Limb Sparing Resection of the Arm due to a Malignant Peripheral Nerve Sheath Tumor

This video teaches the surgical steps involved in removing (resecting) a soft tissue sarcoma called a malignant peripheral nerve sheath tumor arising from the right upper arm. This sarcoma developed from the major peripheral nerve called the musculocutaneous nerve. The tumor and nerve are isolated and radically resected in a way that safely mobilizes and protects all of the pertinent major neurovascular structures (brachial plexus and axillary and brachial vessels) that are not involved and allows proper removal of the mass with any involved tissues while maintaining the best possible function of the limb. This is a limb sparing procedure as opposed to performing an amputation of the arm. Specific protocols for physical therapy must be adhered to postoperatively for an optimal result. Patients may be kept in a sling for 6 weeks and gradually strengthen muscles with physical therapy. Radiation is usually required and may be administered either before or after surgery. There are advantages and disadvantages of giving the radiation before vs after. Generally, radiation doses are lower and the area targeted is more precise when given before surgery, since the dose of radiation is lower compared to postoperative radiation and less normal tissues are treated, the long- term complication rates are lower and the function of the limb usually better. The trade off is a higher risk of wound complications and having wound healing problems. The dose of radiation is higher and the area more substantial with postoperative radiation that can result in more long-term complications and poorer function but lower wound healing problems.

Dr. James C. Wittig is a world-renowned Orthopedic Oncologist and Sarcoma Surgeon who has been in practice for over 20+ years. He has performed close to 10,000 orthopedic oncology and sarcoma surgeries for various benign and cancerous musculoskeletal tumors. Dr. Wittig maintains an active subspecialty clinical practice that focuses on treating pediatric and adult patients with bone sarcomas and soft tissue sarcomas (cancers) as well as benign bone and soft tissue tumors and metastatic cancers to bone. He focuses on complex Limb Sparing Surgery (Limb Saving) for sarcomas. Dr. Wittig has a particular subspecialty interest and extensive experience in limb sparing surgery for shoulder girdle tumors, cryosurgery, radio-frequency ablation and minimally invasive biopsies. He has been named one of the top 13 orthopedic oncologists in the United States. He has also been featured as a Top Doctor in the New York Metro area by New York Magazine and Castle Connolly (2009-2022) as well as America's Top Cancer Doctor and America’s Top Doctor by Castle Connolly. At the time of this post, in 2022, Dr. Wittig holds the position of Chairman of Orthopedic Surgery at Morristown Medical Center and Medical Director of Orthopedics, Orthopedic Oncology, and Sarcoma Surgery in Atlantic Health System in New Jersey. He has previously served as Chief of Orthopedic Oncology and Vice Chairman of Orthopedics at Hackensack University Medical Center, and Chief of Orthopedic Oncology at NYU and Mt. Sinai Medical Center. Under Dr. Wittig's leadership, the department of Orthopedic Surgery at Morristown Medical Center has achieved national recognition as the number 23 Orthopedic Program in the United States and the number 1 Orthopedic Program in New Jersey for several years in a row by US News & World Report. Morristown Medical Center has been named the number 1 hospital in New Jersey for the last 5 years by US News & World report.

For more information about Dr. Wittig or the conditions he treats please visit: www.TumorSurgery.org
www.OrthopedicOncologist.com

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• Category

  Sarcomas, Soft Tissue