Neck dissection surgery

by mustafa | Mar 21, 2024 | Services

Neck dissection surgery, an essential treatment for head and neck cancers, requires a skilled surgeon who combines expertise with compassion. Dr. Emad Kandil, a Professor at Tulane Cancer Center, provides state-of-the-art care for this complex procedure, removing affected lymph nodes to prevent the spread of cancer and assess its extent.

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Types of Neck Dissection Surgery

There are several types of neck dissection surgery. Dr. Kandil customizes the approach depending on the extent of cancer spread:

• Radical Neck Dissection Surgery: It’s a full neck dissection surgery which means a comprehensive removal of all tissue on one side of the neck, including major structures. Typically used for cases of extensive cancer spread.
• Modified Radical Neck Dissection: This procedure removes all lymph nodes while preserving certain neck structures. It’s the most common approach, balancing thoroughness with the preservation of function.
• Selective Neck Dissection: The Least invasive option for less widespread cancer. Targets specific lymph node groups, preserving key structures and function.

Each type is carefully selected to provide the most effective treatment while minimizing the impact on the patient’s quality of life. Dr. Kandil’s expertise ensures the most appropriate approach for each case.

Indications for Neck Dissection Surgery

Neck dissection surgery is typically recommended when there is evidence of cancer in the head or neck region, or when there is a high risk of it spreading to the lymph nodes. This includes cancers of the mouth, tongue, throat, nose, face, skin, thyroid gland, or salivary glands. The procedure is particularly important when:

• Cancer has already spread to the lymph nodes.
• There is a high risk of cancer spreading to the lymph nodes.

Lymph nodes play a crucial role in the body’s immune system, as they can trap cancer cells that have spread from the primary tumor. By removing these nodes and surrounding tissue, neck dissection helps:

• Prevent the spread of cancer to other parts of the body.
• Determine the stage of the cancer.

In some cases, the doctor may recommend surgery even if the cancer has not yet been confirmed. This can be done for diagnostic purposes, to help determine the extent of the cancer and the most appropriate treatment plan.

Dr. Emad Kandil will carefully evaluate the patient’s situation to determine if this surgery is the appropriate course of action. He will consider factors such as the type and stage of cancer, as well as their overall health.

What to Expect Before, During, and After Surgery

Pre-Operative Preparation

• Specific Instructions: The patient will receive detailed instructions on how to prepare for the surgery, including fasting after midnight on the surgery day and potentially adjusting medications.
• Medication Review: It’s essential to inform the healthcare team about all medications, supplements, and lifestyle factors that could affect the surgery.
• Transportation and Post-Operative Care: Arrange for a family member or friend to assist with transportation to and from the hospital, as well as post-operative care.

Recovery and Aftercare

• Hospital Stay: Most patients can expect to stay in the hospital for a few days following neck dissection surgery.
• Pain Management and Care: The patient will receive pain medication, antibiotics, and care for surgical drains during your hospital stay.
• Discharge: The medical team will monitor the patient’s ability to eat, drink, and move comfortably before you are discharged from the hospital.
• Follow-up Care: Follow-up appointments are essential for monitoring your recovery and ensuring that the healing process is on track.

Dr. Emad Kandil and his team are committed to providing the highest quality care and support throughout the entire neck dissection journey. They will be there to answer any questions the patient may have and to ensure his comfort and optimal recovery.

Why Choose Dr. Emad Kandil for Neck Dissection Surgery

When choosing a surgeon for a complex procedure like neck dissection, experience, expertise, and compassionate care are critical. Dr. Emad Kandil excels in all these areas, making him the ideal choice for patients seeking the best possible outcomes.

• Expertise: Years of experience in oncology and neck dissection.
• Innovation: Uses the latest surgical techniques and technology.
• Compassion: Treats patients with empathy and respect.
• Personalized Care: Tailors treatment plans to individual needs.

Contact Dr. Kandil’s office today to schedule your consultation and take control of your health journey.

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Parathyroid surgery

by mustafa | Mar 21, 2024 | Services

PARATHYROID GLANDS:

There are usually four parathyroid glands which are located next to the thyroid gland in the neck. Rarely, there may be a fifth or sixth gland. Occasionally, one or more parathyroid glands may be located elsewhere in the neck or upper chest region. The parathyroid glands make parathyroid hormone (PTH) which helps your body regulate calcium levels. Parathyroid hormone keeps the amount of calcium from falling too low by releasing calcium from the bones, by keeping calcium from being excreted by the kidneys, and by increasing calcium absorption from food.

