This document summarizes four therapeutic procedures for the digestive system: 1) Gastric lavage involves flushing the stomach contents by inserting a tube and using water or saline, often after a drug overdose or before surgery. 2) Hernioplasty repairs hernias either by removing herniated tissue or using the patient's tissue or mesh to repair damaged areas, now often done as an outpatient laparoscopic procedure. 3) Choledocholithotripsy uses sound waves to break up gallstones in the gallbladder or bile ducts. 4) Anastomosis procedures either reconnect parts of the digestive system to bypass damage or disease, such as a Roux-en-Y bypass

1. Chapter 8 PresentationRebecca RayFour therapeutic procedures for the digestive systemLavageHernioplastyCholedocholithotripsyAnastomosis

2. Gastric LavageGastric lavage is popularly known as stomach pumping. After a pH test to ensure the nasogastric tube is correctly insertedinto the stomach, water or saline is used to wash away the contentsof the stomach—either due to an overdose or as a preparation for surgery.

3. HernioplastyHernia repair may involvesimply removing the herniatedtissue (herniotomy) or it may alsoinvolve repairing the adjacenttissue with the patient’s owntissue or with heterogenousmaterial such as a mesh.What used to be an inpatientprocedure is now an outpatientprocedure lasting less than a fewhours. With the advances inlaparoscopic surgery it can evenbe a relatively non-invasiveapproach.

4. Choledocholithotripsy Lithotripsy refers to the breaking or dissolving of stones, whether in the kidneys or gallbladder. “Choledocho-” refers specifically to the common bile duct. The illustration at right shows that stones may collect in the gallbladder itself, in the cystic duct, or in the common bile duct. Believe it or not, the actual crushing is done by sound waves!

5. A patient undergoing lithotripsy

6. Anastomosis An anastomosis can be a pathological condition such as a fistula or incorrectly joined capillaries. It may also be a therapeutic procedure. Let’s look at two different therapies that involve creating an anastomosis.This diagram shows a common type of surgical anastomosis known as a Roux-en-Y. It can be usedto bypass diseased or damaged areas.It is also a somewhat common technique inbariatric surgery. It has the advantage of being donelaparoscopically, and may therefore be safer than“stomach stapling.”

7. Anastomsosis, part 2 This type of surgical anastomosis is intended to eliminate the need for a total colostomy. Instead of wearing an external waste pouch the patient is able to lead a more normal life. The Mayo Clinic is known for this approach.http://www.mayoclinic.org/colostomy-sparing-surgery/