Surgical Operations You Should Know, Chapter 14 P82-91 Flashcards
Define the following procedures:
1. Billroth I
P82 (picture)
Antrectomy with gastroduodenostomy
- Billroth II
P82 (picture)
Antrectomy with gastrojejunostomy
- How can the difference between a Billroth I and a
Billroth II be remembered?
P82 (picture)
Billroth 1 has one limb; Billroth 2 has two limbs
Describe the following procedures:
1. Roux-en-Y limb
P83 (picture)
Jejunojejunostomy forming a Y-shaped figure of small bowel; the free end can then be anastomosed to a second hollow structure (e.g., esophagojejunostomy)
- Brooke ileostomy
P83
Standard ileostomy that is folded on itself to protrude from the abdomen ≈2 cm to allow easy appliance placement and collection of succus
- CEA
P83
Carotid EndArterectomy; removal of atherosclerotic plaque from a carotid artery
- Bassini herniorrhaphy
P83
Repair of inguinal hernia by approximating transversus abdominis aponeurosis and the conjoint tendon to the reflection of Poupart’s (inguinal) ligament
- McVay herniorrhaphy
P83
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)
- Lichtenstein herniorrhaphy
P83
“Tension-free” inguinal hernia repair using mesh (synthetic graft material)
- Shouldice herniorrhaphy
P84
Repair of inguinal hernia by imbrication of the transversalis fascia, transversus abdominis aponeurosis, and the conjoint tendon and approximation of the transversus abdominis aponeurosis and the conjoint tendon to the inguinal ligament
- Plug and patch hernia repair
P84
Prosthetic plug pushes hernia sac in and then is covered with a prosthetic patch to repair inguinal hernias
- APR
P84
AbdominoPerineal Resection; removal of the rectum and sigmoid colon through abdominal and perineal incisions (patient is left with a colostomy); used for low rectal cancers 8 cm from the anal verge
- LAR
P84
Low Anterior Resection; resection of low rectal tumors through an anterior abdominal incision
- Hartmann’s procedure
P84
- Proximal colostomy
2. Distal stapled-off colon or rectum that is left in peritoneal cavity
- Mucous fistula
P84
Distal end of the colon is brought to the abdominal skin as a stoma (proximal end is brought up to skin as an end colostomy)
- Kocher (“koh-ker”) maneuver
P84 (picture)
Dissection of the duodenum from the right-sided peritoneal attachment to allow mobilization and visualization of the back of the duodenum/pancreas
- Seldinger technique
P85
Placement of a central line by first placing a wire in the vein, followed by placing the catheter over the wire
- Cricothyroidotomy
P85
Emergent surgical airway through the cricoid membrane
- Hepaticojejunostomy
P85
Anastomosis between a jejunal roux limb and the hepatic ducts
- Puestow procedure
P85 (picture)
Side-to-side anastomosis of the pancreas and jejunum (pancreatic duct is filleted open)
- Stamm gastrostomy
P85
Gastrostomy placed by open surgical incision and tacked to the abdominal wall
- Highly selective vagotomy
P86 (picture)
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)
- Enterolysis
P86
Lysis of peritoneal adhesions
- LOA
P86
Lysis Of Adhesions (enterolysis)
- Appendectomy
P86
Removal of the appendix
- Lap appy
P86
Laparoscopic removal of the appendix
- Cholecystectomy
P86
Removal of the gallbladder
- Lap chole
P86
Laparoscopic removal of the gallbladder
- Nissen
P86 (picture)
Nissen fundoplication; 360 wrap of the stomach by the fundus of the stomach around the distal esophagus to prevent reflux
- Lap Nissen
P87
Nissen fundoplication with laparoscopy
- Simple mastectomy
P87
Removal of breast and nipple without removal of nodes
- Choledochojejunostomy
P87
Anastomosis of the common bile duct to the jejunum (end to side)
- Graham patch
P87
Placement of omentum with stitches over a gastric or duodenal perforation (i.e., omentum is used to plug the hole)
- Heineke-Mikulicz pyloroplasty
P87 (picture)
Longitudinal incision through all layers of the pylorus, sewing closed in a transverse direction to make the pylorus nonfunctional (used after truncal vagotomy)
- Pringle maneuver
P87 (picture)
Temporary occlusion of the porta hepatis (for temporary control of liver blood flow when liver parenchyma is actively bleeding)
- Modified radical mastectomy
P88
Removal of the breast, nipple, and axillary lymph nodes (no muscle is removed)
- Lumpectomy and radiation
P88
Removal of breast mass and axillary lymph nodes; normal surrounding breast tissue is spared; patient then undergoes
postoperative radiation treatments
- I & D
P88
Incision and Drainage of pus; the wound is then packed open
- Exploratory laparotomy
P88
Laparotomy to explore the peritoneal cavity looking for the cause of pain, peritoneal signs, obstruction, hemorrhage, etc.
- TURP
P88
TransUrethral Resection of the Prostate; removal of obstructing prostatic tissue via scope in the urethral lumen
- Fem pop bypass
P88 (picture)
FEMoral artery to POPliteal artery bypass using synthetic graft or saphenous vein; used to bypass blockage in the femoral artery
- Ax Fem
P89 (picture)
Long prosthetic graft tunneled under the skin placed from the AXillary artery to the FEMoral artery
- Triple A repair
P89
Repair of an AAA (Abdominal Aortic Aneurysm):
Open aneurysm and place prosthetic graft; then close old aneurysm sac around graft
- CABG
P89 (picture)
Coronary Artery Bypass Grafting; via saphenous vein graft or internal mammary artery bypass grafts to coronary arteries from aorta (cardiac revascularization)
- Hartmann’s pouch
P89
Oversewing of a rectal stump (or distal colonic stump) after resection of a colonic segment; patient is left with a
proximal colostomy
- PEG
P90 (picture)
Percutaneous Endoscopic Gastrostomy:
Endoscope is placed in the stomach, which is then inflated with air; a needle is passed into the stomach percutaneously, wire is passed through the needle
traversing the abdominal wall, and the gastrostomy is then placed by using the Seldinger technique over the wire
- Ileoanal pull-through
P90
Anastomosis of the ileum to the anus after total proctocolectomy
- Hemicolectomy
P90
Removal of a colonic segment (i.e., partial colectomy)
- Truncal vagotomy
P90 (picture)
Transection of the vagus nerve trunks; must provide drainage procedure to stomach (e.g., gastrojejunostomy or
pyloroplasty) because after truncal vagotomy, the pylorus does not relax
- Antrectom
P91
Removal of stomach antrum
- Whipple procedure
P91 (picture)
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)
- Excisional biopsy
P91
Biopsy with complete excision of all suspect tissue (mass)
- Incisional biopsy
P91
Biopsy with incomplete removal of suspect tissue (incises tissue from mass)
- Tracheostomy
P91
Placement of airway tube into trachea surgically or percutaneously
