non solid type : Domain of Medical Oncology Solid solid type: Domain of Surgical Oncology

Tuesday October 29 2013

Medical Faculty Ukrida University Henry Naland Oncologist Surgeon

Modalities of Cancer Treatment

6 Therapy Modalities in treating Cancer 1.Surgery 2.Radiation 3.Chemotherapy 4.Hormontherapy 5.Molecular targeted therapy 6.CAM (Complementary Alternative Medicine)

Tuesday October 29 2013

Medical Faculty Ukrida University Henry Naland Oncologist Surgeon

Non solid malignant Tumor

Main treatment modality Chemotherapy and Molecular targeted therapy Supporting treatment modality Surgery as diagnostic tool or Life saving surgery Radiotherapy

Tuesday October 29 2013

Medical Faculty Ukrida University Henry Naland Oncologist Surgeon

Solid Malignant Tumors

Surgery
Surgery as main dominant treatment modality for solid malignant tumors as specially in early stage. Included Endocrine Tumors ,surgery most as definitive Treatment

Surgery cures twice as many as total others

treatment modalities as radiotherapy plus chemotherapy plus others modalities
Tuesday October 29 2013 Medical Faculty Ukrida University Henry Naland Oncologist Surgeon

Role of surgery in curing Cancer

Diagnosis Staging Treating primary tumor Reconstruction and rehabilitation Palliative treatment Treating complication of other Ca treatment Resection of metastasis Cytoreductive surgery Oncologic emergencies Cancer prevention
Tuesday October 29 2013 Medical Faculty Ukrida University Henry Naland Oncologist Surgeon

Surgery disadvantages

Deformity and mutilation Cannot prevent distant metastasis Carefully patients selection are important to detect pre existing distant metastasis

Tuesday October 29 2013

Medical Faculty Ukrida University Henry Naland Oncologist Surgeon

Principles of Surgical Oncology

Eradication of all Tumor mass untill the last single Cancer cells No touch method: en bloc excision Margin of safety in healthy tissue Dissection of every suspected lymphnode . Mind Sentinel lymph-node Prevent spillage of Cancer cells
Tuesday October 29 2013 Medical Faculty Ukrida University Henry Naland Oncologist Surgeon

Surgery for Endocrine Tumors

Good differentiated Thyroid Tumor ( Papilary and Follicular thyroid Cancer) Medullar / C Cell thyroid Cancer Anaplastic thyroid Ca: for diagnosis, release airway Adrenal tumor ( Pheochromocytome) Hypophysis Tumor Rare Pancreatic Tumor ( Insulinoma etc) Testicular and ovary Cancer
Tuesday October 29 2013 Medical Faculty Ukrida University Henry Naland Oncologist Surgeon

Recent advances in Surgical tools

Cutting instruments Conventional disposable blade laser Gamma knife Harmonic knife Anastomosis instruments Suture materials :finer and stronger Tissue glue
Tuesday October 29 2013 Medical Faculty Ukrida University Henry Naland Oncologist Surgeon

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Automatic suturing instrument

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Tuesday October 29 2013

Medical Faculty Ukrida University Henry Naland Oncologist Surgeon

Deep recto-anal Anastomosis instrument

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Tuesday October 29 2013

Medical Faculty Ukrida University Henry Naland Oncologist Surgeon

da Vinci robotic surgical device

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Tuesday October 29 2013

Medical Faculty Ukrida University Henry Naland Oncologist Surgeon

Laser knife in using

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Tuesday October 29 2013

Medical Faculty Ukrida University Henry Naland Oncologist Surgeon

Recent advances in surgical method

Minimal invasive Surgery Endoscopic Surgeries: Transurethral Prostaat Resection Panendoscopic Biopsies ,Polyp-resection Transarterial intervention surgery Laparascopic resection Robotic Surgery ( Robot assisted surgery)

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Tuesday October 29 2013

Medical Faculty Ukrida University Henry Naland Oncologist Surgeon

Other new Instruments in surgery

RFA : Radio Frequency Ablation HIFU:High Intensity Frequency Ultrasound Cryosurgery Stereotatic Gamma Knife surgery

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Tuesday October 29 2013

Medical Faculty Ukrida University Henry Naland Oncologist Surgeon

Gamma knife surgical Instrument

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Tuesday October 29 2013

Medical Faculty Ukrida University Henry Naland Oncologist Surgeon

Stereotatic Gamma knife surgery

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Tuesday October 29 2013

Medical Faculty Ukrida University Henry Naland Oncologist Surgeon

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Tuesday October 29 2013

Medical Faculty Ukrida University Henry Naland Oncologist Surgeon

Meticulous targeted surgery

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Tuesday October 29 2013

Medical Faculty Ukrida University Henry Naland Oncologist Surgeon

Cryosurgery instruments

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Tuesday October 29 2013

Medical Faculty Ukrida University Henry Naland Oncologist Surgeon

Different kinds of Cryosurgery instruments

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Tuesday October 29 2013

Medical Faculty Ukrida University Henry Naland Oncologist Surgeon

Spray type Cryosurgery

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Tuesday October 29 2013

Medical Faculty Ukrida University Henry Naland Oncologist Surgeon

Trends in Cancer surgical Modality

Less mutilation procedures Cape : Not less radical method Pre operative Tumor down sizing by neo adjuvant Chemotherapy neo adjuvant Radiotherapy neo adjuvant Radiochemotherapy

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Tuesday October 29 2013

Medical Faculty Ukrida University Henry Naland Oncologist Surgeon

Thank you

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Tuesday October 29 2013

Medical Faculty Ukrida University Henry Naland Oncologist Surgeon