SMALL BOWEL

Question 1

Examiners asked us to describe how to kocherize

Answer 1

mobilize hepatic flexure

sharply dissect lateral edge of duodenum with medial retraction by assistant

Question 2

Heineke-mukulicz pyloroplasty

Answer 2

Kocherize the duodenum,

Traction sutures on sup and inf margins of pylorus

Longitudinal incision 3 cm on each side of pyloric ring

Pull traction sutures in fashion to orient incision transversely, and close defect

Question 3

Finney

Answer 3

Side to side anastomosis with the apex of U lumen that may be left open and become a problem

Question 4

Heineke-mukulicz strictureplasty

Answer 4

Longitudinal incision closed transversely

Question 5

bianchi small bowel strictureplasty

Answer 5

The LILT (Bianchi) Procedurehttps://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&ved=0ahUKEwjRiOGCx4nMAhUC3mMKHWznCiwQjRwIBw&url=https%3A%2F%2Fwww.pinterest.com%2Fpin%2F490962796855275920%2F&bvm=bv.119408272,d.cGc&psig=AFQjCNESDYrACxHzreL0CAckAZmodqDR0g&ust=1460566139195428&cad=rjt

Bianchi LILT.

Separating the two leaves of the mesentery carrying blood supply to half of the circumference of the bowel.

Creating a mesenteric tunnel for division of the dilated bowel.

Division of the dilated bowel with a surgical stapler into two separate pieces, one-half the size of the original dilated loop.

The two bowel loops are then anastomosed together in an isoperistaltic manner. (Reproduced with permission from

Risks of vascular embarrassment