Presentation8: colonsocopy, bitewing x-ray, hernioplasty, anastomosis

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Presentation8: colonsocopy, bitewing x-ray, hernioplasty, anastomosis

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Presentation8: colonsocopy, bitewing x-ray, hernioplasty, anastomosis

  1. 1. Digestive System<br />Review of Colonoscopy, Bitewing X-ray, Hernioplasty, and Anastamosis<br />
  2. 2. Colonoscopy<br />Visual exam of the inside of the large intestine and rectum for the purpose of detecting abnormalities or evaluating gastrointestinal symptoms<br />Considered the premiere method for colon cancer screening<br />A long, flexible tube with a tiny camera at the tip (a colonoscope) is inserted in the rectum and advanced up through the large intestine<br />Air is inserted through the tube of the scope which inflates the colon for better viewing<br />Instruments may be inserted through the tube during the procedure to remove polyps or take biopsies of abnormal tissue<br />A screening colonoscopy is recommended for anyone 50 years of age and older, and for anyone with parents, siblings or children with a history of colorectal cancer or polyps<br />
  3. 3. Colonoscopy Procedure<br />Doctor will give specific instructions for emptying out the colon the day before the exam<br />Typically no solid food and only clear beverages<br />To begin the exam, a mild sedative and pain medication are given intravenously to minimize any discomfort<br />Wearing a hospital gown, patient lays on the exam table on their side, knees drawn toward chest<br />Doctor inserts colonoscope into the rectum and up through the large intestine<br />Patient may feel abdominal discomfort when the scope is moved or air is introduced<br />Exam takes 20-60 minutes<br />
  4. 4. Bitewing X-ray<br />Type of dental x-ray that depicts the crowns and partial roots of 2-3 teeth, and immediately surrounding bone<br />So called Bitewing because the x-rayfilm holder provides a surface on which to bite down<br />Most common type of dental x-ray<br />Primary uses<br />Detect cavities in between teeth<br />Detect bone loss to evaluate periodontal conditions<br />Determine the quality of previous dental restorations<br />Typically taken annually<br />
  5. 5. Bitewing X-ray Procedure<br />Seated upright in the dental chair , the patient is covered with a lead apron and thyroid collar<br />The bitewing film is placed into the patient’s mouth<br />Patient bites his or her teeth together onto a portion of the cardboard tab to hold in place<br />Patient must remain completely still<br /> Once the film is in position, the operator directs the cone of the x-ray unit toward the film and leaves the room to press a button which expose the film<br />Audible beepis heard once film is exposed<br />Operator re-enters the room and removes the film from the patient’s mouth<br />Procedure typically repeated on different areas of the mouth<br />Lead apron is removed once procedure is complete<br />
  6. 6. Hernioplasty<br />Surgical repair of a hernia where the rupture is “patched” by inserting a piece of synthetic mesh to cover the entire groin area<br />Patch is secured with sutures, clips or staples<br />Typically performed laparoscopically, using several small incisions<br />Fiber-optic tube with a tiny camera is inserted into abdomen via one incision<br />Miniature instruments and materials are inserted through the other incisions <br />Advantages of laparoscopic repair<br />Less discomfort and scarring after surgery, quicker return to normal activities <br />Recommended for patients whose hernias recur following traditional hernia surgery<br />Laparoscopic methods allow surgeons to work around scar tissue from earlier repair(s)<br />Disadvantages of laparoscopic repair<br />Increased risk of complications and of recurrence following surgery<br />Not recommended for patients with large hernias or previous groin surgery<br />
  7. 7. Hernioplasty Procedure<br />Surgeon makes 3small incisions in the patient’s abdomen<br />A thin tube (“trocar”) is inserted into each of the 3 incisions, through which surgical instruments access the hernia site <br />A laparoscope, consisting of a small video camera and light source, is inserted near the navel<br />A “Grasper” is inserted into another incision, which the surgeon uses to manipulate the tissue surrounding the hernia and to position a mesh patch that covers the opening in the muscle wall<br />Through the last tube, the surgeon attaches the mesh patch to the wall with staples or sutures<br />The mesh becomes a strong and permanent part of the abdominal wall<br />The procedure typically takes less than an hour and requires no overnight stay<br />Performed under general anesthesia<br />
  8. 8. Anastomosis<br />Surgical connection between two structures that are not normally connected<br />Typically created between tubular structures, such as blood vessels or loops of intestine<br />Examples of surgical anatomoses<br />Colonostomy<br />Opening created between the bowel and abdominal skin<br />Arterio-venous fistula<br />Veins and arteries are surgically connected to create an area for a dialysis catheter to be introduced<br />Gastric bypass<br />Surgically resized (smaller) stomach is connected directly to the middle portion of the small intestine, bypassing the rest of the stomach and the upper portion of the small intestine <br />
  9. 9. Complex procedure that can be performed laparoscopically or conventionally under general anesthesia<br />Time in surgery is approximately 1-4 hours<br />1-7 day post operative stay in the hospital <br />Aftercare treatments are important to successful “use” of newly reconfigured digestive system<br />Dietary plan<br />Regular exercise<br />Behavioral-modification therapy<br />Anastamosis: Gastric Bypass<br />

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