Minimally invasive/ General surgery Test 2 Flashcards
1
Q
What is a minimally invasive surgery?
A
treatment of pathologies while causing as little trauma to the patient as possible
2
Q
What are some advantages to minimally invasive surgeries?
A
reduce pain
reduce scarring
shorter procedure times
less infection potential
faster recovery
-accessing areas otherwise unsafe to operate on
3
Q
What are some disadvantages of minimally invasive surgeries?
A
-not everyone is a candidate
-complex and expensive
-exposure and working space
-has potential to convert to an open case
4
Q
Define endoscopy
A
broad term referring to looking inside the body with a scope
5
Q
What cavity is a colonoscopy?
A
colon cavity
6
Q
What cavity is the laparoscopy?
A
abdominal cavity
7
Q
What cavity is the thoracoscopy?
A
thoracic cavity
8
Q
Describe a rigid endoscope
A
metal scope
5MM or 10MM
0,30,45,70 degree
9
Q
Describe a flexible endoscope
A
bends and snakes through the system aka flexible
10
Q
What are the attachments to the endoscope?
A
-camera head- ability to zoom and focus
-light cord- fiberoptic and loosely coiled
11
Q
What are parts to the camera head?
A
coupler connects camera to scope
focus and zoom buttons
white balancing button
12
Q
What is fluid distension?
A
fluid pumped into organ to create distension
ex-bladder, uterus, joints
13
Q
What is gas distension?
A
Insufflation: CO2 pumped into body cavity to create distension
ex-pneumoperitoneum- abdomen
Veress needle used
14
Q
Advantages of robotic surgery
A
-provides movement but with improved range of motion
-eliminates tremors of hands
-complex and precise movement
-3-D view
-theoretically can perform surgery from different locations
15
Q
Disadvantages of robotic surgery
A
-Expensive
-Equipment has limited # of uses
-potential to convert to open
-learning curve for all
16
Q
What are the 2 DaVinci systems at Reading?
A
XI- in 3 rooms
X- in 1 room
17
Q
What are the 3 components of the DaVinci robot?
A
-Surgeon console: 3D image, control station, non-sterile
-Patient cart: where arms are connected
-Vision cart: image processing system, fiberoptic light system, mono and bipolar cautery generator
18
Q
What are robotic EndoWrists?
A
exchangeable instruments
grasping, needle drivers, retractors, hemostatic clips
(saves position during instrument exchanges)
19
Q
What are the robotic scopes and trocars?
A
scope 8mm0 and 8mm30
Trocars- 3-4 placed, 8 or 12mm, remote center- depth of perception
20
Q
What are some specific things to have on your table setup?
A
Cutdown
lap set
endowrist set
scope
trocar
drapes Patient and robot
21
Q
What are 2 things to never do during robot case?
A
-move robot when its docked to the patient
-adjust the bed when robot is docked
22
Q
What is the alimentary system and what is the pathway?
A
Gi tract- the entire path that food travels through the body
esophagus
stomach
small/ large intestines
appendix
rectum/ anus
23
Q
What are the abdominopelvic quadrants?
A
right upper
left upper
right lower
left lower
24
Q
What are the abdominopelvic regions?
A
right hypochondriac
epigastric
left hypochondriac
right lumbar
umbilical
left lumbar
right iliac
hypogastric
left iliac
25
What organs are in the right hypochondriac region?
liver
gallbladder
right kidney
small intestine
26
What organs are in the epigastric region?
stomach
liver
pancreas
duodenum
spleen
adrenal glands
27
What organs are in the left hypochondriac region?
spleen
colon
left kidney
pancreas
28
What organs are in the right lumbar?
gallbladder
liver
right ascending colon
29
What organs are in the umbilical region?
umbilicus
some small intestine
duodenum
30
What organs are in the right iliac region?
appendix
cecum
31
What organs are in the hypogastric region?
urinary bladder
sigmoid colon
reproductive organs
32
What organs are in the left iliac region?
descending colon
sigmoid colon
33
Is the abdominal cavity sterile?
yes
34
What is the peritoneum in the peritoneal cavity?
a serous membrane lining the walls and organs of the abdomen
35
The peritoneal cavity includes what intraperitoneal organs?
digestive system
lymphatic system
vessels
adipose tissue
36
What is the first section of the alimentary canal?
mouth
Oropharynx: back of tongue, tonsils, and throat
37
After the mouth, what is the next section of the alimentary system?
