Dr. Iwao Sugitani Professor, Department of Endocrine Surgery, Graduate School of Medicine, Nippon Medical University/ Director for Department of Endocrine Surgery, Nippon Medical University Hospital This is the second of the series in which experienced surgeons evaluate Wearable Surgical Lighting System OPELAⅢ upon using during actual open surgeries. This time, we asked Dr. Iwao Sugitani, the professor of endocrine surgery at Nippon Medical University, to appear on the series. He explains what the challenges are in open surgery of the neck area in the context of light requirement, and how much potential OPELAⅢ holds in improving it. He also shares how effective OPELAⅢ is during the procedures of total thyroidectomy and right cervical lymphadenectomy for papillary thyroid carcinoma. Nerve preservation can be performed appropriately due to nerves and small blood vessels being clearly visible Total thyroidectomy was performed against a papillary thyroid carcinoma with a 2.5 cm primary lesion on the right side of the thyroid gland using OPELAⅢ. At the same time, lymph node dissection was performed because there was a lymph node metastasis of more than 2 cm at the right neck. The thyroid gland is almost entirely exposed when the neck is opened through an approximately 8 cm collar incision, taking minimal esthetic scarring into consideration. However, because the opening above the upper portion is narrow and deep, not enough light from the OR light reaches there. It is an area often difficult to focus the light on and the surgeon’s head casts a shadow over it. This is a critical area where the superior thyroid artery passes, and the external branch of the superior laryngeal nerve runs in various patterns. What I really like about OPELAⅢ is that the light reaches deep into the surgical field and illuminates exactly where I want to see (Fig. 1). Dissection of lymph node in the neck is also a procedure that requires peering into deep parts. Here, too, important blood vessels and nerves run vertically and horizontally. In a thyroid surgery, it is important to ensure that the recurrent laryngeal nerves are properly located and preserved (Fig. 2). As preserving recurrent laryngeal nerves equals to Fig. 2Treatment around the recurrent laryngeal nerve successfully distinguishing small blood vessels around the nerves, clear visibility of small blood vessels is extremely important (Fig. 3). Fig. 1 pper portion of thyroid gland U ON means when OPELAⅢ is lit.

Wearable Surgical Lighting System in Open Surgery I did not feel any burden or heaviness with OPELA1 even with frequent changes in posture during surgery Lymph nodes in the upper neck may not necessarily lie along the internal jugular vein but may also lie behind the pharynx. It happens rarely, but in such cases where lymph node dissection in posterior pharynx or mediastinum is required, OPELAM can be particularly helpful. In other words, surgeons may not be able to confidently perform surgery without the assistance of lights that can illuminate the depths. The headlights I have used in the past...