Panorama Centre For Surgical Oncology

Chemo Ports

Video about needle biopsy (Afrikaans only)

Breast Procedures

A lumpectomy means the removal of the part of the breast containing the cancer.  No muscles are removed.   This may be combined with removal of some lymph nodes from the axilla.  This operation is done when it is possible to treat breast cancer without removing the whole breast .  It is  usually followed by irradiation.  

Indications:

Both infiltrating cancer and in-situ cancers could potentially be managed with lumpectomy. 

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Oncoplastic lumpectomy combines the plastic surgery technique of a breast reduction with lumpectomy surgery to give you a better cosmetic outcome after the cancer is removed.

You can think of oncoplastic lumpectomy,  also called oncoplastic surgery, as a doing a breast reduction operation and including the cancer in the area to be removed while moving the remaining tissue into position to create a normal but more compact breasts mound.

There are many different oncoplastic approaches available to reshape the breast after removing the cancer and in our unit, almost every lumpectomy will have some local tissue transposition to prevent a permanent defect.

… Read more about oncoplastic surgery.

Mastectomy is the removal of all breast tissue. There are different types of mastectomy.

The traditional “simple” or “total” mastectomy is a procedure where skin, nipple and breast tissue is removed. This is them closed with a diagonal of horizontal scar leaving a flat chest. 

A Skin sparing mastectomy is where the breast tissue under the skin is removed, but at least some of the skin is retained. With a Skin- and Nipple sparing mastectomy the nipple is retained as well. This facilitates reconstructive options either immediate or at a later time. 

Any of these options can be combined with procedures to the lymph nodes

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Head and Neck Operations

What to Expect During a Thyroid Lobectomy

A thyroid lobectomy is used to remove one of your two thyroid lobes, leaving the other intact. We may perform this type of surgery if there are nodules that cause symptoms or could be cancerous. We also use it to treat excessive hormone production like that associated with hyperthyroidism.

If you are having a thyroid lobectomy because of an indeterminate biopsy result, we will send the tissues collected to a pathologist for examination. If cancer is found, you might have to undergo a second surgery to ensure that all of the cancerous tissue is removed.

A thyroid lobectomy is performed under general anaesthesia. Some patients may go home the same day but most will spend the night in hospital.  You will require very little post-operative care and should be able to eat and drink normally as soon as you have recovered from the anaesthesia.  At home you will be able to care for yourself.

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What to Expect During a Total Thyroidectomy

Total thyroidectomy involves the removal of the entire thyroid gland. This procedure is performed to treat conditions like thyroid cancer, uncontrollable hyperthyroidism or a large multinodular thyroid that causes severe symptoms.

If you’re having thyroidectomy as a result of thyroid cancer, we may remove lymph nodes around your thyroid to be examined by a pathologist. We use the smallest incisions possible, to limit scarring to your neck and deliver the best possible cosmetic results. In most patients the incision is 4-5cm long.  General anaesthesia is used during a thyroidectomy, and you’ll usually stay in the hospital for one night following the procedure.

The day after surgery we will do blood tests to check your calcium and PTH levels. PTH is produced by the parathyroid glands situated next to your thyroid and they may become underactive due to the surgery. This can lead to low calcium levels. This is usually temporary but most patients will need to take oral calcium supplements for between one and 6 weeks after surgery.

After your procedure, you will need to take thyroid hormone replacement tablets for the rest of your life, because your thyroid gland will no longer supply you with the necessary hormone. We will do blood tests to ensure that you are getting the right amount of thyroid hormone. 

In the weeks after your thyroidectomy, you may have neck pain, soreness of your vocal chords or a weak voice. These symptoms are usually temporary.

…Read more.

The Parathyroid Glands

The parathyroid glands are four pea-sized glands that sit on the back of the thyroid. They work with the kidneys and intestines to help control the calcium levels in our bodies. They do this by making a hormone, called parathyroid hormone (PTH). PTH acts on the bones, intestines, and kidneys to keep the calcium levels in the normal range.

Parathyroid Disease

Hyperparathyroidism
In some people, one or more of the parathyroid glands becomes hyperactive by producing too much PTH. This condition is known as primary hyperparathyroidism. Primary hyperparathyroidism causes patients’ calcium levels to be too high. If not treated primary hyperparathyroidism can lead to kidney damage and stones and weak bones (osteoporosis).

Secondary hyperparathyroidism is the medical condition of excessive secretion of parathyroid hormone (PTH) by the parathyroid glands in response to hypocalcaemia (low blood calcium levels), wich causes enlargement of these glands. This disorder is mostly seen in patients with chronic kidney failure. It is sometimes abbreviated “SHPT” in medical literature.

Some patients with hyperparathyroidism do not have any clearly related symptoms. However, many people do have symptoms related to their disease. These can vary greatly, and may include:

Bone pain
Kidney stones
Broken bones from bone weakening
Chronic fatigue
Stomach problems
Lack of concentration
Depression
Memory Problems
In most patients, treatment for primary hyperparathyroidism is parathyroid surgery. Fortunately, parathyroidectomy is generally very successful, safe, and easy to recover from.

For more information of these conditions and the treatment, click here!

parotidectomy is the surgical removal of the parotid gland, the largest of the salivary glands. The procedure is most typically performed due to inflammatory lumps or neoplasms (tumours / Gowths) . Neoplasms can be benign (non-cancerous) (80%) or malignant (cancerous) (20%).

Anatomy

The parotid gland consists of two lobes: the superficial lobe and the deep lobe. Surgery to remove a tumour in the superficial part is called a superficial or suprafacial parotidectomy. Surgery to remove a tumour in the deep lobe or both the deep and superficial lobes is called a total parotidectomy.

The Facial nerve runs through the parotid gland between the superficial and deep lobes. 

The operation

Treating parotid gland tumours requires meticulous operating technique because of risk to the facial nerve.  

To read more, click here…

Tracheal stenosis is a narrowing of your trachea, or windpipe, due to the formation of scar tissue or malformation of the cartilage in the trachea.

Causes of tracheal stenosis include:

Scar formed from the tip of a breathing tube
Wegener’s granulomatosis – a condition of blood vessel inflammation
Inflammatory diseases
Trauma, such as an inhalation burn injury
Symptoms of tracheal stenosis include:

Shortness of breath during exertion and sometimes at rest
Noisy breathing, also known as stridor Cough
Feeling of phlegm “stuck” within the airway

To read more about how we treat Tracheal Stenosis, click here…

Panorama Centre for Surgical Oncology

The branch of medical practice that treats injuries, diseases, and deformities by the physical removal, repair, or readjustment of organs and tissues