Esophagus including the lower esophageal sphincter
38
After the esophagus, what is the next section of the alimentary canal and its parts?
Stomach: cardia, fundus, greater/lesser curvatures, Pylorus "funnel", pyloric sphincter, rugae (folds on inside)
39
*** what are the 3 things inside the stomach aiding in digestion?***
Gastrin- hormone stimulating stomach to make acid
hydrochloric acid- breaks down and kills bacteria
pepsinogen- enzyme for protein digestion
40
After the stomach, what is the next section of the alimentary canal and its parts?
small intestine (majority of nutrient absorption)
duodenum- shortest section
jejunum
ileum
~22 feet long
41
After the small intestine, what is the next section of the alimentary canal and its parts?
Large intestine/ colon (fluid absorption)
ileocecal valve
cecum/ appendix
ascending colon
transverse colon
descending colon
sigmoid colon
42
What are the corners of the large intestine called?
right and left colic flexures
43
What is the name of the right flexure and what it near?
Hepatic- liver
44
What is the name of the left flexure and what is it near?
splenic- spleen
45
After the large intestine, what is the next section of the alimentary canal?
rectum
anus
46
What is the mesentery?
under layer
connects small and large intestines
blood supply
structural support- no twisting
lymph activity
47
What is the omentum?
Outer fatty layer to protect organs- like a drape
on top of mesentary
48
What are the 5 layers of the GI tract?
Serosa
Muscularis
Submucosa
mucosa
Villi (small intestine)
(SMSMV)
49
What is the serosa layer of the Gi tract?
outer layer- protection, serous lubricant
50
What is the muscularis layer of the GI tract?
muscular layer- contraction/relaxation
peristalsis- wavy movement of food
51
What is the submucosa layer of the GI tract?
intermediate layer- connective, blood supply, glandular
52
What is the mucosa layer of the GI tract?
inner layer (deepest)- absorption and secretion
53
What are the villi and where are they located in the GI tract?
finger like hairs for absorption
small intestine only
54
What is in the biliary tract of the digestive system?
creation, storage, and transport of bile
55
What organs make up the biliary tract?
pancreas- secrets hormones
liver- makes bile
gallbladder- storage
56
What is the biliary duct system?
tubes connecting gallbladder, liver, and pancreas.
delivers bile and digestive juices to duodenum
57
What are the 6 "ducts" of the biliary tract?
cystic duct
hepatic duct
common bile duct
pancreatic duct
ampulla of Vater
Sphincter of Oddi
58
What organ does the cystic duct go into?
gallbladder
59
What organ does the hepatic duct go into?
liver
60
The common bile duct connects what two organs/ducts?
cystic and hepatic (gallbladder and liver)
61
Where is the pancreatic duct located?
in the pancreas
62
What does the ampulla of Vater do?
joins the pancreatic duct and the common bile duct
63
What is the sphincter of Oddi?
located at the ampulla of Vector
controls bile excretion into the duodenum
64
What is the falciform ligament?
fibrous ligament diving right and left lobes of the liver
connects liver to anterior abdominal wall
65
What are the layers of the abdominal tissues? (hint there 6)
skin
subcuticular
subcutaneous fat
muscle
fascia- (holds organs)
peritoneum (lining of interior walls)
66
What are the muscle layers of the abdominal wall?
internal and external oblique
rectus abdominus "6 pack"
transversus abdominus
67
What is the fascia layer of the abdominal tissues?
tough fibrous connective tissue (allows muscles to move)
68
What is the Linea alba layer of the abdominal tissues?
white
fibrous tissue running down midline from xyphoid to pubis
connects rectus muscles
69
What is the Linea Semilunaris layer of the abdominal tissues?
lateral fascial border of rectus muscles
(right and left side)
70
What is the difference between the visceral and parietal peritoneum?
visceral- inner layer closer to organ
parietal- outer layer closer to the wall
71
What is the simplest abdominal incision? What organs can be gotten to?
median/ midline vertical incision
Upper- stomach, duodenum, pancreas
lower- uterus, bladder, lower intestine
72
Where is the paramedian rectus incision located? What organs can be exposed with each incision?
