Chapter 5: Surgery

Question 1

Name 10 laprascopic surgeries, including the ones that are currently under evaluations

Answer 1

appendicectomy
fundoplication
splenectomy
adrenalectomy

hernia repair
colectomy
nephrectomy
parathyroidectomy
sentinel node biopsy
perforated peptic ulcer repair

Question 2

Advantages of laproscopy

Answer 2

Minimally invasive therefore less complications
pt feels better sooner
can go to work earlier
less post-op pain
less immunological suppressive

Question 3

Problem with Minimal Access Surgery (laproscopy)

Answer 3

Inspection: anatomy looks differently due to different surgical approach
Palpation: difficult to palpate lesions in the colon due to restricted access - pre-op diagnosis has to be extensive due to this
Skill!

Question 4

Problems for pts + GP due to Minimal Access Surgery (Post-op Complications)

Answer 4

Early discharge (ex haemorrhage) may make it hard to pinpoint where the problems is occurring
Loss of tell-tale scars: when the scar loses its consistency and vanishes - leaving the surgeon to debate if the pt had a surgery in the first place

Question 5

Not suitable for day case surgery

Answer 5

children who are difficult to supervise
severe dementia
severe learning difficulties
BMI >32
Living alone
Stairs
Infection at the site of operation

Question 6

Discharge Checklist for Use after Day-Case Surgery

Answer 6

L: Lucid, but not vomiting and cough reflex established
E: Easy breathing, easy urination
A: Able to walk without fainting (Ambulatory)
P: Pain relief + post-op drugs + dispensed/given
F: Follow up
R: Rate Rhythm BP
O: Op site checked + explained to pt
G: GP letter, to explain what happened