Sohail Bakkar

Hashemite University | HU · Department of Surgery

A minimal access procedure does not necessarily mean that it is minimally invasive. However, as its name implies, MIVAT is a truly minimally invasive treatment modality. The advantages it offers over its conventional counterpart are indeed related to its minimally invasive nature. Furthermore, this nature has not compromised its ability to accompli...

Background: Robot-assisted transaxillary thyroid surgery, widely accepted and used in Eastern countries, can be an appealing treatment option for both patients with major concerns regarding a cervical scar, and their surgeons. Patients are offered a scarless neck surgery, while their surgeons are offered improved dexterity and ergonomics compared...

Background: Patients labeled as having indeterminate thyroid nodular disease following fine needle aspiration cytology are at risk of non-optimal initial surgery: an overly radical total thyroidectomy, or an unnecessary two stage operation. The objective of this study was to assess the impact of combining mutational markers and ultrasonographic fe...

Purpose: The extent of surgery for pediatric papillary thyroid carcinoma is debatable. The aim of this study was to evaluate the feasibility of offering pediatric patients a tailored surgical approach based on certain clinical features. Methods: A national multicenter retrospective review of 250 pediatric patients treated for papillary thyroid c...

Papillary thyroid carcinomas are favorable prognosis cancers. Most patients have an excellent long term overall survival rate. As a result, disease-free survival has replaced overall survival as the main outcome of interest when effective initial management of these tumors is considered. The role of prophylactic central neck dissection represents a...

Transmetatarsal amputation (TMA) involves the surgical removal of the distal portion of metatarsals in the foot. It aims to maintain weight-bearing and independent ambulation while eliminating the risk of spreading soft tissue infection or gangrene. This study aimed to explore the risk factors and surgical outcomes of TMA in patients with diabetes...

Purpose: Post-operative hypoparathyroidism (POHP), permanent or temporary, is the commonest complication of thyroidectomy. To avoid hypoparathyroidism after thyroidectomy a few centers including ours have explored the use of parathyroid autofluorescent properties intra-operatively (AFI). The present supplementary study aimed to determine the rates...

Fewer than 100 cases of amiodarone-induced thyrotoxicosis (AIT) managed surgically have been reported worldwide. This study aims to assess the outcome of thyroidectomy under general anesthesia in a relatively large case series. A retrospective analysis of the clinical records of 53 patients who underwent thyroidectomy for AIT between 1995 and 2019...

Introduction and importance Retrosternal Goiter (RG) represents a challenging clinical entity for surgeons. Although the vast majority of cases are successfully operated via a cervical access, there still remains a small minority that require an extra-cervical approach, even in experienced hands. Factors that shift the odds towards an extra-cervica...

IntroductionPapillary thyroid cancer (PTC) accounts for up to 80% of thyroid malignancies. New diagnostic and therapeutic options are suggested including innovative molecular methods. MicroRNAs (miRNAs) are nonprotein coding single-stranded RNAs that regulate many cell processes. The aim of the present study is to review the deregulated miRNAs asso...

Purpose Recent clinical practice guidelines consider thyroid lobectomy a viable alternative for low-risk papillary thyroid carcinoma PTC measuring 1–4 cm in size. We aimed to assess the likelihood of finding postoperatively determined high-risk histopathologic features that would lead to the recommendation of completion thyroidectomy. Methods A re...

Introduction L’hypoparathyroïdie postopératoire survient dans 15–30 % après thyroïdectomie totale, restant définitive jusqu’à 7 %. Elle peut être sévèrement symptomatique, entraînant une hospitalisation prolongée ou une réadmission à l’hôpital. Une technique chirurgicale standardisée permet de réduire le taux postopératoire d’hypoparathyroïdie. Néa...

Over the past decade, the incidence of thyroid cancer has rapidly increased worldwide, and thyroid surgery has become one of the most common performed surgical procedure. Even though conventional open thyroidectomy remains the gold standard, this approach leaves a neck scar which could be worrying mainly for young women. The recent progress in surg...

The purpose is to delineate the clinico-pathologic features of papillary thyroid carcinoma (PTC) occurring in a background of Hashimoto’s thyroiditis (HT). A retrospective analysis of consecutive PTC patients who underwent surgery at an academic center between Jan. 2010 and Jan. 2020 was performed. The primary end point was to assess whether a back...

Purpose Intraoperative imaging of parathyroid glands (PGs) has been developed in order to reduce the risk of unintentional parathyroidectomy during total thyroidectomy. This novel modality is based on their intrinsic characteristic of autofluorescence (AF) after near-infrared light exposure. The aim of this study was to assess the effect of this me...

Purpose Recent clinical practice guidelines consider thyroid lobectomy a viable alternative for low-risk papillary thyroid carcinoma PTC measuring 1–4 cm in size. We aimed to assess the likelihood of finding postoperatively determined high-risk histopathologic features that would lead to the recommendation of completion thyroidectomy. Methods A re...

