Surgical Anatomy, Colic surgery Flashcards
Indications of SI surgery
Persistent pain
US hows distension and edema
After failed stbilisation methods
Approaches fro opening the abdomen
- Ventral midline- along linea alba
- Paramedian: opening the rectus, 10cm from the midline
- inguinal
- Flank
Which organs cannot be exteriorised
Stomach
Duodenum
Dist ileum
Laparoscopic anatomy- standing Right side
Duodenum
Caecum
Lateral and ventral taenia
Small colon
Small intestine
Right ovary and uterus
Surgical approaches in lat recumbency
- Modified low flank
- Transcostal
- Intercostal
What are the muscles you must transect for the flank approach
Transc abd
Internus abd
Externus abd
When doing a ventr midline approach along the linea alba, what neonatal structure might we come across?
Lig teres hepatis= the remnant of the umbilical vein
Laparoscopic approach, what vessel to we need to be aware of?
Deep circumflex iliac artery
Laparoscopic approach- the orgasn encountered
Caecum is the first
Corpus of caecum will be in the midline Caecocolic ligament: btw lat taenia of caecum and lat taenia of R ventral colon
Anatomy of the caecum
4 taenias
BS comes from the lat and med taenias
Lat- leads to lig caecocolica (fold)
Dors- leads to lig ileocaecale (fold)
What does the base of the caecum lead into?
The Right ventral colon i.e the asc colon
Main blood vessels supplying the intestines
A. colica dextra
A. colica ventralis
ramus colicus?
3 stages of lesions of the intestinal wall
- Distension
- Ischaemic mucosa
- Vascular closure
- Distension of wall
Intraluminal P for 2-4 hours
- 18H2Ocm: seromusc edema
- 25H2Ocm: hyperperfusion, edema, invasion of inflamm cells, adhesions for up to 10 days postop
- Serous, fibrinous exudate
- Ischaemic mucosa
Small intestine is v.sensitive beacuse tips of villi have specific BS
Large intestine no villi therefore not as sensitive