HYPERPARATHYROIDISM:

Hyperparathyroidism occurs when the parathyroid gland(s) enlarge and make too much parathyroid hormone. This leads to a rise in calcium levels. Hyperparathyroidism occurs sporadically in approximately 90% of cases and is inherited in ap- proximately 10%. There is also an association with previous therapeutic head and neck irradiation. There are approximately 100,000 new cases each year in the U.S. It occurs more commonly in women than in men.

SYMPTOMS:

Symptoms associated with high levels of calcium are often vague. They may include decreased appetite, thirst, lethargy, fatigue, muscle aches, weakness, joint pain and constipation. More severe symptoms and signs associated with higher levels of calcium may include stomach upset, depression, osteoporosis, fractures or kidney stones. Sometimes there are no symptoms and the condition is discovered only by routine laboratory blood work.

A single enlarged parathyroid or parathyroid adenoma is responsible for 80% of cases. Enlargement of all four glands, known as hyperplasia, accounts for about 15% of cases. In approximately 4% of patients, two glands are enlarged. Parathyroid cancer causes hyperparathyroidism less than 1% of the time.

Parathyroid surgery

Hyperparathyroidism can be cured with surgery. The purpose of parathyroid surgery is to locate and remove the abnormal parathyroid gland(s). When performed by an experienced endocrine surgeon, the operation is successful in approximately 97% of cases. Complications can occur, but are uncommon. Rarely, all four para- thyroid glands need to be removed and sometimes, a portion of one is transplanted into the forearm. The hospital stay for these cases may be more than one night depending on the calcium level after surgery. Your surgeon will explain your specific surgery and why it is recommended in your case.

As with any surgical procedure, there are risks involved. There is a risk of bleed- ing, but this is extremely low. The risk of infection is also extremely low that antibiotics are not routinely used. There is also a very low risk of injury to the recurrent laryngeal nerves which control the vocal cords. Inju- ry to these nerves could affect your voice. There is also the possibility that the abnormal glands could not be located or that your symptoms may recur over time. Occasionally, hypoparathyroidism may result after surgery. This is associated with low calcium levels and may require calcium and vitamin D supplements to maintain normal calcium levels. There is also a small risk associated with anesthesia. The overall risk of complications is extremely low, however, and is usually out- weighed by the benefits of surgery. Dr.Kandil will go over this information with you and answer your questions.

Before surgery

Once the surgery has been scheduled, arrangements will be made for your preoperative evaluation. You will meet with a nurse practitioner or physician’s assistant from the Anesthesiology Department. The pre-op exam may include laboratory work, chest x-ray and an EKG.

If you take non-steroidal anti-inflammatory agents, you should stop taking these one week before surgery. On the night before surgery, do not have anything to eat or drink after midnight. Get a good night’s sleep.

The day of surgery

Your doctor’s secretary will let you know where your surgery will be and what time you need to arrive at the hospital on the day of surgery. It is very important to arrive at least 2 hours before surgery. During the surgery, your family can wait in the family waiting area. They will be kept updated by the patient representative and operating room staff. The surgeon will speak with them after surgery has been completed.

What will happen in surgery?

You will be given general anesthesia to put you to sleep. You are positioned with special pillows under your neck to tilt your head back. An incision is made at the base of your neck and is about two to four inches long, depending on the exact type of operation you have. Using magnifying lenses, the surgeon locates the par- athyroid glands and the abnormal one(s) are removed. The incision is stitched closed and is then covered with Steri-strips (tapes) and a dry gauze dressing.

The operation generally lasts from 30 minutes to 90 minutes. After surgery, you will stay in the recovery room for several hours. Depending on the exact type of surgery you have, you will either be discharged home on the same day of surgery or be admitted for one night’s stay.

After surgery

If you are admitted to the hospital, you will have a liquid diet for dinner. You may have a sore throat. The nurse will provide lozenges to help relieve this. If you need something for pain, the nurse will give you a liquid pain medicine. You will have a dressing on your neck which will be removed in the morning. The head of your bed will be raised to decrease swelling. You will have an intravenous line to give you fluids until the next day. Your calcium level will be checked by a blood test in the morning. You will be offered regular food the next morning. Most people are ready to go home after breakfast.

