General Surgery

Question 1

Surgeries done in lithotomy position.
Complications?

Answer 1

1) Obstetric
2) Gynaecological
3) Urogenital surgeries : TURP, Cystoscopy
4) Piles, anal fissures

Comolication: Common peroneal nerve injury if adequate padding is not provided on the stirrups on which legs are supported

Question 2

Surgeries done in lateral/kidney positions. What is the possible complication?

Answer 2

1) Thoracotomy
2) Latissimus dorsi flap for breast reconstruction
3) Pyelolithotomy
4) Nephrolithotomy
5) Nephrectomy

Complication: Over abduction of arm can cause brachial plexus injury

Question 3

Surgeries done in Fowlers position.
Complications & how to prevent?

Answer 3

1) CNS Fossa (posterior fossa)
2) Breast reconstruction may be done in this position

Complication: Air embolism

Prevention:
-Ligating the veins before cutting them
-Saline irrigation into the field so that air doesn’t get sucked in

Question 4

What is Durant’s position?
When is it used?

Answer 4

Left lateral decubitus with foot end up.
Aka Recovery position.

It is used when pt develops Air embolism during surgery (suspected if vitals become suddenly deranged)

After the pt is put in this position, we aspirate air from central line or directly from the heart using a needle under guidance.

Question 5

What is Lloyd Davies position?
Surgeries done in this position?

Answer 5

Trendelenberg + Lithotomy

Uses: Rectum & anal canal surgeries
1) LAR
2) APR

Question 6

Prolene suture properties & uses

Answer 6

• It is a polypropylene monofilament suture
• Blue in colour
• Non-absorbable, synthetic

Uses:
1) Hernia mesh
2) Rectus sheath repair (No. 1 cutting needle)
3) Vascular repair/anastomosis
> 4-0 for Aorta
> 5-0 for Femoral
> 6-0 for Popliteal

Question 7

What is Jenkins theory of mass closure?

Answer 7

Applied while suturing Rectus sheath.
Length of the thread should be at least 4 times the length of the wound.
Less tension & short bites can prevent burst abdomen.

Question 8

Nylon suture uses

Answer 8

It is a synthetic , non absorbable suture.

Uses:
1) Skin (3-0, cutting needle)
2) Fix drains (3-0 cutting needle)
3) Bowel anastomosis (3-0 Round body needle)
4) Nerve repair
5) Tendon repair
6) Cataract surgery (10-0)

Question 9

Use of steel suture.

Answer 9

To close sternotomy incision after CABG