MUST KNOW SURGICAL OPERATIONS Flashcards
Billroth I
proximal stomach is anastomosed directly to the duodenum (i.e. gastroduodenostomy)
Billroth II
greater curvature of stomach is anastomosed directly to the jejunum (i.e. gastrojejunostomy)
Roux-En-Y anastomosis
2 upper limb of the “Y” represent:
• proximal segment of stomach and distal small bowel it joins with
• blind end that is surgically divided off
lower part of “Y”:
• formed by the distal small bowel beyond anastomosis
Brooke Ileostomy
Standard ileostomy that is folded on
itself to protrude from the abdomen
~2 cm to allow easy appliance placement
and collection of succus
CEA
Carotid EndArterectomy; removal of atherosclerotic plaque from a carotid artery
Bassini Herniorrhapy
Repair of inguinal hernia by approximating transversus abdominis aponeurosis and the conjoint tendon to the reflection of POUPART’s (inguinal) ligament
McVay herniorrhaphy
Repair of inguinal hernia by approximating the transversus abdominis aponeurosis and the conjoint tendon to COOPER’s ligament (which is basically the
superior pubic bone periosteum)
addresses BOTH inguinal and femoral ring defects
indicated for femoral hernias and in cases where the use of prosthetic material is contraindicated
Lichtenstein herniorrhaphy
“Tension-free” inguinal hernia repair using
mesh (synthetic graft material)
allows for a tension-free repair of the inguinal floor by buttressing the floor with a prosthetic mesh
Shouldice herniorrhaphy
Repair of inguinal hernia by IMBRICATION of the transversalis fascia, transversus abdominis aponeurosis, and the conjoint tendon and approximation of the transversus abdominis aponeurosis and the conjoint tendon to the inguinal ligament
Plug and patch hernia
repair
Prosthetic plug pushes hernia sac in and
then is covered with a prosthetic patch to
repair inguinal hernias
AbdominoPerineal Resection (APR)
Removal of the rectum and sigmoid colon through
abdominal and perineal incisions (patient is left with a colostomy); used for low rectal cancers ~8 cm from the anal verge
Low Anterior Resection
Resection of low rectal tumors through an anterior
abdominal incision
Hartmann’s Procedure
- Proximal colostomy
- Distal stapled-off colon or rectum that
is left in peritoneal cavity
Mucous Fistula
Distal end of the colon is brought to the
abdominal skin as a stoma (proximal end
is brought up to skin as an end colostomy)
Kocher Maneuver
Dissection of the duodenum from the
right-sided peritoneal attachment to
allow mobilization and visualization of
the back of the duodenum/pancreas
Seldinger
Placement of a central line by first placing a wire in the vein, followed by placing the catheter over the wire
Cricothryroidotomy
Emergent surgical airway through the cricoid membrane
Hepaticojejunostomy
Anastomosis between a jejunal roux limb and the hepatic ducts
Puestow Maneuver
Side-to-side anastomosis of the pancreas
and jejunum (pancreatic duct is filleted
open)
Stamm Gastrostomy
Gastrostomy placed by open surgical incision and tacked to the abdominal wall
Highly Selective Vagotomy
Transection of vagal fibers to the body of the stomach without interruption of fibers to the pylorus (does not need pyloroplasty or other drainage procedure because the pylorus should still function)
Enterolysis
Lysis of peritoneal adhesions
Appendectomy
Removal of appendix
Lap Appy
Laparoscopic removal of the appendix
Cholecystectomy
Removal of the gallbladder
Lap Chole
Laparoscopic removal of the gallbladder
Nissen Fundoplication
360 wrap of the stomach by the fundus of the stomach around the distal esophagus to prevent reflux
Simple Mastectomy
Removal of breast and nipple without
removal of nodes
Choledochojejunostomy
Anastomosis of the common bile duct to the jejunum (end to side)
Graham Patch
Placement of omentum with stitches over a gastric or duodenal perforation (i.e., omentum is used to plug the hole)
Heineke-Mikulicz
pyloroplasty
Longitudinal incision through all layers of the pylorus, sewing closed in a transverse direction to make the pylorus nonfunctional (used after truncal vagotomy)
Pringle Maneuver
Temporary occlusion of the porta hepatis (for temporary control of liver blood flow when liver parenchyma is actively bleeding)
Modified Radical Mastectomy
Removal of the breast, nipple, and AXILLARY lymph nodes (no muscle is removed)
Lumpectomy and Radiation
Removal of the breast, nipple, and axillary lymph nodes (no muscle is removed)
Exploratory Laparotomy
Laparotomy to explore the peritoneal cavity looking for the cause of pain, peritoneal signs, obstruction, hemorrhage, etc.
TransUrethral Resection of the Prostate (TURP)
Removal of obstructing prostatic tissue via scope in the urethral lumen
Fem pop bypass
FEMoral artery to POPliteal artery bypass using synthetic graft or saphenous vein; used to bypass blockage in the femoral artery
Triple A Repair
Repair of an AAA (Abdominal Aortic Aneurysm): Open aneurysm and place prosthetic graft; then close old aneurysm sac around graft
Coronary Artery Bypass Grafting (CABG)
Via saphenous vein graft or internal mammary artery bypass grafts to coronary arteries from aorta (cardiac revascularization)
Hartmann’s pouch
Oversewing of a rectal stump (or distal colonic stump) after resection of a colonic segment; patient is left with a proximal colostomy
Percutaneous Endoscopic Gastrostomy
Endoscope is placed in the stomach which is then inflated with air; a needle is passed into the stomach percutaneously, wire is passed through the needle
traversing the abdominal wall, and the gastrostomy is then placed by using the Seldinger technique over the wire
Ileoanal Pull-through
Anastomosis of the ileum to the anus
after total proctocolectomy
Hemicolectomy
Removal of a colonic segment (i.e., partial colectomy)
Truncal Vagotomy
Transection of the vagus nerve trunks
must provide drainage procedure to stomach (e.g., gastrojejunostomy or pyloroplasty) because AFTER truncal vagotomy, the PYLORUS does NOT relax
Antrectomy
Removal of stomach antrum
Whipple Procedure
Pancreaticoduodenectomy:
Cholecystectomy
Truncal vagotomy
Pancreaticoduodenectomy—removal of the head of the pancreas and duodenum
Choledochojejunostomy
Pancreaticojejunostomy (anastomosis of distal pancreas remnant to the jejunum)
Gastrojejunostomy (anastomosis of stomach to jejunum)
Excisional Biopsy
Biopsy with complete excision of all suspect tissue (mass)
Incisional Biopsy
Biopsy with incomplete removal of suspect tissue (incises tissue from mass)
Tracheostomy
Placement of airway tube into trachea surgically or percutaneously
