1- Intestinal and urinary surgery Flashcards
Name the 4 layers of the bowel
Outer serosa
Muscularis- longitudinal and circular
Submucosal
Mucosa
What are stay sutures?
Temporary sutures put in at time of surgery to allow the assistant to manipulate the tissue without using forceps
Define a gastrotomy
incision into the stomach
What is omentalisation and why is it used?
Draping the greater omentum over the incisions/organs
Improves vascular supply, and lymphatic drainage, rich source of inflammatory & immunogenic cells (remove bacteria)
Define intussusception
A portion of bowel invaginates into an adjacent segment of bowel
Can cause bowel obstruction
Define enterotomy
incision into the intestines
What type of sutures should you use when closing a enterotomy?
Simple interrupted or simple continuous appositional
What is a leak test?
Clamp of the bowel either side of incision, inject sterile saline into lumen - does it leak?
What is an enterectomy?
Removal of a piece of intestine
What is a subtotal colectomy?
Removal of colon
Explain the principles of feeding postoperatively
Starvation after GI surgery is considered detrimental to healing
Early enteral nutrition indicated in most circumstances
Oral route best but other routes in different circumstances
When it comes to closing the bowel or bladder, what is the most important layer in terms of suture holding and strength?
Submucosa
In a gastrotomy how is the stomach held open and why
with stay sutures and packed off with saline soaked swabs
Ease of surgery and to prevent peritonitis
When closing a gastrotomy, what are the 2 seperate layers that you close composed of
layer 1- serosa and muscular layers
Layer 2 - submucosa and mucosa
What are the 2 ways of closing the stomach
one layer closure- closing all at once
two layer closure- close submucosa and mucosa seperately to the rest on the stomahc