Lateral to the midline
right upper- stomach, duodenum, pancreas
right lower- pelvic structures, proximal colon
left upper- spleen, stomach
left lower- pelvic structures, distal colon
73
Where is the McBurney oblique incision?
right lower quadrant at 45 degree angle
splits external & internal oblique and transversalis muscles
used for appendectomy
74
Where is the subcostal oblique incision located? what organs are exposed when incised?
left and right side starts at midline between xiphoid & umbilicus
extends laterally to below the rib cage
right- gallbladder & biliary system
left- spleen
75
Where is the lower oblique inguinal incision?
Lower then McBurneys incision
right or left side
Inguinal hernia repair
76
Where is the thoracoabdominal incision made?
patient in lateral position
left or right side
provides access to thoracic and abdominal cavity
77
Where is the midabdominal transverse incision located?
right or left side
umbilicus to lateral
stomach, pancreas, biliary system
not as common
78
In what order to wound closures occur? (same as incision or reverse)
reverse order of incision
79
What are the 3 layers of closing skin for a laparotomies? By
deep fascial layer- majority of wound support (1 or 0 PDS; 1 or 0 Vicryl)
Subcutaneous layer- closing fatty dead space or muscle (3-0 Vicryl)
skin- staples ; 4-0 Monocryl
80
What is an anoscopy?
examination of mucous of the anal canal
81
What is a choledochoscopy?
exam of common bile duct
82
What is a colonoscopy?
exam entire colon from anus to ileocecal valve
(may obtain tissue specimens or remove polyps)
83
What is an esophagoscopy?
exam of the esophagus
84
What is a gastroscopy?
exam of gullet, stomach and duodenum
85
What is an egd?
esophagogastroduodenoscopy
exam of esophagus, stomach, and duodenum
86
What is an ERCP?
endoscopic retrograde cholangiopancreatography
scope goes down mouth to duodenum
catheter passed into biliary ducts for x-ray of ducts
obstructions removed
87
What is a proctoscopy?
exam of the mucosa of rectum and anal canal
88
What is a sigmoidoscopy?
exam of sigmoid and rectum
remove polyps/ tissue specimens
89
What is a laparoscopy?
exam abdominal cavitiy
trocars placed
instruments through trocars
diagnostic or treatment
90
What is pneumoperitoneum?
insufflation/ gas in the body
CO2 introduced into abdomen
provide visualization and working room
91
What is a hernia?
protrusion of organ through a defect
usually in a sac
contents of sac may be abdominal or pelvic viscera or mesentery
92
What are the different types of hernias?
congenital
traumatic
acquired
93
What is a congenital hernia?
a hernia formed at birth
94
What is an acquired hernia?
a hernia that forms at anytime
95
What is a traumatic hernia
hernia caused by blunt force
96
What are the purposes of hernia repair?
return contents to correct anatomical location
strengthen and support structures
suture or mesh
97
Why use mesh when doing a hernia repair?
reinforces peritoneum
allows tissue ingrowth
98
What material do meshes come in?
prolene
PTFE
Vicryl
99
When do you start the counts when doing a hernia repair?
closing count starts when mesh is halfway sutured- not at beginning of
100
What is an incarcerated hernia?
contents of hernia trapped in a sac
can not be returned to anatomical location
101
What is a strangulated hernia?
contents of hernia trapped in sac
blood supply is cut off
sac contents die/ necrosis
immediate surgery
may need to do a bowel resection
102
What are the 4 types of ventral hernias?
incisional
epigastric
umbilical
spigelian
103
What is an incisional hernia?
postoperative
weakness in abdominal wall and incise location
104
What is an epigastric hernia?
protrusion of fat through abdominal wall between xiphoid and umbilicus
105
What is an umbilical hernia?
small fascial defect at umbilicus
106
What is a spigelian hernia?
defect through the linea semilunaris
107
What is a hiatal hernia?
part of stomach protrudes through diaphragm &into chest
emergency for newborns
108
What symptoms occur with a hiatal hernia?
trouble swallowing
GERD/ acid reflux
109
What is type 1 hiatal hernia?
sliding hernia-
stomach and distal esophagus up into chest
110
What is type 2 hiatal hernia?
paraoesophageal hernia
fundus protrudes through diaphragmatic defect
(worst hernia)
111
What does the bougie/ Maloney dilator look like?
