Final

Question 0

Anal Fistula Removal

Answer 0

What?
An anal fistula, or fistula-in-ano, is an abnormal connection between the epithelialized surface of the anal canal and (usually) the perianal skin.
Anal fistulae originate from the anal glands, which are located between the two layers of the anal sphincters and which drain into the anal canal. If the outlet of these glands becomes blocked, an abscess can form, which can eventually point to the skin surface. The tract formed by this process is the fistula.

Why?
Anal fistula repair is done if the patient has repeated abscesses in the anal and rectal areas or if the patient is experiencing chronic discharge from the fistula.

Question 1

Anal Fissure Removal and Sphincterotomy

Answer 1

What?
An anal fissure is a crack or tear(s) in the membrane that is the lining of the anus or anal canal. This procedure allows for removal of the anal fissure and for incision of the muscular anal sphincter - to allow for the fissure repair.

Why?
To relieve the pain related to an anal fissure.

Question 2

Appendectomy

Answer 2

What?
An appendectomy is the surgical removal of the vermiform appendix. The appendix is an outgrowth of tissue from the cecum (the first part of the large intestine).

Why?
The appendix may become infected and then needs to be removed. The patient may experience abdominal pain, loss of appetite, tenderness in the right lower quadrant, low-grade fever, and an elevated white blood cell count if the appendix is infected. It is usually an emergency to prevent the inflamed or infected appendix from rupturing.

Question 3

Bariatric Surgery (Gastric Bypass)

Answer 3

What?
Bariatric surgery, or weight-loss surgery, is a type of procedure performed on people who are dangerously obese, for the purpose of losing weight. This weight-loss is usually achieved by reducing the size of the stomach with an implanted medical device, gastric banding, or through removal of a portion of the stomach (sleeve gastrectomy or biliopancreatic diversion with duodenal switch) or by resecting and rerouting the small intestines to a small stomach pouch (gastric bypass surgery).

Why?
For patients who are morbidly obese with the purpose of losing weight.

Question 4

Cholecystectomy (Laparoscopic)

Gallbladder Removal

Answer 4

What?
Cholecystectomy is the surgical removal of the gallbladder. It is the most common method for treating systematic gallstones. Surgical options include the standard procedure, called laparoscopic cholecystectomy, and an older more invasive procedure, called open cholecystectomy.

A laparoscope (a fiber-optic instrument) is used for diagnostic imaging and surgical procedures. In this case, it is used to remove the gallbladder.

Why?
Laparoscopic cholecystectomy is done to treat gallstones, treat acute inflammation of the bladder, treat malignant or benign gallbladder tumours.

Question 5

Cholecystectomy, Open

Gallbladder Removal

Answer 5

What?
A traditional open cholecystectomy is a major abdominal surgery in which the surgeon removes the gallbladder. The risks of doing the surgery increase, in addition to items mentioned in the general G.I. surgeries file, if the patient has: cirrhosis of the liver, calcification of the gallbladder, and COPD (chronic obstructive pulmonary disease.

Why?
Open cholecystectomy is done to treat gallstones, chronic gallbladder infection, suspected gallbladder tumors, and sudden, severe infection of the gallbladder that is not resolved quickly with treatment such as antibiotics.

Question 6

Colonoscopy

Answer 6

What?
Colonoscopy is the endoscopic examination of the colon to the distal part of the small bowel with a fiber optic camera on a flexible tube (called a colonoscope) passed through the anus. It may provide a visual diagnosis (ulceration polyps) and grants the opportunity for biopsy or removal of suspected lesions.

Colonoscopy is similar to but not the same as sigmoidoscopy, the difference being related to which parts of the colon each can examine. While colonoscopy allows an examination of the entire colon, measuring 4 to 5 feet in length, sigmoidoscopy allows doctors to view only the final 2 feet of the colon. Sigmoidoscopy is often used as a screening procedure for a full colonoscopy.

