Principles of surgery Flashcards
What are Halsted’s principles of surgery
Gentle tissue handling
Strict asepsis
Haemostasis
Preservation of blood supply
No tension on tissues
Good approximation of tissues
Obliteration of dead space
what are important basic skills you need to have during surgery?
Recognise anatomy
Recognise abnormal tissue
Recognise planes of dissection
Understand how tissues heal
What are some factors that might influence wound healing?
What is an exploratory laparotomy?
A laparotomy performed with objective of obtaining information that isn’t available via clinical diagnostic methods
Once underlying pathology has been determined, procedure may continue as therapeutic procedure
If no pathology can be found, then organ biopsy should be performed
How is an exploratory laparotomy performed?
Abdominal cavity is divided into 5 regions so all organs & tissues are examined:
- cranial abdomen
- gastrointestinal tract
- right paravertebral region
- left paravertebral region
- caudal abdomen
What organs/tissues can be assessed from the greater peritoneal cavity?
Peritoneal fluid
What organs/tissues can be assessed from the cranial abdomen?
liver
gallbladder & bile ducts
hepatic hilus
epiploic foramen
spleen
What organs/tissues can be assessed from the gastrointestinal tract
stomach
intestinal tract
pancreas
regional lymph nodes
What organs/tissues can be assessed from the right paravertebral region
hepatic portal vein
caudal vena caba
coeliac artery
hepatic lymph nodes
right adrenal gland
right kidney & proximal ureter
right ovary & uterine horn
What organs/tissues can be assessed from the left paravertebral region
aorta
left adrenal gland
left kidney & proximal ureter
left ovary & uterine horn
What organs/tissues can be assessed from the caudal abdomen
bladder & distal ureters
proximal urethra
prostate gland & ductus deferens
uterine body & proximal vagina
regional lymph nodes
What organs/tissues can be assessed from the abdominal wall, peritoneal surface & mesenteries
diaphragm
oesophageal hiatus
aortica & caval hiatus
greater & lesser omentum
internal inguinal rings