Blue snake with holes and measurements. Can be green
112
What is scarpa's facia?
white layer (looks like underwear) membranous layer
113
What structures are in a inguinal hernia for a male?
spermatic cord
vas deferens
spermatic veins and artery
cremaster muscle
*penrose drain often used to drain during procedure
114
What structures are in an inguinal hernia for a female?
round ligaments
supports uterus
115
In an inguinal hernia, where do structures enter?
internal ring
natural opening in transversalis fascia
116
In an inguinal hernia, where do structures exit?
external ring continues into genitals
opening is in external oblique aponeurosis
117
What are two classifications of an inguinal hernia.
direct
indirect
or both
118
What is Hesselbach's Triangle?
Anatomical landmark to determine direct or indirect hernia
119
What are the anatomical landmarks that make up Hesselbach's Triangle?
Lateral-deep epigastric vessels
inferior- inguinal ligament
medial- rectus abdominus muscle
120
Where is a direct hernia located? How is one acquired?
located within Hesselbach's triangle
weakness in transversalis fascia
heavy lifting
chronic coughing
straining to pee/ defecate
121
Where is an indirect hernia located?
protrudes through (IN) internal ring and follows spermatic cord down inguinal canal
congenital or acquired
122
What is a TEP hernia repair?
Total Extraperitoneal Patch
abdominal cavity not entered
defect is sealed from outside of peritoneum
123
What is a TAPP hernia repair?
Transabdominal Preperitoneal Patch
abdominal cavity IS entered
sealed from inside peritoneum
124
What is a cholecystectomy?
removal of the gallbladder
125
What is cholecystitis?
inflammation of the gallbladder
126
What is cholelithiasis?
stones
127
What wound class are most cholecystectomies?
Class 1- no spillage/ leakage
128
What wound class is a gross spillage of bile going to be?
Wound class 3
129
In a cholecystectomy what are the major structures to identify?
cystic artery
cystic duct
130
What is Calot's Triangle?
Hepatobiliary
anatomical landmark to locate the cystic artery- in the middle of the triangle-
131
What is a choledochostomy?
an incision into the common bile duct
remove stones in common bile duct
132
What is used for drainage in a choledochostomy?
whalen-moss T-tube
133
What does the liver do?
create and balance of nutrients
metabolism of drugs
filtration/ detoxification -> bile creation
134
Whay does the spleen do?
blood cell storage
removal of damaged blood cells
-does not heal so can be removed
135
Why have a liver surgery?
hepatic resection
segmental resection
lobectomy- disease
136
Why have spleen surgery?
Splenectomy- removal
traumatic injury
tumor
extra spleen
hypersplenism
Hodgkins cancer
137
What does the pancreas do?
enzymes to aid in digestion
hormones to control blood sugar (insulin and Glucagon)
head, neck, body, and tail
138
What is another name for a whipple?
pancreaticoduodenectomy
139
What id another name for a pancreaticoduodenectomy?
Whipple
140
Why is a whipple procedure done?
treat cancer at the head of the pancreas
141
What is removed during a whipple procedure?
head of pancreas
entire duodenum
portion of jejunum
distal 1/3 of stomach
gallbladder
cystic duct
common bile duct
peripancreatic lymph node
hepatoduodenal duct
142
What 3 systems need to be reestablished during a whipple procedure? And what are the attached to?
biliary
pancreatic
gastrointestinal
The jejunum
143
What is the name of the 3-anastomosis made in a whipple procedure?
gastrojejunostomy
hepaticojejunostomy
pancreatojejunostomy
144
What is a distal pancreatectomy?
Tx of cancer in the tail of the pancreas
145
What happens in a procedure of an esophagectomy with esophagogastrostomy? Where is incision made?
-tumor removed from cardia of stomach or distal esophagus
-anastomosis between stomach and esophagus
-thoracoabdominal
146
What is a gastrotomy?
incision into stomach
to remove an object
147
What is a gastrostomy?
creation of an opening between the stomach and the body surface- Feeding tube
148
What is a total gastrectomy? And what is main reason to perform?
removal of entire stomach
malignant cancer
149
What needs to be connected after a total gastrectomy?
anastomosis of the jejunum and esophagus
150
What is a subtotal gastrectomy?
removal of distal portion of stomach
151
What is a Billroth1 procedure? and what is the procedure name for it?
remaining stomach is anastomosed to duodenum
gastroduodenostomy
152
What is a Billroth2 procedure? And what is the procedure name for it?
