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Medicine and Surgery Mushkies > Practical Surgery Mushkies > Flashcards

Practical Surgery Mushkies Flashcards

1
Q

Nissen Fundoplication aim?

A

Prevent reflux and repair diaphragm

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2
Q

Nissen Fundoplications procedure?

A
  1. Usually lap
  2. Wrap gastric fundus around lower oesophagus
  3. Close any diaphragmatic hiatus
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3
Q

Complications of Nissen Fundoplication?

A
  1. Gas-bloat syndrome = inability to belch/vomit

2. Dysphagia if wrapped too tight

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4
Q

Types of gastrectomy?

A
  1. Antrectomy
  2. Total Gastrectomy
  3. Subtotal Gastrectomy
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5
Q

Antrectomy types?

A
  1. Bilroth I = simple anastomosis

2. Bilroth II = duodenal stump oversown + gastrojejunostomy

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6
Q

Complications of gastrectomy?

A
  1. Physical

2. Metabolic

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7
Q

Physical complications of gastrectomy?

A
  1. Increased risk of gastric cancer
  2. Reflux or bilious vomiting
  3. Abdominal fullness
  4. Stricture
  5. Stump leakage
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8
Q

Metabolic complications of gastrectomy?

A
  1. Dumping syndrome
  2. Blind loop syndrome
  3. Vitamin deficiency = B12, osetoporosis, bypassing proximal SB –> Fe and folate deficiency
  4. Weight loss = malabsorption
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9
Q

Blind loop syndrome?

A

Overgrowth of bacteria in duodenal stump, leading to malabsorption and diarrhoea

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10
Q

Dumping syndrome?

A

Collection of signs and symptoms that occurs post gastrectomy when sugar moves too quickly into the duodenum, characterised by 2 phases:

  1. Early DS (10-30mins after meal) = osmotic hypovolaemia
  2. Late DS (2-3 hours after meal) = reactive hypoglycaemia
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11
Q

S&S of dumping syndrome?

A

Abdo distension, flushing, N&V, fainting, sweating

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12
Q

Ivor-Lewis Oesophagectomy?

A

2-stage surgical procedure for removing tumours of the distal 2/3rds of the oesophagus
1st = abdominal rooftop incision
2nd = right thoracotomy

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13
Q

Whipple’s procedure?

A

Pancreaticoduodenectomy performed for removing tumours of the head of the pancreas, including removal of:

  1. Gastric antrum
  2. Gallbladder
  3. Head of pancreas
  4. Proximal duodenum
  5. Regional lymph nodes
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14
Q

EVAR complications?

A
  1. MI
  2. Spinal or mesenteric ischaemia
  3. Renal failure
  4. Graft migration or stenosis
  5. Endoleaks
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15
Q

What are endoleaks?

A

Persistent blood flow within the aneurysm sac following EVAR

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16
Q

EVAR advantages?

A
  1. Reduced perioperative mortality
  2. Less stress in high risk pts
  3. Reduced hospital stay
  4. Improved cosmesis
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17
Q

EVAR disadvantages?

A
  1. No data on long term outcomes
  2. Cant be used on all aneurysms
  3. Lifelong monitoring with CT for endoleaks
  4. More expensive
  5. Doubtful long term advantage in terms of all cause mortality
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18
Q

Carotid endarterectomy complications?

A
  1. 7% risk of stroke/death w/in 30d
  2. Haemorrhage –> haematoma
  3. MI
  4. Hypoglossal nerve damage = rare
19
Q

Indications for bypass grafting?

A
  1. Very short claudication distance
  2. Symptoms affecting pts QoL
  3. Development of rest pain
20
Q

Practicalities of bypass grafting?

A
  1. Need good proximal supply and sital run off
  2. More distal grafts have increased rates of thrombosis
  3. Saphenous vein grafts have increased rates of thrombosis
  4. Prosthetic grafts may be employed
21
Q

Bypass grafting procedures?

A
  1. Aorta/double iliac occlusion = aorto-bifem/axillo-fem
  2. Single iliac = aorto-fem/fem-fem crossover/axillo-fem
  3. SFA/PF = Fem-pop/fem-distal
22
Q

Complications of bypass grafting?

A
  1. Haematoma
  2. Distal embolism
  3. Thrombosis
23
Q

TURP indications?

A

Surgical rx of choice for BPH when medical Rx has failed

24
Q

Principals of TURP?

A
  1. Performed under spinal anesthetic
  2. Cytoscopic inspection
  3. Locate external urethral sphincter and use as distal resection landmark
  4. Electrosurgical resection of prostatic tissue under direct vision
  5. Send chippings for histology
  6. Insert 3 way catheter post-op to irrigate bladder
25
Q

Complications of TURP?

A
  1. Immediate
  2. Early
  3. Late
26
Q

Immediate complications of TURP?

A
  1. TURP syndrome = absorption of large quantity of fluids -> reduced Na
  2. Haemorrhage
27
Q

Early complications of TURP?

A
  1. Haemorrhage
  2. Infection
  3. Clot retention = requires bladder irrigation
28
Q

Late complications of TURP?

A
  1. Retrograde ejaculation = common
  2. ED = 10%
  3. Incontinence = <10%
  4. Urethral stricture = LUTS post TURP
  5. Recurrence
29
Q

Dohlman’s procedure?

A

Pharyngeal pouch = minimally invasive endoscopic stapling

30
Q

Heller’s cardiomyotomy?

A

Achalasia = longitudinal incision through muscularis propria at LOS

31
Q

Ramstedt’s pyloromyotomy?

A

Pyloric stenosis = longitudinal incision through muscularis propria at the pylorus

32
Q

Ivor-Lewis?

A

Oesophageal cancer = 2-stage oesophagectomy

33
Q

Anal fissure surgery?

A

Lateral sphincterotomy = division of internal anal sphincter @ 3 o clock

34
Q

Delorme’s procedure?

A

Rectal prolapse = perineal approach with mucosal resection

35
Q

Trendelenberg operation?

A

Varicosities = SFJ ligation

36
Q

Cockett’s operation?

A

Varicosities = perforator ligation

37
Q

Trahere transplantation?

A

Chronic venous insufficiency = transplant of axillary vein with valve into the deep venous leg veins

38
Q

Kistner operation?

A

Chronic venous insufficiency = venous valvuloplasty

39
Q

Palma operation?

A

Chronic venous insufficiency = bypass venous obstruction with contralateral GSV

40
Q

Palomo operation?

A
  1. Varicocoele = high retroperitoneal approach for ligation of testicular veins
  2. Transverse incision at level of the ASIS centred on the mid-inguinal point
41
Q

Lord’s repair?

A

Hydrocele = plication of the tunica vaginalis

42
Q

Jaboulay’s repair?

A

Hydrocele = eversion of the tunica vaginalis

43
Q

Dartos Pouch Procedure?

A

Undescended testis = mobilisation of testis and placement in a s/c pouch via a hole in the dartos muscle (dartos prevents retraction)

44
Q

Sistrunk’s operation?

A

Thyroglossal cyst = excision of cyst and thyroglossal duct

Medicine and Surgery Mushkies (52 decks)

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