Why?
Conditions that call for colonoscopies include gastrointestinal hemorrhage, unexplained changes in bowel habits and suspicion of malignancy. Colonoscopies are often used to diagnose colon cancer, but are also frequently used to diagnose inflammatory bowel disease.

Question 7

Colostomy

Answer 7

What?
Colostomy is a reversible surgical procedure in which a stoma is formed by drawing the healthy end of the large intestine or colon through an incision in the anterior abdominal wall and suturing it into place.

Why?
This opening, in conjunction with the attached stoma appliance, provides an alternative channel for feces to leave the body. This new opening may be temporary to allow healing in a portion of the colon or it may be permanent.

Question 8

Esophagectomy

Answer 8

What? Esophagectomy is the surgical removal of all or part of the esophagus. The esophagus, sometimes known as the gullet, is an organ in vertebrates which consists of a muscular tube through which food passes through from the pharynx to the stomach.

Why?

• To correct a congenital defect in newborns where the esophagus has a closure and needs to be opened to allow for passage of food, called esophageal atresia.
• Cancer of the esophagus.
• Blockage or occlusions caused by burns or scarring.

Question 9

Gastroenterostomy for Pyloric Stenosis

Answer 9

What?
A gastroenterostomy is the surgical creation of a connection between the stomach and the jejunum (the upper small intestine). This allows for bypassing any obstructions caused by scarred tissue or pyloric stenosis. Surgical risks increase with adults older than 60 and for newborns/infants, under a year.

Why?
Allows for normal functioning of the gastrointestinal system and digestion.

Question 10

Gastrostomy, Percutaneous Endoscopic

PEG procedure

Answer 10

What?
Percutaneous endoscopic gastrostomy is a surgical technique that allows placement of a feeding tube, without having to use a general anesthetic or create a surgical incision in the abdomen.

Why?
PEG administration of control feeds is the most commonly used method of nutritional support for patients in the community. Many stroke patients, for example, are at risk of aspiration pneumonia due to poor control over the swallowing muscles, some will benefit from a PEG to maintain nutrition. PEG may also be inserted to decompress the stomach in cases of gastric volvulus.

Question 11

Gastrostomy

Answer 11

What?
Gastrostomy refers to a surgical opening into the stomach.

Why?
Creation of an artificial external opening into the stomach for nutritional support or gastrointestinal compassion. The opening maybe used for feeding, such as with a gastrostomy tube.

Question 12

Hemorrhoidectomy

Answer 12

What?
A hemorrhoid is a varicose vein on the outside of the anus or just inside the rectum. Hemorrhoidectomy is the surgical removal of hemorrhoids.

Why?
Hemorrhoidectomy is done to relieve pain, bleeding, and itching. Thrombosed hemorrhoids (contain a blood clot) are removed to relieve severe pain.

Question 13

Ileostomy

Answer 13

What?
An ileostomy is the surgical creation of an opening in the ileum, the lower part of the small intestine. This creates an ostomy or a stoma to the outside of the body through which all fecal matter will leave the body. Surgical risks increase for infants and newborns.

Why? 
Ileostomies are necessary where disease or injury has rendered the large intestine incapable of safely processing intestinal waste, typically because the colon has been partially or wholly removed. Diseases of the large intestine which may require surgical removal include:
- Crohn's disease
- ulcerative colitis
- familial adenomatous polyposis
- total colonic Hirschsprung's disease

Question 14

Peptic Ulcer Surgery

Answer 14

What?
A Peptic ulcer (defined as mucosal erosions equal to or greater than 0.5 cm) of an area of the gastrointestinal tract that is usually acidic and thus extremely painful.

Why?
Peptic ulcer surgery is used to treat complications of peptic ulcers that affect the esophagus, stomach, small intestine (duodenum and jejunum).
- Complications of peptic ulcers
- Gastrointestinal bleeding
- Pain
- Scarring, causing obstruction, preventing the contents of the stomach from moving onto the intestine
- Perforation of the stomach wall (peritonitis is caused at the stomach contents go to a perforation into the abdominal cavity. This requires immediate surgery).