You will be given instructions about taking calcium supplements and possibly Vitamin D (Rocaltrol).

Same day surgery

If you are discharged on the day of surgery, you will have plastic dressing over your incision. You may shower on the night of surgery, but keep the dressing as dry as possible. Two days after surgery, remove the plastic dressing and gauze. Your diet may consist of liquids and soft foods, depending upon which feels better to you, since your throat will be sore.

The incision

After the dressing is removed, you may shower. Try to keep the neck area as dry as possible and pat dry after showering. The stitches will be removed in the office about a week and a half after surgery. Infection is extremely rare.

You can do to improve the appearance of your scar is to protect it with scar cream or sunscreen that has a sun protection factor (SPF) of 30 for an entire year. During the year your scar may become raised or red, but will almost always fade into a thin line which will be less noticeable.

Thyroid surgery

by mustafa | Mar 21, 2024 | Services

The Thyroid Gland is located in the neck and consists of two lobes, right and left.

The thyroid gland makes thyroid hormone with helps regulate the body metabolism.

Thyroid surgery is performed for reasons such as symptomatic thyroid goiter nodules, recurrent thyroid cysts, Graves’ disease, and to rule out or treat thyroid cancer.The purpose of the surgeryis to remove part or the entirethyroid.

Usually, patients will be discharged home same day or in some cases, will stay in the hospital one night to recover.

Before surgery

Before surgery you will have a pre-op exam which can include laboratory work, chest x-ray, and EKG.

Stop taking non-steroidal anti-inflammatory drugs ten days before surgery. Do not eat or drink anything after midnight the night before surgery.

The day of surgery

Arrive at the hospital at least two hours before surgery. Your family will wait in the family waiting area during surgery and will be updated on your situation by the patient representative and operating room staff. Dr. Kandil will speak to your family after the surgery is complete.

What will happen in surgery?

1. You will be given general anesthesia to put you to
2. You will be positioned with special pillows under your neck to tilt your head back.
3. An incision is made at the base of your neck is about 3-4 inch- es long.
4. The surgeon will locate the thyroid gland and associated struc- tures and all remove all or part of the thyroid.
5. The incision is stitched closed and is then covered with dry

dressing.

6. The surgery lasts 1-2

Risks

• Bleeding or infection which almost never happens in our experience.
• Injury to nerves
  • Injury to the laryngeal nerves in the neck control the vocal cords could affect your voice. ( Routine use of nerve monitoring will help us to decrease the risk to well below 1%)
  • The parathyroid glands could be injured, which would cause a drop in calcium levels (risk is also less than 1%)

After surgery

• liquid diet for dinner
• lozenges and throat spray will be provided if you experience sore throat
• pain medicine will be provided
• During your post operative clinic visit drains may be removed before you are discharged
• you will be sitting in the bed in an upright position to decrease swelling
• you will be given blood tests
• regular food the following morning
• Most patients are discharged home on the same day as surgery, however, if admitted for 23 hour observation, you will have an IV to give you fluids until the next day.

The incision

After the dressing is removed, you will see the tapes that cover the incision. Keep these in place until your follow-up visit. You may shower and wash your hair the day after surgery, but try to keep the neck area as dry as possible. If you notice any redness or drainage from the incision, contact your surgeon. After stitches are removed, use scar cream or sunscreen (SPF) of 30 to improve the appearance of the scar, or keep the scar covered the whole year. The scar may be- come raised or red, but will fade into a less noticeable thin line.

How will I feel after surgery?

Some people may be tired and a bit sore for a few days. You may experience pain from your incision as well as from muscle soreness in your upper back and shoulders. Most patients don’t require any narcotics after surgery, whoever,  if needed, a prescription for pain medication will be given to you. Throat lozenges may be used for sore throat.Calcium levels may drop after surgery if you have had a thyroidectomy. You may also experience numbing and tingling of your fingers or around your mouth. You will be given instructions for taking calcium replacement if needed. If you notice a sudden swelling in your neck along your incision, call your surgeon. The swelling may be a result of hematoma (bleeding) or a seroma (collection of body fluid).