Lesion Type Analysis of Hemodialysis Patients Who Underwent Endovascular Management for Symptomatic Central Venous Disease

Introduction The novel COVID-19 pandemic has imposed unprecedented restrictions on healthcare services worldwide. In developing nations such as Jordan, appreciable impacts on healthcare delivery ensued owing to limited resources. As a result, managing chronic limb-threatening ischemia (CLTI) has been modified to accommodate altercations in the syst...

Background: The novel coronavirus and the disease it causes COVID-19, like other viral outbreaks, have an unpredictable timeline. Therefore, a triumph in the battle against COVID-19 could only be achieved if a health care system's capacity to support a potentially overwhelming increase in critical patient care needs is maintained, and the viral cu...

Cryptorchidism is the most common congenital anomaly of the male genital tract. Cryptorchidism is associated with potentially serious consequences including reduced fertility, increases risk of cancer, susceptibility to torsion and traumatic injury, as well as future psychological problems related to an abnormal scrotal appearance. The mainstay of...

Background: Robot-assisted transaxillary thyroidectomy is a well-established remote-access thyroid procedure that has been demonstrated to be as safe and effective as its time-honored conventional clamp-and-tie counterpart. However, it has been incriminated for a set of unprecedented complications that surgeons need to be aware of and deal with app...

Purpose: Central venous lesions (CVLs) can adversely affect hemodialysis access maturation and maintenance, which in turn worsen patient morbidity and access circuit patency. In this study, we assessed several clinical variables, patient characteristics, and clinical consequences of symptomatic central vein stenosis and obstruction in patients who...

To evaluate the validity and reliability of an innovative training model for endocrine surgical procedures. A simulator training model for endocrine procedures (SimLife) was developed at an academic center. The model consisted of a realistic operating environment with a coherent simulated patient dynamized by pulsatile vascularization with simulate...

COVID-19 has profoundly modified the way healthcare is delivered. Jordan imposed lockdown and restrictive policies between March 17 and May 20, 2020. We aimed to assess the impact of such measures on thyroid cancer treatment plans. In the specified period, 12 patients were scheduled for surgery. Since papillary carcinoma was the preoperative diagno...

The 2019 novel corona virus and the disease it causes (COVID-19) is a public health crisis that has profoundly modified the way medical and surgical care is delivered. Countries around the globe had a variable initial response to the COVID-19 pandemic from imposing massive lock downs and quarantine to surrendering to herd immunity. However, healthc...

Background: Recent clinical practice guidelines consider thyroid lobectomy a viable alternative for low-risk papillary thyroid carcinomas (PTCs) measuring1-4 cm in size. We aimed to assess the likelihood of finding postoperatively deter-mined high-risk histopathologic features that would lead to the recommendation of completion thyroidectomy. Mater...

Purpose: To assess the reliability of a simple, accessible, cost-effective rule-out tool, for use in triaging patients with Bethesda IV nodules to appropriate surgery. Methods: The diagnostic tool was assembled by combining the negativity for suspicious ultrasound features (irregular margins, microcalcification, and a taller-than-wide orientatio...

Background: Hemostasis is fundamental in thyroid surgery. The aim of this randomized active comparator-controlled study was to compare the effectiveness of LigasureTM Exact to previously existing sealing devices in patients undergoing thyroidectomy. Methods: A total of 180 patients were randomly allocated into 4 groups according to the hemostatic...

Purpose: Non-traumatic major lower extremity amputation (NMLEA) is a commonly performed procedure that presents a substantial cost burden. Patients who undergo NMLEA are usually considered as a high-risk group with significant comorbidities, which translates into a protracted peri-operative course and increased health-care costs. The primary aim o...

Background: Minimally invasive video-assisted thyroidectomy (MIVAT) was first described in 1999 and it has become a widespread technique performed worldwide. Although initially limited to benign thyroid nodules, MIVAT was progressively adopted for all types of thyroid diseases, while remaining within the selection criteria. It is reported that, in...

Background: We aimed to explore the surgical outcomes of major lower extremity amputation (MLEA) and influencing factors at an academic tertiary referral centre in north Jordan, optimistically providing a platform for future health care policies and initiatives to improve the outcomes of MLEA in Jordan. Methods: Clinical records of patients who...

Purpose To delineate the clinicopathologic features and biologic behavior of the diffuse sclerosing variant of papillary thyroid carcinoma (DSV-PTC) and to report its outcome. Methods The clinical records of 25 patients who had surgery for DSV-PTC from 2004 to 2017 were retrospectively analyzed. Comparisons were made to similar studies in the lite...

To assess the utility of mutational markers in determining the most appropriate initial surgery for patients with thyroglossal duct cyst carcinoma (TGDCCa) and a normal thyroid gland. Our sample comprised 15 patients with a diagnosis of TGDCCa and a thyroid gland histologically negative for any malignant involvement, who underwent surgery between t...

In the mid-20th century Theodor Kocher standardized the conventional clamp-and-tie thyroidectomy, and a procedure that was banned or prohibited for so long was labeled as “extremely safe and efficient”. Ever since, innovations and refinements in the field of thyroid surgery have focused on improving patient clinical outcome profiles, and offering p...