Question 15

Polypectomy - Rectal or Colon

Polyp Removal

Answer 15

What?
Polypectomy is a medical term for the removal of a polyp. Polypectomy can be performed by excision if the polyp is external (on the skin). Gastrointestinal polyps can be removed endoscopically through colonoscopy or esophagogastroduodenoscopy, or surgically if the polyp is too large to remove endoscopically.

A polyp is a fleshy growth of the lining in the nose or in the wall of colon/rectum. Often a polyp is considered a sign of possible malignancy, mainly in the colon. Rectal/Colon polypectomy is the surgical removal of polyp(s) from the membranous lining of the rectum or colon.

Why?
Rectal/Colon polypectomy is done to relieve symptoms of pain or bleeding as well as to remove a potentially cancerous growth.

Question 16

Rectovaginal Fistula Repair

Answer 16

What?

• A fistula is an abnormal passage. Rectovaginal fistula is a passage that joins the rectum to the vagina - allowing fecal matter to enter the vagina.
• If the opening between the rectum and vagina is wide it will allow both flatulence and feces to escape through the vagina, leading to fecal incontinence. There is an association with recurrent urinary and vaginal infections.
• Rectovaginal fistulae are often the result of trauma during childbirth (in which case it is known as obstetric fistula) in situations where there is an inadequate healthcare, such as in some developing countries.
• Fistulas can also develop and women and children were great.
• Rectovaginal fistula can also be a symptom of various diseases, including infection by some bacterium, or the unintended result of surgery, such as episiotomy or sexual reassignment surgery.
• They may present as a complication of vaginal surgery, including vagina hysterectomy. They are a recognized presentation of rectal carcinoma, or rarely diverticular disease of the bowel, or Crohn’s disease.
• Rectovagina fistula repair is a surgical correction of an abnormal passageway or tract between the rectum and the vagina.

Why?
To prevent fecal matter from entering the vagina, therefore contaminating the urinary tract and vagina, leading to potential infection.

Question 17

Sigmoid Colectomy

Sigmoid Colon Removal

Answer 17

What?
Colectomy consists of the surgical resection of any extent of the large intestine (colon). The sigmoid colon is the portion of the large intestine that is on the left side of the body and descends from the transverse colon to the rectum. The risks for this surgery are increased for infants/newborns. If there has been recent illness such as diverticulitis, and for adults over 60.

Why?
The procedure is done to treat:
- precancerous or malignant/cancerous polyps
- colon cancer.
- Infection and bleeding, caused by diverticulitis.
- Diverticulitis and diverticular disease of the large intestine.
- Ruptured diverticular - causing peritonitis from the infection, due to severe diverticulitis.
- trauma
- Inflammatory bowel disease such as ulcerative colitis or Crohn’s disease.

Question 18

Small Bowel Resection

Answer 18

Why?
Small bowel resection is the removal of a section of the small intestine (duodenum, jejenum, ileum) due to disease.

Why? 
It may be performed due to:
- Cancer
- Necrosis, death of tissue
- Enteritis, intestinal inflammation
- Intestinal obstruction
Some patients require Ileostomy after this procedure.

Question 19

Vagotomy

Answer 19

Why?
Vagotomy is surgical procedure in humans and animals that involves resection (Removal of, or at least severing) of part of the vagus nerve. The vagus nerve is the XII cranial nerve and serves many organs (heart, skeletal muscles, colon, stomach, and much more).There is a vagus nerve in the stomach area. To decrease the production of acid in the stomach, the vagus nerve branches can be severed.

Why?
This surgery is normally done prior to other Gastrointestinal surgeries to minimize the amount of stomach acid. Disconnection of branches of the vagus nerve can treat some complications of peptic ulcers. Some of these complications are: Perforation of the ulcer, bleeding ulcers, uncontrollable abdominal pain.

Question 20

Abdominoperineal Resection

Answer 20

What?
Resection, in surgery, refers to removal of an organ or lesion by cutting it away from the body or the remainder of the tissue.

