remove it with a little bit of a bull
shaper of bevel to the edge because the
technician is going to turn this three
dimensional piece into the few
dimensions and thanks for joining us dr.
mark bond not at the other medical group
but at Sacramento ents office in
roseville where dr. Michael trailer is
going to work on mark our patient to
remove skin lesion to turn out to be
what kind of cancer that basal cell
carcinoma yeah but you have been able to
see it because you lost your glasses
what have your glasses when I pull the
great out of the creek and my classes
remain with the water so let me get your
glasses are in the Greek the mark with
those glasses in the creek is going to
get this lesion on the right side of his
nose completely removed using the most
technique under dr. trainer good variety
i'm going to go ahead and now you back
your feet will come up a bit your backs
going to go down the first place the
worst part is going to sting a bit
we use lidocaine with epinephrine and
it's buffered with bicarbonate to try to
make it a little less intense in terms
of the discomfort but it still stings a
bit alright one two three
so we're going to put a generous amount
of anesthetic again because we want
pain-free surgery
screams bad for business and the waiting
room isn't too far away you're doing
alright good so you can see we raised a
wheel and it blanches and that just
proves the epinephrine is working and
that we should have good anesthesia and
again we'll use a generous amount we
won't cut health care dollars with the
Minnesota compromise and that should get
your good num cleaning apples a little
bit of soap
ok so the advantages of most surgery in
this area is we're trying to be tissue
spearing we're trying to remove the skin
cancer and preserve as much normal skin
on the nose who would give you a smaller
wound in a smaller scar
at the same time getting you a very high
cure rate comes the paper drink
ok everything has to stay oriented your
surgeon might be disoriented but
everything else will stay oriented and
specifically your tissue we have a
convention that the fold of the Gods is
always up and you'll see what we do with
the tissue so the first thing we're
going to do is called curating skin
cancer cells aren't as adherent as
normal skin so they tend to scrape away
a bit and this helps me define what's
called the gross clinical margin what
that is i'm going to create a little
divot and it helps me know how deep and
how wide to cut around to remove your
skin cancer a little bit of pressure you
can see a little bit of scraping away
which proves they're still residual skin
cancer below the biopsy site scar any
pain at all no good that's the answer we
want and it's pretty much scraping out
right about what the purple circle that
we dress or estimate was pretty spot-on
so to speak so now what I'm going to do
is draw out about a 1 22 millimeter
margin around the area of the obvious
skin cancer was persisting and now we're
going to remove it and we're going to
remove it with a little bit of a bowl
shape of bevel to the edge because the
technician is going to turn this three
dimensional piece into two dimensions
any pain at all you know good and you
can see and we're putting orientation
marks at 12 and six o'clock and that's
again just to keep everything oriented
so that we always know if we have to go
back to remove more we can do it in
frustration directed manner so the
answer is going to hold a little
pressure to minimize any bleeding we're
going to try to create a flat plane on
the bottom because again it makes the
technicians job easier to process how we
doing there any pain you know
ok and the tissue is removed and put an
orientation mark at the top everything's
on the tissue state oriented and we
transfer this to a petri dish to take it
to the layout of the next thing we're
going to do there is a little bit of
Carter Isaac
little buzzing sound a little burnt
flesh smell and this is to just start
any bleeding
ok and it's a little bit of above the
queue of you smell on the frame
ok ok so if your camera and this worked
best with a dry field to UCI blot and
cauterize button clutter raised and I
try not to cauterize the surface edge
because that tends to leave a little
more scarring so if I can avoid that I
will
because everything's going perfectly ok
yo man she's going to create a little
bit of a pressure bandage we're going to
do a tiny bit more colorizing just to
make her job a little easier and we'll
take the tissue to the lab will get you
bandaged and sitting up more comfortably
what we do here is to just draw the
orientation of the tissue that was
removed with again the notch marks at 12
and 6 and it matches the tissue and
that's what I cooks that's what I then
take to the lab so you want to follow to
the lab and loves you
yeah okay and basically the technician
you'll see she's going to prepare the
tissue turning three dimensions into two
she's gonna freeze it slice it
microscopically thin and then staying at
this is Rachel our technician here's the
tissue
hey guys thanks for watching that
procedure where dr. crowler took that
sample out of marks knows now we need to
process the tissue and look at it under
a microscope that's the next video so be
sure to click to watch that once it's up
I need to thank our patrons to make this
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until next time this is dr. mark
continue to stay in good health