remaining stomach anastomosed to the jejunum.
gastrojejunostomy
153
What is a pyloromyotomy
incision through pyloric muscle to release a stricture
154
What is a vagotomy?
treat/prevent gastric ulcer
extreme cases of peptic ulcer
resection of vagus nerve at esophagus
decreases gastric juices
155
What is a gastric band?
creation of small pouch/ stomach
near esophagus
156
What is a gastric sleeve?
portion of stomach removed via stapler
stomach is smaller so feel less hungry
157
What is a Roux-en-Y gastric bypass?
procedure to bypass portion of stomach and entire duodenum
158
What is a brief explanation of Roux-en-Y gastric bypass
create small stomach pouch
divide duodenum and jejunum
gastrojejunostomy performed (stomach to jejunum)
duodenojejunostomy performed (duodenum to jejunum)
159
What is diverticulosis?
formation of small sacs in the wall of the large intestine, usually
160
What is diverticulitis?
inflammation or infection of the small sacs in the wall of the intestine
161
What is Meckel's diverticulum?
congenital diverticulum occurring in the small bowel
162
What is intussusception?
"telescoping" of bowel into itself ( folds into itself)
mostly in kids
high mortality if not treated within 24 hours
163
What is volvulus?
twisting of bowel upon itself
causes obstructions
blood supply possibly compromised
164
What are polyps?
growth of the mucosa (intestinal lining) of the intestine
165
What are 2 types of polyps?
pedunculated- have a stalk
sessile- "mound"/ no stalk
166
Do polyps need resection?
benign- no
malignant or family history of- yes
167
What happens in a bowel resection?
resection of all or part of small or large bowel/colon
168
What are the 3 types of anastomoses?
end to end- EEA stapler
side to side- common
end to side
169
What is an ostomy?
diversion of bowel to skin
170
What is a stoma?
bowel sutured to the skin
171
What are the 3 types of ostomies?
ileostomy
jejunostomy
colostomy
172
What is a duodenectomy?
removal of all or part of the duodenum
173
What is a jejunectomy?
removal of all or part of the jejunum
174
What is a ileectomy?
removal of all or part of the ileum
175
What is a colon (large bowel) resection?
excision of the colon
176
What is a total colectomy?
What does it treat? What is usually the result?
removal of the entire colon
tx of colitis and polyposis
ileostomy
177
What is a sub-total colectomy?
removal of a portion of the colon
178
What are the 5 type of sub-total colectomies?
right
right hemi
transverse
left
left hemi
179
What is a sigmoid colectomy?
removal of diseased portion of sigmoid and rectum
and resection
180
What is the ileoanal endorectal pouch?
recreation of rectum after removal of entire colon and proximal rectum
181
What is an abdominoperineal resection?
removal of distal sigmoid, rectum, and anal sphincter
anus sutured close- ostomy required
tx of rectal cancer
182
What is an appendectomy? What suture used in open cases?
removal of the appendix
McBurney's incision
183
What is a hemorrhoidectomy?
excision and ligation of rectal veins
184
Where are hemorrhoids located? What position is used for these cases?
external on anal sphincter
internal in the anus
Kraske or lithotomy
184
What wound class is a bowel technique in a good case?
class 2- clean contaminated
185
What wound class is a gross spillage of contents in a bowel case?
class 3- contaminated
emergency surgery
186
What is done with instruments used in a contaminated bowel procedure?
instruments used are separated from other instruments
187
What are advantages to using staplers?
faster
more reliable than suture
188
What are 4 categories of staplers?
linear
linear cutting
ligating/ dividing
circular
189
What is a GIA stapler? what category is it? How does it work?
Gastrointestinal anastomosis
linear cutting
places two parallel rows of staples and cuts between the rows
-bowels, vessels, thoracic tissue
190
What is a TA stapler? What category is it? How does if work?
Thoracoabdominal
linear
1 row of staples
used on thicker tissues ex- esophagus/ esophagectomy
(use 10 blade)
(looks like a T shape)
191
What is an EEA stapler? What category is it? How does it work?
end-to-end anastomosis
circular
places circular staples and cuts away excess tissue
esophagectomy or deep colon resection
192
What is an LDS stapler? What category is it? How does it work?
ligating/ dividing stapler
only fires 2 parallel staples and cuts between them
appendectomy or splenic vessel ligation
193
What is a purse string stapler? How does it work?
places a nylon purse string suture line around a lumen.
