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The spoon retractor has proven to be useful for gliomas and metastatic tumours, particularly for haemorrhagic lesions such as haemangioblastomas and arteriovenous malformations, because the retractor facilitates an en bloc removal of the mass by retracting it without causing laceration or rupture, and with feeding or draining vessels easily visualised.
The intention should be to achieve en bloc removal of the whole tumour (R0 resection).
Radical surgery comprising in addition to the above mentioned elements, en bloc removal of the uterus, both ovaries, the pelvic peritoneum and recto-sigmoid +/− simple peritonectomies.
After en bloc removal of the tumor, a standard technique for prosthetic reconstruction was used as recommended by the manufacturer [ 8, 9].
TORS involves en bloc removal of the tumour as per the principles outlined in the da Vinci Transoral Surgery Procedure Guide: http://www.uphs.upenn.edu/pennorl/education/documents/daVinciTORSProcedureGuide.pdf.pdf
These unfavourable results have been attributed mainly to the en bloc removal of the spleen and the tail of the pancreas for middle and upper third tumours in the D2 arms of both trials.
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Lymphadenectomy comprised en bloc removal of all lymphatic tissue in the lower posterior mediastinum, along the cardia and the lesser curvature of the stomach.
A retrospective case series describing the results of en bloc removal of articular cartilage and subchondral bone showed that 20 of the 33 operated knees were pain-free after an average of 31-months of follow-up (Beltran 1987).
In all cases, wide local excision of breast parenchyma around the tumor was undertaken, along with en bloc removal of an ellipse of overlying skin.
Endoscopic submucosal dissection (ESD) permits en bloc removal of superficial esophageal squamous cell carcinoma.
Endoscopic submucosal dissection (ESD) is increasingly used for en bloc removal of GI lesions.
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