Chapter 8 presentation
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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
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Laparoscopic Cholecystectomy
A laparoscopic cholecystectomy is a minimally invasive surgical procedure to remove the gallbladder through several small incisions in the abdomen. During the procedure, carbon dioxide is used to inflate the abdomen so instruments can be inserted to tie off the cystic duct and artery before removing the gallbladder. It is usually performed to treat gallstones, gallbladder polyps, or cholecystitis. Compared to open surgery, laparoscopic cholecystectomy results in less pain, shorter hospital stays, and better cosmetic outcomes, though there are risks such as injury to other organs or postoperative bleeding.
Cholecystectomy
This document discusses cholecystectomy, the surgical removal of the gallbladder. It describes the gallbladder's location and function of storing and concentrating bile produced by the liver. Cholecystectomy is commonly performed to treat gallstones and gallbladder inflammation. The risks of the procedure include bile leaks, bleeding, infection, and injury to nearby structures. The two main types are open cholecystectomy, involving a single large incision, and laparoscopic cholecystectomy using 3-4 smaller incisions and an endoscope. Laparoscopic surgery has a shorter recovery time.
Cholecystectomy open versus laparoscopic surgery
This document compares open and laparoscopic cholecystectomy procedures. Open cholecystectomy is easier to perform and more cost effective, but results in a longer hospital stay and poorer cosmetic outcomes. Laparoscopic cholecystectomy is now the gold standard, providing shorter recovery time and fewer complications, but requires specialized equipment and training and carries a higher risk of duct injuries. Both approaches are appropriate depending on the patient's condition and surgeon's expertise.
Orthotopic neobladder
This document provides an overview of the history and techniques for orthotopic neobladder urinary diversion. Some key points:
- Orthotopic diversion was pioneered in the 1950s as an alternative to ureterosigmoidostomy and ileal conduit diversion due to complications of those procedures.
- Patient selection considers oncologic factors like risk of urethral recurrence and tumor stage, as well as patient factors like age, renal function, manual dexterity, and prior treatments.
- Surgical techniques aim to optimize continence by preserving the rhabdosphincter and its innervation during cystectomy. For males the urethra is detached in a retrograde
Stomas
The document discusses stomas, which are artificial openings in the colon or small intestine used to divert feces outside the abdomen. It describes two types of stomas - loop ileostomies, which are temporary and used to defunction a low rectal anastomosis, and end ileostomies, which can be permanent. It also discusses short bowel syndrome, defined as less than 200cm of residual small intestine in adults, and its causes and management through medical therapy including TPN, intestinal lengthening surgeries, and intestinal transplantation in severe cases.
urinary diversions in bladder cancer
1. Radical cystectomy is the surgical removal of the bladder and surrounding organs for bladder cancer treatment. It is often combined with pelvic lymphadenectomy.
2. There are three main types of urinary diversions performed after radical cystectomy: ileal conduit, continent cutaneous reservoir, and orthotopic neobladder.
3. The ileal conduit diverts urine through a segment of isolated ileum and out through an abdominal stoma. The continent cutaneous reservoir and orthotopic neobladder provide continent diversions using intestinal segments to form a pouch emptied through catheterization. Choice of diversion depends on disease factors, patient factors, and surgeon experience.
Open Vs Laparoscopic cholecystectomy
This document summarizes information on gallbladder removal surgery (cholecystectomy). It discusses the history and types of cholecystectomy procedures, including open and laparoscopic techniques. Key points include that laparoscopic cholecystectomy has become the gold standard treatment for gallstone disease since the 1990s as it is associated with less pain, smaller incisions, shorter hospital stays and faster recovery compared to open cholecystectomy. However, laparoscopic approaches may be more technically challenging and carry a higher risk of bile duct injuries.
