009 Principles of Urologic Surgery - Incisions and Access Flashcards
There remains several indications for open surgical approaches in urology. Decisions regarding open versus minimally invasive approaches depend on __, __, and __.
There remains several indications for open surgical approaches in urology. Decisions regarding open versus minimally invasive approaches depend on COMPLEXITY/SIZE OF PATHOLOGY, PATIENT PREFERENCE, and SURGEON’S SKILL SET.
Knowledge of the abdominal wall musculature and anatomy are important to avoid key vessels and nerves when making incisions. These can usually be avoided by staying in the __.
Knowledge of the abdominal wall musculature and anatomy are important to avoid key vessels and nerves when making incisions. These can usually be avoided by staying in the MIDLINE.
__ can be used to access pelvic, intraperitoneal, retroperitoneal, and extraperitoneal structures. Urologists most commonly use a __ for access to the bladder and prostate.
ANTERIOR ABDOMINAL INCISIONS can be used to access pelvic, intraperitoneal, retroperitoneal, and extraperitoneal structures. Urologists most commonly use a LOWER MIDLINE INCISION for access to the bladder and prostate.
There are many open approaches to the kidney, each with their own advantages and disadvantages. Usually the kidney is approached via __, however __ were a traditional approach which are being explored again by some groups.
There are many open approaches to the kidney, each with their own advantages and disadvantages. Usually the kidney is approached via ANTERIOR OR FLANK INCISIONS, however DORSAL INCISIONS were a traditional approach which are being explored again by some groups.
__ traditionally have some advantages over anterior abdominal incisions, but with current minimally invasive options, this incision is used far less commonly. The lumbodorsal region is bordered between the __ superiorly, __ inferiorly, __ medially, and __ laterally.
DORSAL LUMBOTOMY INCISIONS traditionally have some advantages over anterior abdominal incisions, but with current minimally invasive options, this incision is used far less commonly. The lumbodorsal region is bordered between the 12TH RIB superiorly, ILIAC CREST inferiorly, SPINOUS PROCESSES medially, and AN IMAGINARY LINE BETWEEN THE ASIS AND COSTAL MARGIN laterally.
Inguinal incisions can be above or below the __ depending on the indication. They give access to contents of the spermatic cord, testicle, and ilio-inguinal lymph nodes.
Inguinal incisions can be above or below the INGUINAL LIGAMENT depending on the indication. They give access to contents of the spermatic cord, testicle, and ilio-inguinal lymph nodes.
Adult circumcisions are commonly performed through a __ on either side of the prepuce.
Adult circumcisions are commonly performed through a TWO-INCISION TECHNIQUE on either side of the prepuce.
__ is necessary for scrotal and penile incisions as one can have significant bruising and bleeding complications.
METICULOUS HEMOSTASIS is necessary for scrotal and penile incisions as one can have significant bruising and bleeding complications.
__ might become more common for various pelvic procedures with the development of new robotic technology.
PERINEAL INCISIONS might become more common for various pelvic procedures with the development of new robotic technology.
A __ is used for trauma nephrectomies. __ are used for transplants and transplant nephrectomies.
A COMPLETE MIDLINE INCISION (LAPAROTOMY INCISION) is used for trauma nephrectomies. GIBSON INCISIONS are used for transplants and transplant nephrectomies.
When closing abdominal fascia, one should not use __ as these have been linked to higher hernia rates.
When closing abdominal fascia, one should not use RAPIDLY ABSORBABLE SUTURES as these have been linked to higher hernia rates.
__ are better for specimen extractions than extension of a port site during minimally invasive procedures.
PFANNENSTIEL INCISIONS are better for specimen extractions than extension of a port site during minimally invasive procedures.
__ are usually made above the 9th and 10th rib bed, although they can be modified through the 8th rib bed and combined with a __ along with the standard longitudinal abdominal incision. A chest tube is not always required unless a parietal pleural injury is suspected.
THORACOABDOMINAL INCISIONS are usually made above the 9th and 10th rib bed, although they can be modified through the 8th rib bed and combined with a SUBCOSTAL INCISION along with the standard longitudinal abdominal incision. A chest tube is not always required unless a parietal pleural injury is suspected.
Penile fractures can be approached through a __ or by directly incising onto the suspected injury if the region is confirmed with imaging.
Penile fractures can be approached through a DEGLOVING TECHNIQUE or by directly incising onto the suspected injury if the region is confirmed with imaging.
With advancements in minimally invasive surgery and surgical technique, many incisions are being revisited for modern indications. These include __ for partial nephrectomies and __ for robotic prostatectomies or cystectomies.
With advancements in minimally invasive surgery and surgical technique, many incisions are being revisited for modern indications. These include LUMBODORSAL APPROACH for partial nephrectomies and PERINEAL INCISION for robotic prostatectomies or cystectomies.
