Abdominal Exploratory Surgery

Question 1

What are the major advantages of exploratory celiotomies?

Answer 1

• technical ease
• ability to perform both diagnositc and therapeutic procedures simultaneously
• efficiency
• ability to achieve hemostasis
• ability to obtain high quality biopsy samples

Question 2

What are the disadvantages to using flexible endoscopy for abdominal exploratory surgery?

Answer 2

need for anesthesia and inability to obtain full-thickness GI biopsies

Question 3

How do the methods of laparoscopically obtaining biopsies from liver, kidney, GI, and lymph node differ?

Answer 3

liver and kidney biopsies are performed intracorporeally, while GI and lymph node biopsies are performed extracorporeally

Question 4

What the advantages and disadvantages of using laparoscopy?

Answer 4

• A: allow abdominal exploration, full-thickness biopsy sampling, hemostasis, and completion of therapeutic procedures via small keyhole incisions
• DA: cost, technical difficulty, and requirement of trained staff to trouble shoot equipment and potential anesthetic complications

Question 5

What are the most common methods used to get a liver biopsy?

Answer 5

Baker’s punch method and the sutured guillotine technique (diffuse lesions)

Question 6

What is the appropriate way to close the linea alba?

Answer 6

full thickness sutures in the cranial aspect where there is little muscle, while wide partial thickness bites are taken to only incorporate the external rectus fascia in the caudal aspect of the incision

Question 7

Why might someone choose to make an omental patch after taking an intestinal biopsy?

Answer 7

it improves healing primarily by its rich vascular and lymphatic supply

Question 8

What do you use to obtain a kidney biopsy?

Answer 8

a spring-loaded needle biopsy instrument (Tru-Cut)