Patient: Male, 53 Final Diagnosis: Gastric cancer Symptoms: Abdominal and/or epigastric pain • vomiting • weigh loss Medication: — Clinical Procedure: Gastrectomy Specialty: Surgery Objective Unusual setting of medical care Background Hypothyroidism is the second most common endocrine disorder following diabetes. Appropriate hormone replacement t...

Papillary thyroid carcinoma (PTC) is an often indolent disease implying a long survival and in most of the cases an excellent prognosis, but there is still a limited percentage of cases where, in spite of their pre-operative conventional staging, these tumors could better be treated through a more selective surgical approach. Small PTC in fact are...

Purpose: To report the clinical implications of an initial experience with transoral endoscopic thyroidectomy vestibular approach (TOETVA). Methods: From March to November 2017, five cases of TOETVA were performed. Data reported include patient demographics, indication for surgery, extent of surgery, operative time, the need to convert to cervic...

Papillary thyroid carcinoma (PTC) is an often indolent disease implying a long survival and in most of the cases an excellent prognosis, but there is still a limited percentage of cases where, in spite of their pre-operative conventional staging, these tumors could better be treated through a more selective surgical approach. Small PTC in fact are...

Background: The study aims to assess the risk of cancer in solitary thyroid nodules ≥30 mm in size reported as Bethesda II, and its implications. Method: The clinical records of 202 patients, who underwent thyroid lobectomy for solitary nodules measuring ≥30 mm, reported as Bethesda II on preoperative FNAC between Jan 2015 and Apr 2016 were revi...

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Background: Robot-assisted transaxillary thyroidectomy (RATT) is widely accepted in Asian countries. However, concerns regarding the balance between its real advantages and safety and cost have been raised by North American authorities. In Europe, assessments have been limited by small numbers since now. The purpose here is to report a large Europ...

Purpose The optimal management of thyroglossal cyst carcinoma, particularly the extent of surgery required is controversial. The aim of this study was to evaluate the need for routinely adding total thyroidectomy to Sistrunk’s operation in the management of this condition. Methods The clinical records of 19 patients with a diagnosis of thyroglossal...

Background: The treatment of gallstone ileus (GI) consists of surgical removal of the impacted bilestone with or without cholecystectomy and repair of the biliodigestive fistula. The objective of this study was to assess whether sparing patients a definitive biliary procedure adversely influenced the outcome. Materials and methods: Patients with...

Post-thyroidectomy neck hematoma represents a major concern for surgeons because it can result in severe and even life-threatening complications. In fact, postoperative hemorrhage may result in airway compression and respiratory distress, and therefore, effective hemostasis is an important goal in thyroid surgery. Postoperative hematoma occurs at a...

Posterior retroperitonoscopic adrenalectomy (PRA) has become a standard approach to the adrenal gland. The aim of this study was to report an initial experience with the procedure following a proper preparatory phase highlighting the rapidity, safety and effectiveness by which it could be introduced into a surgeon’s practice. Between May 2015 and J...

The surgical management of papillary thyroid carcinoma remains contentious and the optimal surgical strategy has not been yet established. The extent of thyroid resection has been the nub of this debate. Literature lacks prospective randomized controlled trials that could help put this debate to rest, and these have been labeled as being impractica...

Purpose: Minimally invasive video-assisted parathyroidectomy (MIVAP) is one of the most widespread targeted parathyroid surgeries for primary hyperparathyroidism (PHP). The aim of this study was to assess its limits and propose an expansion of its indications in the management of parathyroid pathology. Methods: A retrospective analysis of 77 con...

Background: Injury to thoracic duct is a rare potential complication of time-honored conventional thyroidectomy. Nevertheless, it can be a cause of significant morbidity, and sometimes life-threatening. Patient findings: A 78-year-old female patient with a previous surgical history of thyroid lobectomy for nodular disease presented with primary...

Background. In the era of minimal access thyroid surgery, the terms minimal access and minimally invasive are often used interchangeably and in most instances this is far from being accurate. The aim of this article is to examine the characteristics and potential of one of the first minimal access thyroid procedures described; minimally invasive vi...

BRAF mutations represent the most common genetic alteration in papillary thyroid carcinoma (PTC). The p.V600E mutation is specific for the classic and tall-cell variants of PTC and has been associated with a more aggressive biologic behavior. On the other hand, the p.K601E mutation is peculiar to the follicular variant of PTC, and seems to be a fav...

Background. Since the early 1990s endoscopic adrenalectomy has become the gold standard surgical approach to the adrenal gland with the most widely used approach being lateral transperitoneal adrenalectomy (LTA). Posterior retroperitonoscopic adrenalectomy (PRA) is another safe and effective approach to the adrenal gland. However, it has not gained...

Targeted parathyroid surgery also referred to as minimally invasive parathyroidectomy has replaced full neck exploration as the preferred surgical approach to primary hyperparathyroidism. This is attributed to the ability to accurately localize enlarged parathyroid glands preoperatively and obtain objective evidence of adequate resection intraopera...