Holding only the non-viable tissue, the surgeon dissected along the skin interface circumferentially, freeing the placode and leaving the cicatrix temporarily attached to the skin.
The surgeon then released any arachnoid tethering the placode, resected any filum terminale, and detached the placode from inferior nonviable roots that attach to the deep surface of the myelomeningocele. The use of electrocautery (most bleeding will stop with tamponade) and the direct handling of any tissue that you are leaving behind is minimized.
Notes:
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