En Bloc Dissection of Thoracic and Abdominal Viscera: a Beneficial Approach for Medical Student Learning

Abstract

A typical medical school approach to dissecting the thorax and abdomen begins with removal of the anterior body wall. With the viscera caged in the body cavities, access to dissection is limited, the view is restricted, and critical relationships may be disrupted due to removal of structures. To overcome these challenges, an en bloc dissection of the thoracic and abdominal viscera was experimented, in which the thoracic and abdominal organs, diaphragm, and neurovasculature were removed as a unit for dissection and study. Removal of the visceral block required transecting: (1) structures that traverse the anatomical thoracic inlet, (2) the mural attachments of the diaphragm, and (3) the ureters, rectum, and distal ends of the abdominal aorta and inferior vena cava. This preparation has a number of advantages: (1) a 360° view of the viscera not confined by body wall; (2) increased space for dissection of abdominal organs and neurovasculature; (3) a clear display of relationships between retroperitoneal organs (e.g., kidneys and great vessels); (4) an easier view of the diaphragm in relation to surrounding structures; and (5) unhindered dissection of the posterior abdominal and thoracic walls. In addition, integrity of the thoraco‐abdominal structures (e.g., descending aorta, esophagus, sympathetic chain and vagus nerve) was maintained. First‐year medical students found these preparations to be extremely useful as a supplement to more traditional dissection. We conclude that en bloc dissection of thoracic and abdominal viscera provides advantages that underscore its potential role in anatomy education.