Study Guide Review (Chapters 23 and 33) Flashcards
Two techniques currently used for laparoscopic approach to a direct inguinal hernia are:
- transabdominal preperitoneal (TAPP) laparoscopy
2. Total extraperitoneal (TEP) surgery
In the TAPP approach, a _____ is created, and the inguinal canal is entered via the _____.
pneumoperitoneum
abdominal cavity
In the TEP approach, instead of a pneumoperitoneum, the _____ is inflated with a balloon dissector, which expands the tissue planes.
peritoneal space
A _____ is performed to remove a section of diseased colon and restore continuity to the intestine.
partial colectomy
The colon is removed to treat _____, _____, _____, and _____.
carcinoma, ulcerative colitis, diverticulitis, and intestinal obstruction
A _____ is the general term applied to removal of the large intestine.
colectomy
During a colectomy, the _____ and _____ are not removed.
sigmoid colon and rectum
What are the 7 abdominal incisions?
- midline
- paramedian
- subcostal
- flank
- inguinal
- McBurney
- lower transverse (Pfannenstiel)
When is a midline incision used?
- laparotomy
- percutaneous endoscopic gastronomy
- partial gastrectomy
- Billroth I
- Billroth II
- transhiatal esophagectomy
- segmental resection of the small intestine
- resection of the colon
- colectomy
- abdominoperineal resection
- liver transplantation
When is a paramedian incision used?
- percutaneous endoscopic gastronomy
- loop colostomy
- colectomy
- segmental resection of the liver
When is a subcostal incision used?
- segmental resection of the liver
2. liver transplantation
When is a flank incision used?
??
When is an inguinal incision used?
- open repair of an indirect inguinal hernia
When is a McBurney incision used?
- appendectomy
When is a lower transverse (Pfannenstiel) incision used?
??
Direct inguinal hernia is a protrusion of abdominal or inguinal tissue through the _____.
tranversalis fascia
A direct hernia protrudes through a weakness in the abdominal wall in the region between the _____ and _____ and medial to the inferior epigastric artery.
rectus abdominis muscle and inguinal ligament
The _____ is the most difficult type to repair.
direct inguinal hernia
With an _____ hernia, the peritoneal sac containing intestine protrudes through the internal inguinal ring and passes down the inguinal canal outside Hesselbach’s triangle.
indirect inguinal
An _____ hernia is more common in males, but can occur in females.
indirect inguinal
A _____ procedure may be used to repair either an indirect or direct reducible inguinal hernia using mesh behind the hernial defect.
laparoscopic
A _____ involves repairing the defect in the transversalis fascia below the inguinal ligament and removing the peritoneal sac protruding through the femoral ring. (more common in women)
femoral herniorrhaphy
Repair of an _____ consists of closing the peritoneal opening and uniting the fasciae above and below the defect to reconstruct the abdominal wall surrounding the umbilicus. (most often is children/congenital, some women after childbirth)
unbilical hernia
An _____ is an abdominal wall defect occurring in the linea alba at the umbilical ring.
umbilical hernia
Impaired healing of a previous surgical incision, usually a vertical abdominal incision, may cause a _____.
ventral (incisional) hernia
An _____ is sometimes the aftermath of postoperative hematoma, infection, or undue strain.
incisional hernia
A _____ has a high recurrence rate when mesh is placed on the outside of a large repair.
ventral hernia
What is the duct of Wirsung?
is a duct joining the pancreas to the common bile duct to supply pancreatic juices which aid in digestion
The _____ are sections of the small bowel suspended from the abdominal wall by a sheet of vascular tissue called the mesentery.
jejunum and ileum
The pancreatic duct (duct of Wirsung) and the common bile duct from the liver drain their contents into the _____ section of the small intestine.
duodenum
During a _____, the entire breast is removed. Axillary lymph nodes are not removed. The muscles of the chest wall are preserved.
simple mastectomy
The peritoneum is usually closed with a/an _____ suture line.
continuous
The peritoneum is usually closed with _____.
absorbable suture swaged to a taper needle, size 0 or 2-0
When entering the abdominal cavity, the _______________is lifted with hemostats and a small incision made with the deep knife or Metzenbaum
peritoneum
What type of breast biopsy involves removing the entire mass?
excisional biopsy
Which type of breast biopsy involves a needle being inserted into the mass and tissue is retrieved for histologic examination?
core biopsy
A mastectomy where a wedge or quadrant of breast tissue is removed.
segmental mastectomy
Signs of gallstones or cancer near the gallbladder are:
swelling, pain, and infection; obstructive jaundice may occur
What is the function of a t-tube?
drain bile
When is a tube used?
cholecystectomy and operative cholangiography
What does the surgeon use to irrigate a mastectomy wound?
antibacterial solution
What instruments are used in a common bile duct exploration?
- four trocars (umbilical 10mm, midline 10mm, 2 at axillary line 5mm)
- 30 degree telescope
- laparoscope
- straight locking grasper
- scissors
- esu hook
- surgical clips
What is a vagotomy?
performed to reduce gastric enzymes by severing the nerves that control their release
What is pyloroplasty?
enlarging the pyloric opening between the stomach and the duodenum
What is gastrectomy?
the stomach may be totally or partially resected