Open cholecystectomy vs laparoscopic cholecystectomy
1. Open Cholecystectomy v/s Laparoscopic cholecystectomy - Gallbladder Stone Surgery
2. Introduction - Gallstones are a common occurrence in northern India. However, this trend is now showing pa
3. n India presence probably because of migration and blending of cultures and lifestyle. As many as 16% and 29% of women above the age of 40-49 years and 50-59 years, respectively, had gall stones. For every patient with symptomatic gallstone disease there are many more with asymptomatic gallstones. Laparoscopic cholecystectomy has now replaced open cholecystectomy as the first-choice of treatment for gallbladder stone and inflammation of the gallbladder.
4. Open Cholecystectomy - Cholecystectomy is one of the most commonly performed abdominal surgical procedures. The laparoscopic approach is preferred due to documented physiologic, economic, and cosmetic benefits compared with the open approach. However, when laparoscopic cholecystectomy is not possible or cannot be completed safely, open cholecystectomy is indicated. Open cholecystectomy may also be performed as an integral part of another operation (eg, pancreaticoduodenectomy) or incidentally, if indicated, during another gastrointestinal operation (eg, colon resection).
5. Laparoscopic cholecystectomy - Cholecystectomy is one of the most commonly performed abdominal surgical procedures, and in developed countries many are performed laparoscopically. As an example, 90 percent of cholecystectomies in the United States are performed laparoscopically. Laparoscopic cholecystectomy is considered the "gold standard" for the surgical treatment of gallstone disease. This procedure results in less postoperative pain, better cosmetics, and shorter hospital stays and disability from work than open cholecystectomy [2-8]. However, the overall serious complication rate in laparoscopic cholecystectomy remains higher than that seen in open cholecystectomy.
6. Risks & Complications - The risk of complications is very low, however, potential risks might include: - Bleeding, Infection, Common bile duct injury, Minor shoulder pain (from the carbon dioxide gas), Bile leakage.
7. Benefits: - Less discomfort than regular surgery, Shorter hospital stay, with a quicker recovery time compared to regular (open) surgery, Smaller scars than regular surgery.
8. Consult us for Gallbladder Stone Treatment - For Appointment Call 079-29703438 Or Visit :- www.drchiragthakkar.com
Recommended
Laparoscopic Cholecystectomy
A laparoscopic cholecystectomy is a minimally invasive surgical procedure to remove the gallbladder through several small incisions in the abdomen. During the procedure, carbon dioxide is used to inflate the abdomen so instruments can be inserted to tie off the cystic duct and artery before removing the gallbladder. It is usually performed to treat gallstones, gallbladder polyps, or cholecystitis. Compared to open surgery, laparoscopic cholecystectomy results in less pain, shorter hospital stays, and better cosmetic outcomes, though there are risks such as injury to other organs or postoperative bleeding.
Cholecystectomy
This document discusses cholecystectomy, the surgical removal of the gallbladder. It describes the gallbladder's location and function of storing and concentrating bile produced by the liver. Cholecystectomy is commonly performed to treat gallstones and gallbladder inflammation. The risks of the procedure include bile leaks, bleeding, infection, and injury to nearby structures. The two main types are open cholecystectomy, involving a single large incision, and laparoscopic cholecystectomy using 3-4 smaller incisions and an endoscope. Laparoscopic surgery has a shorter recovery time.
Cholecystectomy open versus laparoscopic surgery
This document compares open and laparoscopic cholecystectomy procedures. Open cholecystectomy is easier to perform and more cost effective, but results in a longer hospital stay and poorer cosmetic outcomes. Laparoscopic cholecystectomy is now the gold standard, providing shorter recovery time and fewer complications, but requires specialized equipment and training and carries a higher risk of duct injuries. Both approaches are appropriate depending on the patient's condition and surgeon's expertise.
Orthotopic neobladder
This document provides an overview of the history and techniques for orthotopic neobladder urinary diversion. Some key points:
- Orthotopic diversion was pioneered in the 1950s as an alternative to ureterosigmoidostomy and ileal conduit diversion due to complications of those procedures.
- Patient selection considers oncologic factors like risk of urethral recurrence and tumor stage, as well as patient factors like age, renal function, manual dexterity, and prior treatments.
