Surgeries

Question 1

What is a total colectomy, its incisions and why you have it?

Answer 1

Removal of all of the colon

Midline incision

Bowel cancer or bleeding

Question 2

What is a sigmoid colectomy, its incisions and why you have it?

Answer 2

Removal of the sigmoid colon - lies on the left side of the abdominal cavity

Midline incision

Cancer or bleeding

Question 3

What is a hemi-colectomy (left or right), its incisions and why you have it?

Answer 3

Removal of part of the colon

Midline incision

Cancer or bleeding

Question 4

What is a ileostomy, its incisions and why you have it?

Answer 4

Connects the last part of the small intestine (ileum) to the abdominal wall

Midline incision

Cancer, Crohn’s disease or bleeding

Question 5

What is an anterior resection - rectum and descending colon, its incisions and why have it?

Answer 5

Removal of your bowel and rectum

Midline incision

Cancer or bleeding

Question 6

What is a appendicectomy, its incisions and why you have it?

Answer 6

Removal of the appendix

Right Gridiron or Lanz incision

Appendicitis

Question 7

What is a gastrectomy and its incisions?

Answer 7

Removal of the stomach

Midline incision

Cancer or bleeding

Question 8

What is a cholecystectomy, its incisions and why have it?

Answer 8

Removal of the gallbladder

Right Kocher incision or laproscopy

Gallstones

Question 9

What is a hernia repair and its incisions?

Answer 9

Repairs the hernia by placing the lump of fatty tissue or loop of bowel back into the abdomen and placing a mesh at the weak spot where the hernia came out to strengthen it

Incision directly over the hernia

Question 10

What is a nephrectomy, its incisions and why have it?

Answer 10

Removal of a kidney

Incision made on the side of the patient just below the ribs

Cancer

Question 11

What is a oesophagectomy, its incisions and why have it?

Answer 11

Removal of the oesophagus

Mercedes Benz, Rooftop or Kocher

Cancer

Question 12

What is a lung resection and why would you have it?

Answer 12

Removal of part or all of the lung

Cancer

Question 13

What is a lobectomy and its incisions?

Answer 13

Removal of an entire lobe of the lung

Thoracotomy

Question 14

What is a segmentectomy and its incisions?

Answer 14

Removal of part of one of the lobes of the lung to remove a cancerous tumor

Thoracotomy

Question 15

What is a pneumonectomy and its incisions?

Answer 15

Removal of an entire lung

Thoracotomy

Question 16

Explain a thoracotomy procedure

Answer 16

Technique to open up the chest

Incision between the 5th and 6th rib

Elevate the arm to move the scapula out of the way

Involves cutting out 1 rib to get enough space and cut through the latissimus dorsi and serratus anterior

May damage neurovascular bundle

Causes trauma to the costocondral, costovertebral and costotransverse joints

Question 17

What are the precautions after a thoracotomy?

Answer 17

No pushing/pulling with the arms

No lifting for 6 weeks

Question 18

What are the aims of treatment after a thoracotomy?

Answer 18

Must move shoulder through full ROM

Supported cough and progress walking distance daily

Aim for slight shortness of breath

Question 19

What is a coronary artery bypass and its incisions?

Answer 19

Involves taking a blood vessel from another part of the body (usually chest, leg or arm) and attaching it to the coronary artery above and below the narrowed area or blockage

Sternotomy

Question 20

What is the reason for having a valve repair or replacement?

Answer 20

Valve does not open fully which obstructs flow of blood = valve stenosis or narrowing

If valve does not close properly it will allow blood to leak backwards = valve incompetence or regurgitation or leaky valve

Question 21

What is the reason for having a coronary artery bypass?

Answer 21

Narrowing and hardening of the left and/or right coronary arteries due to a build-up of plaque = athersclerosis

Question 22

What is a valve replacement and its incisions?

Answer 22

Replacement of the valve with a new one

Sternotomy

Question 23

Which valve most commonly has a replacement or repair?

Answer 23

Mitral valve

Question 24

What is an abdominal aortic aneurysm?

Answer 24

Bulge or swelling in the aorta

The main blood vessel that runs from the heart down through the chest and into the abdomen

Can get bigger over time and rupture causing life-threatening bleeding

Question 25

What is an aneurysm repair and what is its incisions?

Answer 25

Graft is placed in the aorta

Open surgery - incision in the abdomen

Endovascular surgery – the graft is inserted into a blood vessel in your groin and then carefully passed up into the aorta

Question 26

What is a sternotomy?

Answer 26

Cutting through and dividing the sternum to provide acces to the heart

Wires are used to fix the sternum back together

Question 27

What are the precautions to a sternotomy?

Answer 27

Cough with support

No pushing/pulling with arms

No lifting for 6 weeks

Do not sleep with arms behind head

Do not sleep on side at first

6-8 weeks recovery

Question 28

What is the main problem in patients following surgery that affects physiotherapy management?

Answer 28

Reduced Lung Volume (Atelectasis)

Question 29

What type of disease is atelectasis?

Answer 29

Restrictive