La reconstrucción mamaria después de una mastectomía - Medical Animation
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La reconstrucción mamaria después de una mastectomía - Medical Animation
MEDICAL ANIMATION TRANSCRIPT: La reconstruccin mamaria ayuda a restaurar la apariencia de la mama despus de una mastectoma. Se puede llevar a cabo al momento de realizar la mastectoma o con posterioridad. Usted y su cirujano seleccionarn el tipo de ciruga reconstructiva que mejor le convenga. Generalmente, sus opciones incluirn un implante sinttico o uno de dos procedimientos que utilizan su propio tejido para reconstruir su mama: un colgajo musculocutneo del dorsal ancho o un colgajo miocutneo transverso del recto abdominal, conocido tambin como colgajo TRAM. Antes del procedimiento se le colocar una va endovenosa y es posible que se le suministre un sedante por va oral para ayudarle a relajarse. Las reconstrucciones mamarias se realizan con anestesia general. Durante el tiempo que dure la ciruga usted estar dormida y se le insertar un tubo respiratorio por la boca y la garganta para ayudarla a respirar durante la operacin. Para un colgajo musculocutneo del dorsal ancho, el cirujano realizar una incisin en la parte superior de la espalda, separar una seccin de tejido y girar el colgajo hasta posicionarlo en la zona de la mastectoma. Un colgajo miocutneo transverso del recto abdominal o colgajo TRAM comienza cuando el cirujano realiza una incisin en la piel del trax. Luego el cirujano realizar una incisin elptica en la piel, la grasa y el msculo de la pared abdominal, o de no haber suficiente tejido en el abdomen, en la parte inferior de la espalda. A continuacin, el cirujano deslizar el tejido debajo de la piel hasta la zona de la mastectoma para formar un montculo mamario. Se tendr mucho cuidado de conservar el suministro de sangre hacia el montculo reconstruido. Finalmente, el cirujano suturar la herida original de la espalda o abdomen. El procedimiento para los colgajos de tejido es similar, independientemente de que se realice de inmediato o un tiempo despus de la mastectoma. Sin embargo, el procedimiento para los implantes sintticos depende del momento en que se realice la reconstruccin. Si decide realizarse el implante al momento de someterse a la mastectoma, el cirujano lo insertar inmediatamente despus de extirpar el tejido de la mama y cerrar la herida con suturas. Si elige realizarse el implante con posterioridad, es posible que la piel necesite estirarse antes de que se produzca la reconstruccin. En este caso, el cirujano volver a abrir la incisin en el lugar de la mastectoma e insertar un expansor de tejidos con forma de globo. Durante algunas semanas el cirujano lograr que la pared torcica y la piel se estiren al inyectar regularmente solucin salina en el expansor de tejidos. En una segunda operacin, el cirujano realizar otra incisin, extraer el expansor de tejidos, insertar un implante sinttico y cerrar la herida con suturas. Despus de la ciruga, se retirar el tubo respiratorio y se le trasladar al rea de recuperacin posquirrgica para su monitoreo. Generalmente, las reconstrucciones mamarias son procedimientos hospitalarios y la mayora de las pacientes permanecen en el hospital de 1 a 5 das despus de la ciruga. Una vez completado el montculo mamario, puede decidir que le reconstruyan el pezn y la areola. Este es un procedimiento relativamente fcil y por lo general se puede realizar en el consultorio del mdico ya que dura de 30 a 60 minutos. Existen diferentes tipos de reconstrucciones del pezn. La ms comn consiste en extraer tejido del muslo interno u oreja para crear un montculo pequeo parecido a un pezn que se puede tatuar para parecerse ms a un pezn y areola naturales. Este pezn de reemplazo se fija en el rea central de la mama reconstruida.
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Noel Turner, III
Burts, Turner, Rhodes & Thompson
Spartanburg, SC
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Andrew Needle
Needle Gallagher & Ellenberg, P.A.
Miami, FL
"I just wanted to let you know that after several days on trial, I settled
[my client's] construction accident case for $4.5 million. Immediately after
the jury was discharged, I spoke with several jurors who told me that they
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with [my client's] devastating injuries. They also expressed their gratitude
in being able to read from a distance all of the notations without
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Michael Gunzburg, Esq.
Attorney at Law.
New York, NY
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thousand words, as juries perk up and look intently to capture concepts
that are otherwise too abstract. Start with good illustrations, a clear and
direct voice, a view of the jury as 12 medical students on day one of
training, and your expert testimony becomes a pleasure, even on cross
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As a treating physician, I also use these accurate illustrations to educate
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Richard E. Seroussi M.D., M.Sc.
Diplomate, American Boards of Electrodiagnostic Medicine and PM&R
Seattle Spine & Rehabilitation Medicine
www.seattlespine.info
Medical Legal Art creates medical demonstrative evidence (medical
illustrations, drawings, pictures, graphics, charts, medical animations,
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