SR 14 - Surgical Operations You Should Know

Question 1

Define - Billroth I

Answer 1

Antrectomy with gastroduodenostomy

One limb

Question 2

Define - Billroth II

Answer 2

Antrectomy with gastrojejunostomy

Two limbs

Question 3

Define - Roux-en-Y limb

Answer 3

Jejunojejunostomy forming a Y-shaped figure of small bowel

The free can can then be anastomosed to a second hollow structure

Question 4

Define - Brooke ileostomy

Answer 4

Standard ileostomy that is folded on itself to protrude from the abdomen ~2cm to allow easy appliance placement and collection of succus

Question 5

Define - CEA

Answer 5

Carotid endarterectomy

Removal of atherosclerotic plaque from a carotid artery

Question 6

Define - Bassini herniorrhaphy

Answer 6

Repair of inguinal hernia by approximating transversus abdominis aponeurosis and the conjoint tendon to the relfection of Poupart’s (inguinal) ligament

Question 7

Define - McVay herniorrhaphy

Answer 7

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)

Question 8

Define - Shouldice herniorrhaphy

Answer 8

Repair of inguinal hernia by imbrication of teh transversalis fascia, transversus abdominis aponeurosis, and the conjoint tendon and approximation of the transversus abdominis aponeurosis and the conjoint tendon of the inguinal ligament

Question 9

Define - Plug and patch hernia repair

Answer 9

Prosthetic plug pushes hernia sac in and then is covered with a prosthetic patch to repair inguinal hernias

Question 10

Define - APR

Answer 10

Abdominoperienal resection
Removal of the rectum and sigmoid colon through abdominal and perineal incisions (patient is left with a colostomy)
Used for low rectal cancers

Question 11

Define - LAR

Answer 11

Low anterior resection

Resection of low rectal tumors through an anterior abdominal incision

Question 12

Define - Hartmann’s procedure

Answer 12

Proximal colostomy

Distal stapled-off colon or rectum that is left in peritoneal cavity

Question 13

Define - Mucous fistula

Answer 13

Distal end of the colon is brought to the abdominal skin as a stoma
P’/roximal end is brought up to skin as an end colostomy

Question 14

Define - Kocher maneuver

Answer 14

Dissection of the duodenum from the right-sided peritoneal attachment to allow mobilization and visualization of the back of the duodenum/pancreas

Question 15

Define - Seldinger technique

Answer 15

Placement of a central line by first placing a wire in the vein, followed by placing the catheter over the wire

Question 16

Define - Cricothyroidotomy

Answer 16

Emergent surgical airway through the cricoid membrane

Question 17

Define - Hepaticojejunostomy

Answer 17

Anastomosis between a jejunal roux limb and the hepatic ducts

Question 18

Define - Puestow procedure

Answer 18

Side-to-side anastomosis of the pancreas and jejunum

Pancreatic duct is filleted open

Question 19

Define - Stamm gastrostomy

Answer 19

Gastrostomy placed by open surgical incision and tacked to the abdominal wall

Question 20

Define - Highly selective vagotomy

Answer 20

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)

Question 21

Define - Enterolysis

Answer 21

Lysis of peritoneal adhesions

Question 22

Define - LOA

Answer 22

Lysis of adhesions (enterolysis)

Question 23

Define - Appendectomy

Answer 23

Removal of the appendix

Question 24

Define - Lap appy

Answer 24

Laparoscopic removal of the appendix

Question 25

Define - Cholecystectomy

Answer 25

Removal of the gallbladder

Question 26

Define - Lap chole

Answer 26

Laparoscopic removal of the gallbladder

Question 27

Define - Nissen

Answer 27

Nissen fundolication | 360 wrap of the stomach by the fundus of the stomach around the distal esophagus to prevent reflux

Question 28

Define - Lap nissen

Answer 28

Nissen fundoplication with laparoscopy

Question 29

Define - Simple mastectomy

Answer 29

Removal of breast and nipple without removal of nodes

Question 30

Define - Choledochojejunostomy

Answer 30

Anastomosis of the common bile duct to the jejunum (end to side)

Question 31

Define - Graham patch

Answer 31

Placement of omentum with stitches over a gastric or duodenal perforation Omentum is used to plug the hole

Question 32

Define - Heineke-Mikulicz pyloroplasty

Answer 32

Longitudinal incision through all layers of the pylorus, sewing closed in a transverse direction to make the pylorus nonfunctional (used after truncal vagotomy)

Question 33

Define - Pringle maneuver

Answer 33

Temporary occlusion of the porta hepatis (for temporary control of liver blood flow when liver parenchyma is actively bleeding)

Question 34

Define - Modified radical mastectomy

Answer 34

Removal of the breast, nipple, and axillary lymph nodes | No muscle is removed

Question 35

Define - Lumpectomy and radiation

Answer 35

Removal of breast mass and axillary lymph nodes Normal surrounding breast tissue is spared Patient then undergoes postoperative radiation treatments

Question 36

Define - I&D

Answer 36

Incision and drainage of pus | The wound is then packed open

Question 37

Define - Exploratory laparotomy

Answer 37

Laparotomy to explore the peritoneal cavity looking or the cause of pain, peritoneal signs, obstruction, hemorrhage, etc

Question 38

Define - TURP

Answer 38

Transurethral resection of the prostate | Removal of obstructing prostatic tissue via scope in the urethral lumen

Question 39

Define - Fem pop bypass

Answer 39

Femoral artery to popliteal artery bypass using synthetic graft or saphenous vein Used to bypass blockage in the femoral artery

Question 40

Define - Ax Fem

Answer 40

Long prosthetic graft tunneled under the skin placed from the axillary artery to the femoral artery

Question 41

Define - Triple A repair

Answer 41

Repair of Abdominal Aortic Aneurysm Open aneurysm and place prosthetic graft Then close old aneurysm sac around graft

Question 42

Define - CABG

Answer 42

Coronary artery bypass grafting Via saphenous vein graft or internal mammary artery bypass grafts to coronary arteries from aorta (cardiac revascularization)

Question 43

Define - Hartmann's pouch

Answer 43

Oversewing of a rectal stump (or distal colonic stump) after resection of a colonic segment Patient is left with a proximal colostomy

Question 44

Define - PEG

Answer 44

Percutaneous Endoscopic Gastrostomy Endoscope is placed in the stomach, inflated with air - needle is passed percutaneously into the stomach, wire is passed over the needle transversing the abdominal wall, the gastrostomy is then placed by using the seldinger technique of the the wire

Question 45

Define - Ileoanal pull-through

Answer 45

Anastomosis of the ileum to the anus after a total proctocolectomy

Question 46

Define - Hemicolectomy

Answer 46

Removal of a colonic segment

Question 47

Define - Truncal vagotomy

Answer 47

Transection of the vagus nerve trunks | Must provide drainage procedure to the stomach because the pylorus does not relax

Question 48

Define - Antrectomy

Answer 48

Removal of stomach antrum

Question 49

Define - Whipple procedure

Answer 49

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)

Question 50

Define - Excisional biopsy

Answer 50

Biopsy with complete excision of all suspect tissue (mass)

Question 51

Define - Incisional biopsy

Answer 51

Biopsy with incomplete removal of suspect tissue (incises tissue from mass)

Question 52

Define - Tracheostomy

Answer 52

Placement of airway tube into trachea surgically or percutaneously