Table 2 Task analysis

1

Find the MM nerve

1.1 Use landmarks

1.2 Cut parallel to nerve with scalpel

1.3 Trace retrograde

2

Dissect external jugular vein from anterior border of SCM

3

Unwrap the SCM

3.1 Grasp SCM in nondominant hand, retracting laterally

3.2 Run monopolar along edge of SCM

3.3 Roll SCM laterally

4

Identify CN XI

5

Identify posterior belly of digastric

5.1 Identify posterior edge of submandibular gland

5.2 Identify digastric tendon using army navy and dental

5.3 Dissect superficial to the muscle in posterior direction

6

Skeletonize CN XI

7

Expose carpet/floor of neck

7.1 Identify IJV

7.2 Dissect superior aspect of IJV

7.3 Find carpet in the lateral posterior border of jugular vein

8

Release level IIb

8.1 Monopolar or bipolar scissors to remove fibrofatty tissue from level IIB

8.2 Dunk under CN XI

9

Free nodal packet from IJV inferiorly

9.1 Identify the IJV

9.2 Dissect nodal packet free off IJV

9.3 Cut fascia posterior to jugular vein

9.4 Use dentals to sweep nodal packet superiorly

9.5 Identify phrenic

9.6 Cut omohyoid as goes into level V of neck

10

Dissect out and preserve cervical rootlets

10.1 Use 15blade and run parallel to posterior SCM

10.2 Identify cervical rootlets

10.3 Change to plane medial to rootlets

11

Identify the vagus nerve

11.1 Identify carotid sheath

11.2 Identify vagus nerve

11.3 Cut on vagus in a parallel plane

12

Free the IJV

12.1 Incise sheath over IJV

12.2 Cut parallel to “white line”

12.3 Identify and preserve any branches of IJV

13

Hypoglossal nerve

13.1 Identify hypoglossal nerve with blunt dissection or dental anterior to jugular vein

13.2 Release nodal pack superior to inferior preserving lingual vein and hypoglossal nerve

14

Dissect down to strap muscles

14.1 Identify ansa

14.2 Cut medial to ansa

14.3 Identify and preserve superior thyroid artery and veins

14.4 Continue and identify strap muscles

15

Free nodal package from straps and digastric

15.1 use monopolar cautery to free up