Radiofrequency Ablation (RFA)

by mustafa | Mar 21, 2024 | Services

When conditions such as thyroid nodules cause discomfort and disrupt daily life, finding a safe and effective treatment becomes essential. Dr Emad Kandil, Professor and Elias Hanna Chair in Surgery, specialises in thyroid Radiofrequency Ablation (RFA), a minimally invasive procedure that reduces thyroid nodule size and alleviates symptoms.

What is Radiofrequency Ablation (RFA)?

The RFA procedure is similar to a fine-needle biopsy, involving the insertion of a thin, needle-like probe into the targeted area. The probe emits radiofrequency waves that generate heat, destroying surrounding cells. Over time, the body’s immune system naturally removes these cells, gradually shrinking the nodule. Ultrasound or other imaging techniques are used to guide the probe for precise placement.

RFA is performed under local anaesthesia, ensuring patient comfort throughout the procedure. It is an outpatient procedure, meaning you can return home the same day and resume light activities soon after.

Dr Emad Kandil, a leading expert in endocrine surgery, specialises in performing this advanced procedure, ensuring that patients receive personalised and effective care. This treatment is particularly beneficial for individuals who may not be suitable candidates for open surgery due to other medical conditions or who prefer a less invasive approach.

Benefits of Radiofrequency Ablation (RFA)

RFA provides numerous benefits for patients seeking long-term relief from discomfort. Here are some key benefits:

A Minimally Invasive Alternative to Surgery

RFA removes the need for traditional open surgery, significantly reducing surgical risks and post-operative complications.

Preserves Thyroid Function

Unlike conventional surgery, which may require partial or total thyroid removal, RFA targets only the nodule, preserving healthy thyroid tissue and lowering the likelihood of long-term hormone therapy.

Fast Recovery

Most patients can resume normal daily activities within 24 hours, with significantly less downtime than surgical procedures.

Minimal Scarring and No Incisions

RFA leaves no visible scars, as it requires only a needle puncture—unlike surgery, which often involves a neck incision.

Relief from Symptoms

By reducing thyroid nodules in size, RFA alleviates symptoms such as discomfort, difficulty swallowing, and cosmetic concerns.

A Safe and Well-Tolerated Procedure

Patients typically experience minimal discomfort during the procedure, with complications being rare when performed by experienced specialists such as Dr Emad Kandil.

Suitable for More Patients

RFA is an ideal option for patients who may not be candidates for surgery due to age, medical conditions, or a preference for a less invasive approach.

What to Expect Before, During, and After RFA?

Before undergoing RFA, Dr Emad Kandil conducts a thorough evaluation, including a fine-needle aspiration biopsy, to confirm that the thyroid nodule is benign. While RFA does not completely remove the nodule, it significantly reduces its size and alleviates symptoms over time. Patients typically experience minimal discomfort and can resume normal activities within 24 hours.

After the Procedure

After the procedure, you can expect the following:

• You will be monitored for a short period before being discharged.
• Mild discomfort at the treatment site is normal and usually subsides within a few days.
• Dr Emad Kandil provides detailed post-procedure instructions to support a smooth recovery.

Follow-Up and Ongoing Care

Regular follow-up ultrasounds are essential to monitor the size of the nodule and track ongoing improvement. In some cases, RFA may also be a suitable option for patients with small, carefully monitored cancers.

If you have symptomatic thyroid nodules and are seeking a less invasive, highly effective treatment, a consultation with Dr Emad Kandil can help determine whether RFA is the right option for you.

Why Choose Dr Emad Kandil for Radiofrequency Ablation (RFA)?

Dr Emad Kandil brings extensive experience and surgical expertise to thyroid nodule treatments.His compassionate approach ensures that every patient receives personalised care, with a focus on effective and lasting solutions. Key reasons to trust Dr. Kandil include:

• Comprehensive Expertise: As a leading surgeon in endocrine and oncological surgery, Dr Emad Kandil applies his vast knowledge to innovative thyroid treatment solutions.
• State-of-the-Art Technology: The clinic is equipped with cutting-edge imaging and treatment technologies to ensure precision and effectiveness.
• Patient-Centred Care: Dr Emad Kandil and his team prioritise your comfort, safety, and long-term well-being at every stage of your treatment.

Book Your Consultation Today

If thyroid nodules are impacting your daily life, Radiofrequency Ablation (RFA) could be the solution you have been looking for. With Dr Emad Kandil’s expertise and compassionate care, you can explore this advanced, minimally invasive treatment designed to offer lasting relief. Contact us today to book your consultation.