General Surgery Flashcards

1
Q

Colon Resection

A

Cut made in your abdomen; diseased part of the large bowel is removed and two healthy ends are resected (sewn back together) and cut is closed.

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2
Q

Transverse Colectomy

A

Removal of the transverse colon with appropriate anastomosis;
13,000 annual procedures in the US

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3
Q

Left Hemi-Colectomy

A

Removal of a portion of the transverse and descending colon

  • Anastomosis of transverse and sigmoid colon
  • 37,000 annual procedures in US
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4
Q

Sigmoid Colectomy

A

Removal of Colon between partially retroperitoneal descending colon and the rectum.
- Anastomosis of the descending colon and the rectum or sigmoid colon.

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5
Q

Low Anterior Resection (LAR)

A

Removal of the (proximal) rectosigmoid portion of the rectum and mid portion of the sigmoid colon.

  • Anastomosis of the proximal sigmoid colon and proximal rectum 8 cm above the anal verge.
  • 26,000 annual procedures in US
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6
Q

Total Colectomy

A
  • Removal of total colon, usually through open approach
  • Anastomosis of ileum to rectum w/ ileo pouch.
  • If resection is very low, rectum/anus is stapled.
  • 12,500 annual procedures in US
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7
Q

Abdominoperineal Resection (APR)

A
  • Removal of the distal sigmoid colon
  • Suturing of the perineum
  • Permanent colostomy
  • 12,000 procedures performed annually
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8
Q

Gastrectomy

A

Surgical removal of all or part of the Stomach

  • Performed for several reasons, most common to remove a malignant tumor or cure a perforated / bleeding stomach ulcer
  • 25,000 annual open and lap procedures in US
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9
Q

Distal (Antrectomy) Gastrectomy

A

Removal of distal section of stomach (antrum) for duodenal or gastric ulcer disease, benign ulcer disease or benign gastric tumor.
- May include a vagotomy.

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10
Q

Partial (Subtotal) Gastrectomy

A

Billroth 1

  • Resection of tumor in pyloric portion of stomach
  • Anastomosis of the stomach and duodenum
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11
Q

Total Gastrectomy

A

Complete removal of the stomach.

  • Potentially curative or palliative procedure for malignant lesions and metastases in the adjacent lymph nodes.
  • Involes Roux-en-Y followed by Esophagojejunostomy
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12
Q

Laparoscopic Nissen Fundoplication

A

Treatment of symptomatic esophageal reflux (GERD). The fundus of the stomach is wrapped 360 degrees around the distal esophagus to restore sufficient esophageal pressure in the abdomen
Treatment of hiatal hernia.

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13
Q

Gastric Bypass (Laparoscopic & Open)

A
  • Laparoscopic approach is most common.
  • 80,000 annual procedures in US
    Employs both Mechanisms:
  • Restrictive - limits volume of the stomach.
  • Malabsorptive - Limits the amount of small bowel for fat and protein absorption.
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14
Q

Splenectomy

A
  • Removal of the spleen for benign conditions, malignant tumors, or trauma.
  • 30,000 annual open/lap in US
  • Hilar Vessels tend to be greater than 7mm in adults
  • Surgeon is cautioned about using clips around the hilium because it may interfere with stapling of the splenicartery and vein.
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15
Q

Hilar Vessels

A

The hilar region is the area through which blood vessels and nerves, etc., enter and leave the service of the lungs.

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16
Q

Whipple - Pancreaticoduodenectomy

A
  • Removal of head of pancreas, distal bile duct, entire duodenum, and usually the gallbladder.
  • 4,000 annual Distal Pancreatectomies in US
  • 6,000 annual Whipples in US
  • Pancreas and gastric antrum are anastomosed to jejunum.
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17
Q

Liver Resections

A

Performed for benign or malignant tumors

  • 5,500 annual open resections in US
  • 4 lobes & 8 Segments of the Liver
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18
Q

Caudate Lobe (Liver Resections)

A

Segment 1 of 8 - Dorsal portion of liver, embraces the Inferior Vena Cava on the posterior surface
- Segment 1 is not typically removed

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19
Q

Left Liver (Resections)

A

Splits into Anterior Segments (3 & 4) and Posterior Segments (2)

20
Q

Right Liver (Resections)

A

Splits into Anterior (Segments 5 & 8) and Posterior (Segments 6 & 7)

21
Q

4 Lobes of the Liver

A

1 - Caudate - Posterior (1 segment)
2 - Left Liver (3 Segments)
3 - Right Liver (4 segments)
4 - Quadrate Lobe - On inferior surface of liver near gallbladder

22
Q

Hemorrhoidectomy

A
  • Enlarged, distended venous mass of the hemorroidalplexus. Hemorroidhal tissue is located at the distal endo of the rectum within the anal canal.
  • 3 and 4 degree hemorrhoids are typically excised.
  • 310,000 annual procedures in the US
23
Q

Modified Radical Mastectomy

A
  • 60,000 annual procedures in US

- Removal of the breast, nipple-areolar complex (mastectomy) and axillary nodes (axillary dissection)

