Tricks of the Senior Surgeon

■ A subcostal incision provides excellent lateral exposure, greatly facilitating access for the dissection.

■ An anterolateral oblique duodenotomy gives ideal exposure, allows further extension if needed, and a two-layer closure does not compromise duodenal lumen.

■ An extended Kocher maneuver is imperative.

■ A folded laparotomy pad placed behind the duodenum displaces the operative field anteriorly.

■ A catheter placed antegrade via the cystic duct provides assurance in locating and protecting the retroduodenal common bile duct, especially when a full thickness excision is performed.

■ Placement of sutures at the margin of the specimen assists exposure and dissection.

■ Optical magnification is very helpful for resection and reconstruction.

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How to Stay Young

How to Stay Young

For centuries, ever since the legendary Ponce de Leon went searching for the elusive Fountain of Youth, people have been looking for ways to slow down the aging process. Medical science has made great strides in keeping people alive longer by preventing and curing disease, and helping people to live healthier lives. Average life expectancy keeps increasing, and most of us can look forward to the chance to live much longer lives than our ancestors.

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