There are various methods that can be implemented for systemic dissection. These methods vary with dissection sequences and procedures but the aim remains the same. The doctor can adapt to any of the procedures described below as per requirement of the case and diagnosis of the disease.
Till date, many techniques have been developed for postmortem examination. Most common ones include Virchow, Ghon, Letulle and Rokitansky procedure. However, Rokitansky procedure, characterizing in-situ dissection without removal of any organs, have failed to convince medical examiners over time and is less routinely done.
Virchow method is used by examiners when removal of organ one by one is desired. Disadvantage of this method is that a clear picture of inter-organ relationship is lost. For example removal of kidneys alone and examining it may not be helpful to understand pathology involving ureters and bladder.
Ghon method removes thoracic, abdominal and genitourinary organs in separate blocks whereas Letulle’s method removes all the organs from tongue to rectum in a single mass (en-masse).
As an examiner, one should be prepared to modify any standard autopsy technique to best demonstrate the pathologic changes and important pathologic relationships. Regardless of the method of dissection, well-maintained instruments can make the work less tedious. A list of instruments useful in postmortem procedures is presented below.
Instruments and equipment useful for postmortem examinations
- Organ knife 10 inches or 15 inches
- Scalpel knife holder and no. 22 disposable blades
- Forceps, teeth, 10 inches
- Forceps, teeth, 6 inches
- Forceps, serrated tips, 6 inches
- Forceps, Adson, teeth
- Forceps, Adson, serrated tips
- Forceps, straight and curved, 8 inches
- Mosquito forceps, straight and curved, 5 inches
- Scissors, , straight, 9 inches
- Scissors, curved, 9 inches
- Scissors, straight round point 5.5 inches
- Scissors, curved round point 5.5 inches
- Enterotome (intestinal) scissors, 8 inches
- Wire cutters
- Rib shears
- Probe, 1 mm thickness
- Postmortem hammer
- Millet and chisel
- Self-oscillating (Stryker) saw
- Small ruler
- Meter stick
- Plastic-coated measuring tape
- Postmortem needles