The principal reason for abdominoperineal resection (APR) is a rectal carcinoma situated in the distal (lower) one third of the rectum. APRs involves removal of the anus, the rectum, and part of the sigmoid colon along with the lymph nodes in the area.

Why?
To remove cancer of the anus or rectum.

Question 21

Baker’s Cyst Removal

Answer 21

What?
Baker’s cyst (also known as Popliteal cyst) is a benign swelling of the semi-membranous bursa found behind the knee joint.

Baker’s cyst removal is the surgical removal of the cyst, which consists of fluid behind the knee, causing pain and difficulty bending the knee. It is normally the benign.

Why?
If the cyst does not go away by treating any underlying disease, the cyst can be removed prior to becoming very painful, large, and disfiguring. Normally the cyst will heal on its own in children. It will only be removed in children if it is pressing on a nerve or blood supply.

Question 22

Bone-Marrow Transplant

Answer 22

What?
Definition of transplant: an organ transplant is the moving of an organ from one body to another (or from a donor site on the patient’s own body, in some cases) for the purpose of replacing the recipient damaged or absent organ.

Bone marrow is removed from part of the hipbone (the ilium) from one person (the donor) and given to a another person (the recipient) through a vein (the blood stream).

Why?
A bone marrow transplant is sometimes needed if the recipient has a poor immune system that may have been weakened due to:
- Aplastic anemia (a condition where bone marrow does not produce sufficient new cells to replenish blood cells).
- Leukemia, a cancer of the blood or bone marrow characterized by an abnormal increase of blood cells, usually leukocytes (white blood cells)
- Multiple myeloma, a cancer of the white blood cells.
- Sickle cell disease, a genetic blood disorder characterized by red blood cells that assume an abnormal, rigid, sickle shape. Sickling decreases the cells’ flexibility and results in the risk of serious complications.
- Myelodysplastic syndrome (a diverse collection of hematological conditions).
- Neuroblastoma (the most common extracranial solid cancer in childhood and infancy).
- Lymphoma (a cancer that begins in the lymphatic cells of the immune system and presents as a solid tumor).
- Ewing’s sarcoma (a malignant round-cell tumor. It is a rare disease in which cancerous cells are found in the bone or in soft tissue)
- Desmoplastic small round tumour (a soft tissue sarcoma. It is an aggressive and rare tumor).
- Hodgkin’s disease (a type of cancer originating from white blood cells called lymphocytes. A type of lymphoma.)
- A Bone marrow transplant can be used as a method to treat HIV

Question 23

Gastrectomy - (Stomach Cancer Surgery)

Answer 23

What?
A gastrectomy is a partial or full surgical removal of the stomach.

Why?
Gastrectomies are performed to treat cancer and perforations of the stomach wall.

Question 24

Laryngectomy

Answer 24

What?
The larynx, commonly called the voice box, is an organ in the neck of mammals involved in protecting the trachea and sound production. It manipulates pitch and volume. The larynx houses the vocal folds, which are an essential component of phonation. The vocal folds are situated just below where the tract of the pharynx splits into the trachea and the esophagus.

Laryngectomy is the removal of the larynx and separation of the airway from the mouth, nose, and esophagus. Laryngectomee breathes through an opening in the neck, a stoma.

Why?
It is done in cases of laryngeal cancer. However, many laryngeal cancer cases are now treated only with radiation and chemotherapy or other laser procedures, and laryngectomy is performed when those treatments fail to conserve the larynx.

Question 25

Lipoma Removal

Answer 25

What?
A lipoma is a benign, fatty mass (also called a tumor). Lipomas are soft to the touch, usually movable, and are generally painless. Lipomas normally show on the back, legs, or arms. They can lie on top of the muscle (easier to remove) or under the muscle (which is more difficult to remove). Lipoma removal is the surgical removal of this body mass.

Why?

• Done for cosmetic reasons, to improve the person’s appearance (especially if it is a large lipoma).
• Occasionally a lipoma can cause irritation or discomfort (if it is at the bra strap area or at the waistline)
• A lipoma progressing to cancer is a rare occurrence (but the lipoma may be removed to prevent this eventuality).

