General Surgery Flashcards
Colon Resection
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.
Transverse Colectomy
Removal of the transverse colon with appropriate anastomosis;
13,000 annual procedures in the US
Left Hemi-Colectomy
Removal of a portion of the transverse and descending colon
- Anastomosis of transverse and sigmoid colon
- 37,000 annual procedures in US
Sigmoid Colectomy
Removal of Colon between partially retroperitoneal descending colon and the rectum.
- Anastomosis of the descending colon and the rectum or sigmoid colon.
Low Anterior Resection (LAR)
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
Total Colectomy
- 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
Abdominoperineal Resection (APR)
- Removal of the distal sigmoid colon
- Suturing of the perineum
- Permanent colostomy
- 12,000 procedures performed annually
Gastrectomy
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
Distal (Antrectomy) Gastrectomy
Removal of distal section of stomach (antrum) for duodenal or gastric ulcer disease, benign ulcer disease or benign gastric tumor.
- May include a vagotomy.
Partial (Subtotal) Gastrectomy
Billroth 1
- Resection of tumor in pyloric portion of stomach
- Anastomosis of the stomach and duodenum
Total Gastrectomy
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
Laparoscopic Nissen Fundoplication
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.
Gastric Bypass (Laparoscopic & Open)
- 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.
Splenectomy
- 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.
Hilar Vessels
The hilar region is the area through which blood vessels and nerves, etc., enter and leave the service of the lungs.
Whipple - Pancreaticoduodenectomy
- 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.
Liver Resections
Performed for benign or malignant tumors
- 5,500 annual open resections in US
- 4 lobes & 8 Segments of the Liver
Caudate Lobe (Liver Resections)
Segment 1 of 8 - Dorsal portion of liver, embraces the Inferior Vena Cava on the posterior surface
- Segment 1 is not typically removed