24
Q

Axillary Dissection

A
  • 90,000 annual procedures in US
  • Removal of fatty tissue and lymph nodes in the axilla for staging of breast cancer
  • Procedure is necessary if there is nodal spread
25
Q

Total Abdominal Hysterectomy (TAH)

A
  • Abdominal removal of uterus and cervix through an incision in the abdomen
  • 400,000 annual procedures in US
  • Typical Ligasure Instruments - Max / Xtd / Atlas 20 cm / Axs
26
Q

Vaginal Hysterectomy

A
  • Vaginal removal of uterus and cervix
  • 165,000 annual procedures in US
  • Typical Ligasure Intruments - Max / Xtd / Atlas 20 cm
27
Q

Laparoscopic Assisted Vaginal Hysterectomy (LAVH)

A
  • 75,000 annual procedures in US
  • Removal of uterus and cervix to include salpingo-oophorectomy
  • Above cardinal ligament / laparascopically ligated
  • Below cardinal line / structures ligated through vagina (uterus)
  • Open Ligasure - Max / Xtd / Atlas 20 cm
  • Laparo Ligasure - Atlas 20 cm / V
28
Q

Supracervical Hysterectomy

A
  • 65,000 annual procedures in the US
  • Removal of Uterus / Cervix is amputated but left in place
  • May includesalpingo-oopherectomy
  • Laparo or open approach
  • Open Ligasure Instruments - Max / Xtd / Atlas 20 cm
  • Laparo Ligasure Instruments - Atlas 20 cm / V
29
Q

Sapingo-oophorectomy (SO)

A
  • 450,000 annual open procedures in the US
  • 60,000 annual Laparo procedures in the US
  • Removal of ovary and fallopian tubes (uni- or bilateral)
  • For ovarian tumors, torsion of ovary, ectopic pregnancy, or in conjunction w/ hysterectomy
  • Ligasure Laparo - Atlas / V / Lap
  • Ligasure Open - Max /
30
Q

Thyroidectomy

A
  • 90,000 annual procedures in the US
  • Typical Ligasure Instruments - Liga Precise
  • Total - Complete removal of thyroid gland
  • Subtotal - Removal of half the gland with isthmusectomy
  • Lobectomy - 1/4 gland removal
  • Careful around Laryngeal nerve as its very close to superior thyroid artery running lateral to trachea/esophagus and posterior to thyroid.
31
Q

Parotidectomy

A
  • 27,000 annual procedures in the US
  • Ligasure Precise
  • En bloc excision of the gland for malignancies
  • Surgeon should be aware of lateral thermal spread due to proximity of facial nerve
  • Benign/low grade malignant, superficial lobe tumors are treated by superficial lobectomy with preservation of the facial nerve
32
Q

Urology

A

Surgical Specialty dealing with problems of the urinary tract and the genital tract

33
Q

Radical Prostatectomy

A
  • Removal of prostate for cancer with anastomosis of urethra to bladder
  • Open or Laparoscopic
  • Note: Incision/Cannula insertion site is superior and anterior to symphysis pubis
34
Q

Cystectomy

A
  • Removal of Urinary bladder due to vessel malignancy not invasive to bladder wall
  • Anastomosis for bladder reconstruction or diverting ileostomy
35
Q

Nephrectomy

A
  • Removal of Kidney with ligation of ureter
  • Done for malignant tumors, trauma, and living donor (transplant)
  • Open / Laparo
  • 61,000 open / 21,000 laparoscopic procedures annually in the US
36
Q

Adrenalectomy

A
  • 5,000 open / 41,000 laparo procedures performed annually in US
  • Partial/Total excision of one or both glands
  • Done for benign lesions or malignant tumors
  • Open approach for larger, malignant and metastatic lesions
37
Q

Benfits of Laparoscopic Surgery

A
  • Less postoperative pain
  • More Rapid Recovery
  • Better cosmetic results
  • Shorter hospital stays
  • Quicker return to work
38
Q

Insufflator

A
  • Delivers CO2 into abdominal cavity

- Maintains pneumoperitoneum

39
Q

Insufflation Needle or Veress needle

A

Creates pneumoperitoneum by passing CO2 from the insufflator into the abdominal cavity IOT create working room for surgeons

40
Q

Surgineedle

A
  • 14 gauge stainless steel
  • 120 mm long & 150 mm long (obese pts)
  • Spring loaded blunt style w/ red safety band to indicate sharp needle is exposed
41
Q

Ligation

A

The process of closing or tying off a vessel, duct or tube using ligature or a clip

42
Q

Radical Abdominal Hysterectomy

A

Removal of the ovaries, oviducts, lymph nodes, and lymph channels along w/ cervix and Uterus

43
Q

Adnexa

A

Appendages of the Uterus, namely the ovaries, the Fallopian tubes, and the ligaments that hold the uterus in place

44
Q

Mesosalpinx

A

Part of the lining of the abdominal cavity; broad ligament that stretches from the ovary to the level of the uterine tube

45
Q

Ligaments of the Uterus

A

TOP TO BOTTOM:

  • Infunibulopelvic
  • Ovarian
  • Round
  • Uterorosacral