Tie it to seal the organ
194
What are breasts?
mammary glands that lie on the pectoralis major muscle
195
How many lobes are in a breast? What are the lobes separated by?
12-20 lobes
adipose and connective tissue
196
What is a breast lobe divided up into? What is the name of the duct that drains to the nipple?
lobules- alveoli
lactiferous duct
197
What is the area around the nipple called?
areola
198
The central and upper portion of the breast is made up of what?
glandular tissue
199
What is the peripheral portion of the breast mostly made up of?
adipose tissue
200
How many lymph nodes are in the axillary area?
average of 53
201
Where and what is the tail of spence?
section of breast, adipose, and lymph nodes extending into axilla
202
What % of women have an abnormality of the breast at some time in their life?
80%
203
What is a fibroadenoma?
benign firm, round, moveable lump in breast
monitored
shrink post menopause- possible hormone related
204
What is an intraductal papilloma?
wart-like growth in a lactiferous duct at edge of areola
benign
205
What is a galactocele?
milk filled cyst that forms in lactiferous duct
206
What is a mastitis?
inflammation of the breast
occurs during lactation from dirty hands or infection from infant
207
What is gynocomastia?
hypertrophy of breast tissue in a male
either puberty or over 50
caused by excessive hormone production or alteration in hormonal balance
208
How many women will develop breast cancer? What percent are men?
1 in 7
3%
209
Leading cancer death is in women at what age?
40-55
210
What is Paget's disease?
discharge, flaking, and color changes in nipple/ areola
211
Malignant breast tumors are evaluated for what? What is normally used?
estrogen and progestin binding abilities
positive might be able to use hormone Tx
Tamoxifen (antiestrogen)
212
What types of incisions are used?
radial
peri areolar
inframammary
trans axillary
213
What is an incision and drainage of the breast procedure?
incision into infected area
drainage of pus
214
What is a needle biopsy procedure of the breast?
core tissue withdrawn by large bore needle
215
What is an excisional biopsy/ lumpectomy?
incision over lesion
entire lesion removed
incision closed with
216
What is a wire localization? What is used to make sure mass is removed?
guided by imaging-percutaneously placed
helps identify mass
Faxitron machine used intra-op to ensure mass removed
217
What is a partial mastectomy? What is a disadvantage?
removal of tumor with 1Inch of normal tissue
to many nodes removed could lead to lymphedema
218
What is a simple mastectomy?
removal of entire breast
including nipple and areola
219
What is a subcutaneous mastectomy?
Removal of all breast tissue
(leave nipple and areola
220
What is a radical mastectomy?
removal of:
breast, nipple, areola
overlaying skin
axillary nodes
minor/ major pectoral muscle
fat, fascia, tissues
221
What is a modified radical mastectomy?
Removal of:
breast, nipple, areola
overlaying skin
axillary node
222
What 2 ways are used to reduce regrowth of malignant cancer cells?
H2O- hypotonic solution
isolate supplies- 2 sets if needed
223
What are margins of breast tissue?
samples of "clean" tissue around site of removal
224
What methos do we use to organize the margins on our field?
SMILAP
superior
medial
inferior
lateral
anterior
posterior
225
What is a sentinel node biopsy?
Where is it located in a breast?
main lymph node to absorb cancer cells as it leaves an organ
the axilla
226
What does doctor use to hear and see the location of the sentinel node?
blue dye (isosulfan) before surgery
Geiger counter
227
What is reconstructive mammoplasty?
insertion of inert prosthesis
tissue expander
228
What are the 2 types of flaps used to reconstruct a breast?
Tram flap
back flap
229
What muscle is used in the back flap breast reconstruction?
latissimus dorsi
230
What is a TRAM flap?
transverse rectus abdominis myocutaneous flap
rectus abdominus and blood supply are flipped upwards
231
What is a reduction mammoplasty?
excision of excessive breast tissue
reconstruct symmetrically
232
What is a port-a-cath placement procedure?
long term central venous catheter- administer meds
subclavian vein into superior vena cava
233
What is a Taut Catheter used for?
Cholangiography to explore common bile duct
234
What is a Maloney/ Bougie dilator used for?
Used to dilate the esophagus
235
What is used to insufflate the abdomen?
cardon dioxide (CO2)