Question 26

Mastectomy, Modified Radical

Answer 26

What?
Modified radical mastectomy is a surgical procedure in which the breast tissue and lymph nodes of the axilla are removed as a treatment for breast cancer. The underlying chest muscle (including pectoralis major and pectoralis minor) is not removed.

Why?
For malignancy (cancer) of the breast.

Question 27

Mastectomy, Partial- (Lumpectomy)

Answer 27

What?
Lumpectomy, (Partial Mastectomy) is a common surgical procedure designed to remove a discrete length, usually a benign tumor or breast cancer, found an affected man or woman’s breast. As the tissue removed is generally quite limited and the procedure relatively non–invasive, compared to a mastectomy, a lump ectomy is considered a viable means of “breast conservation” or “breast preservation” with all the attendant physical and emotional advantages of such an approach.

Why?
If cancer (malignancy) is suspected or confirmed in the breast, and if a lumpectomy is appropriate, the cancer will be removed using this method.
Lumpectomy may be performed for ductal carcinoma in situ (DCIS), for invasive ductal carcinoma, or for other conditions.

Question 28

Melanoma Removal

Answer 28

What?
The most dangerous form of skin cancer is malignant melanoma. Melanoma removal is the removal of any skin lesion that is suspected of being malignant Melanoma.

Melanoma is a malignant tumor of melanocytes. Such cells are found predominately in skin, but are also found in the bowel and the eye.

Melanoma is one of the least common types of skin cancer, but causes the majority (75%) of skin cancer related deaths. Melanocytes are normally present in skin, being responsible for the production of the dark pigment melanin. Despite many years of intensive laboratory and clinical research, early surgical resection of the thin tumours still gives the greatest chance of cure.

Why?
To treat malignant (cancerous) melanoma.

Question 29

Morton’s Neuroma Removal

Answer 29

What?
The most common Naroma is Mortensen aroma in the foot, and is benign. It is a thickening or enlargement of the nerve. It occurs between the second and third toes or the third and fourth toes, producing great pain. The cause has not been determined. This problem is characterized by numbness and pain, relieved by going Barefoot (not wearing shoes).

Why?
Removal of Morton’s Naroma will relieve the pain.

Question 30

Myomectomy (Fibroid Tumour Removal)

Answer 30

What?
A leiomyoma is a fibroid tumour in the uterus. Myomectomy is the removal of these tumors through a lower abdominal incision.
There is increased surgical risk if the patient is anemic due to poor iron intake and poor nutrition.

Why?
Removal is called for when the fibroid causes pain or pressure, abnormal bleeding, or interferes with reproduction.

Question 31

Ovarian Cyst or Tumour Removal

Answer 31

What?
An ovarian cyst is any collection of fluid, surrounded by a very thin wall, within an ovary. Any ovarian follicle that is larger than about 2 cm is termed an ovarian cyst. An ovarian cyst can be as small as a pea or larger than orange.
Most ovarian cysts are functional in nature, and harmless. Ovarian cyst affect women of all ages. They occur most often, however, during a woman’s childbearing years.

This procedure allows for the removal of cyst on the ovary.

Why?
This procedure is done to treat…
- Suspected or known cancer of the ovaries
- Ruptured ovarian cysts
- Twisted ovarian cysts

Question 32

Prostatectomy, Suprapubic Transvesicle

Prostate Gland Removal

Answer 32

What?
Suprapubic prostatectomy is the removal, through an opening in the abdomen, of all or part of an enlarged or cancerous prostate gland. This will involve the prostate gland, the bladder, urethra, and it will affect the rectum.

This type of open prostatectomy is suprapubic transvesicle prostatectomy (SPP) where an incision is made in the bladder. SPP remains a common surgical treatment for BPH (Benign Prostatic Hypertrophy) in Africa but has largely been replaced by TURP (Transurethral Resection of the Prostate) in the North America for this application. SPP may be indicated for use with large patients.

Why?
This procedure is done to allow restoration of normal urination.