Chapter 13: Surgical Operations You Should Know

Question 1

Billroth I

Answer 1

Antrectomy with gastroduodenostomy

Question 2

Billroth II

Answer 2

Antrectomy with gastrojejunostomy

Question 3

How can the difference between a Billroth I and Billroth II be remembered?

Answer 3

Billroth 1 has one limb; Billroth 2 has two limbs

Question 4

Roux-en-Y limb

Answer 4

Jejunojejunostomy forming a Y-shaped figure of small bowel; the free end can then be anastomosed to a second hollow structure (e.g.,esophagojejunostomy)

Question 5

Brooke ileostomy

Answer 5

Standard ileostomy that is folded on itself to protrude from the abdomen ≈2cm to allow easy appliance placement and collection of succus

Question 6

CEA

Answer 6

Carotid EndArterectomy; removal of atherosclerotic plaque from a carotidartery

Question 7

APR

Answer 7

AbdominoPerineal Resection; removal of the rectum and sigmoid colon through abdominal and perineal incisions (patient is l_eft with a colostomy_);used for low rectal cancers

Question 8

LAR

Answer 8

Low Anterior Resection; r_esection of low rectal tumors_ through an anteriorabdominal incision

Question 9

Hartmann’s procedure

Answer 9

1. Proximal colostomy
2. Distal stapled-off colon or rectum that is left in peritoneal cavity

Question 10

Mucous fistula

Answer 10

Distal end of the colon is brought to the abdominal skin as a stoma (proximal end is brought up to skin as an end colostomy)

Question 11

Kocher (“koh-ker”) maneuver

Answer 11

Dissection of the duodenum from the _right-sided peritoneal attachmen_t to allow mobilization and visualization of the back of the duodenum/pancreas

Question 12

Cattel maneuver

Answer 12

Mobilization of the ascending colon to the midline. If combined with a Kocher maneuver, exposes the vena cava

(Think: Cattel = Kocher = rightsided)

Question 13

Seldinger technique

Answer 13

Placement of a central line by first placing a wire in the vein, followed by placing the catheter over the wire

Question 14

Cricothyroidotomy

Answer 14

Emergent surgical airway through the cricoid membrane

Question 15

Hepaticojejunostomy

Answer 15

Anastomosis between a jejunal roux limb and the hepatic bile ducts

Question 16

Puestow procedure

Answer 16

Side-to-side anastomosis of the pancreas and jejunum (pancreatic duct is filleted open)

Question 17

Enterolysis

Answer 17

Lysis of peritoneal adhesions

Question 18

LOA

Answer 18

Lysis Of Adhesions (enterolysis)

Question 19

Appendectomy

Answer 19

Removal of the appendix

Question 20

Lap appy

Answer 20

Laparoscopic removal of the appendix

Question 21

Cholecystectomy

Answer 21

Removal of the gallbladder

Question 22

Lap chole

Answer 22

Laparoscopic removal of the gallbladder

Question 23

Nissen

Answer 23

Nissen fundoplication; 360-degree wrap of the stomach by the fundus of the stomach around the distal esophagus t_o prevent reflux_

Question 24

Lap Nissen

Answer 24

Nissen fundoplication with laparoscopy

Question 25

Simple mastectomy

Answer 25

Removal of breast and nipple **without removal of nodes**

Question 26

Choledochojejunostomy

Answer 26

Anastomosis of the common bile duct to the jejunum (end to side)

Question 27

Graham patch

Answer 27

Placement of omentum with stitches over a gastric or duodenal perforation(i.e., omentum is used to plug the hole)

Question 28

Heineke–Mikulicz pyloroplasty

Answer 28

Longitudinal incision through all layers of the pylorus, sewing closed in a transverse direction t**o make the pylorus nonfunctional** (used *after truncalvagotomy*)

Question 29

Pringle maneuver

Answer 29

Temporary occlusion of the porta hepatis (for temporary control of liver blood flow when liver parenchyma is actively bleeding)

Question 30

Modified radical mastectomy

Answer 30

Removal of the breast, nipple, **and axillary lymph nodes** *(no muscle is removed)*

Question 31

Lumpectomy and radiation

Answer 31

**Removal of breast mass and axillary lymph nodes**; n*ormal surrounding breast tissue is spared;* p_atient then undergoes postoperative radiation treatments_

Question 32

I & D

Answer 32

Incision and Drainage of pus; the wound is then packed open

Question 33

Exploratory laparotomy

Answer 33

Laparotomy to explore the peritoneal cavity l*ooking for the cause* of pain,peritoneal signs, obstruction, hemorrhage, etc.

Question 34

TURP

Answer 34

TransUrethral Resection of the Prostate; removal of obstructing prostatic tissue via scope in the urethral lumen

Question 35

Fem pop bypass

Answer 35

FEMoral artery to POPliteal artery bypass **using synthetic graft or saphenous** **vein;** *used to bypass blockage in the femoral artery*

Question 36

Ax Fem

Answer 36

Long prosthetic graft tunneled under the skin placed from the AXillary artery to the FEMoral artery (Extra-Anatomic bypass)

Question 37

Triple A repair

Answer 37

Repair of an AAA (Abdominal Aortic Aneurysm): 1. Open aneurysm and placeprosthetic graft 2. then close old aneurysm sac around graft

Question 38

CABG

Answer 38

**Coronary Artery Bypass Grafting**; via saphenous vein graft or internalmammary artery bypass grafts to coronary arteries from aorta (cardiac revascularization)

Question 39

Hartmann’s pouch

Answer 39

Oversewing of a rectal stump (or distal colonic stump) after resection of a colonic segment; patient is left with a proximal colostomy

Question 40

PEG

Answer 40

**Percutaneous Endoscopic Gastrostomy:** Endoscope is placed in the stomach,which is then inflated with air; a needle is passed into the stomach percutaneously, wire is passed through the needle traversing the abdominal wall, and the gastrostomy is then placed by using the **Seldinger technique** over the wire

Question 41

Hemicolectomy

Answer 41

Removal of a colonic segment (i.e., partial colectomy)

Question 42

Truncal vagotomy

Answer 42

**Transection of the vagus nerve trunks**; * must provide drainage procedure to stomach * gastrojejunostomy or pyloroplasty * because after truncal vagotomy, **the pylorus does not relax**

Question 43

Antrectomy

Answer 43

Removal of stomach antrum

Question 44

Whipple procedure

Answer 44

**Pancreaticoduodenectomy:** * Cholecystectomy * Truncal vagotomy * Pancreaticoduodenectomy—removal of the head of the pancreas and duodenum * Choledochojejunostomy * Pancreaticojejunostomy (anastomosis of distal pancreas remnant to the jejunum) * Gastrojejunostomy (anastomosis of stomach to jejunum)

Question 45

Excisional biopsy

Answer 45

Biopsy with complete excision of all suspect tissue (mass)

Question 46

Incisional biopsy

Answer 46

Biopsy with incomplete removal of suspect tissue (incises tissue from mass)

Question 47

Tracheostomy

Answer 47

Placement of airway tube into trachea surgically or percutaneously