- Surgical techniques aim to optimize continence by preserving the rhabdosphincter and its innervation during cystectomy. For males the urethra is detached in a retrograde
Stomas
The document discusses stomas, which are artificial openings in the colon or small intestine used to divert feces outside the abdomen. It describes two types of stomas - loop ileostomies, which are temporary and used to defunction a low rectal anastomosis, and end ileostomies, which can be permanent. It also discusses short bowel syndrome, defined as less than 200cm of residual small intestine in adults, and its causes and management through medical therapy including TPN, intestinal lengthening surgeries, and intestinal transplantation in severe cases.
urinary diversions in bladder cancer
1. Radical cystectomy is the surgical removal of the bladder and surrounding organs for bladder cancer treatment. It is often combined with pelvic lymphadenectomy.
2. There are three main types of urinary diversions performed after radical cystectomy: ileal conduit, continent cutaneous reservoir, and orthotopic neobladder.
3. The ileal conduit diverts urine through a segment of isolated ileum and out through an abdominal stoma. The continent cutaneous reservoir and orthotopic neobladder provide continent diversions using intestinal segments to form a pouch emptied through catheterization. Choice of diversion depends on disease factors, patient factors, and surgeon experience.
Open Vs Laparoscopic cholecystectomy
This document summarizes information on gallbladder removal surgery (cholecystectomy). It discusses the history and types of cholecystectomy procedures, including open and laparoscopic techniques. Key points include that laparoscopic cholecystectomy has become the gold standard treatment for gallstone disease since the 1990s as it is associated with less pain, smaller incisions, shorter hospital stays and faster recovery compared to open cholecystectomy. However, laparoscopic approaches may be more technically challenging and carry a higher risk of bile duct injuries.
Open cholecystectomy vs laparoscopic cholecystectomy
1. Open Cholecystectomy v/s Laparoscopic cholecystectomy - Gallbladder Stone Surgery
2. Introduction - Gallstones are a common occurrence in northern India. However, this trend is now showing pa
3. n India presence probably because of migration and blending of cultures and lifestyle. As many as 16% and 29% of women above the age of 40-49 years and 50-59 years, respectively, had gall stones. For every patient with symptomatic gallstone disease there are many more with asymptomatic gallstones. Laparoscopic cholecystectomy has now replaced open cholecystectomy as the first-choice of treatment for gallbladder stone and inflammation of the gallbladder.
4. Open Cholecystectomy - Cholecystectomy is one of the most commonly performed abdominal surgical procedures. The laparoscopic approach is preferred due to documented physiologic, economic, and cosmetic benefits compared with the open approach. However, when laparoscopic cholecystectomy is not possible or cannot be completed safely, open cholecystectomy is indicated. Open cholecystectomy may also be performed as an integral part of another operation (eg, pancreaticoduodenectomy) or incidentally, if indicated, during another gastrointestinal operation (eg, colon resection).
5. Laparoscopic cholecystectomy - Cholecystectomy is one of the most commonly performed abdominal surgical procedures, and in developed countries many are performed laparoscopically. As an example, 90 percent of cholecystectomies in the United States are performed laparoscopically. Laparoscopic cholecystectomy is considered the "gold standard" for the surgical treatment of gallstone disease. This procedure results in less postoperative pain, better cosmetics, and shorter hospital stays and disability from work than open cholecystectomy [2-8]. However, the overall serious complication rate in laparoscopic cholecystectomy remains higher than that seen in open cholecystectomy.
6. Risks & Complications - The risk of complications is very low, however, potential risks might include: - Bleeding, Infection, Common bile duct injury, Minor shoulder pain (from the carbon dioxide gas), Bile leakage.
7. Benefits: - Less discomfort than regular surgery, Shorter hospital stay, with a quicker recovery time compared to regular (open) surgery, Smaller scars than regular surgery.
8. Consult us for Gallbladder Stone Treatment - For Appointment Call 079-29703438 Or Visit :- www.drchiragthakkar.com
Powerpoint gallbladder
Cholecystectomy is a surgical procedure to remove the gallbladder. Over half a million people in the US undergo cholecystectomy each year. During the procedure, instruments such as a laparoscope, grasper, needle driver, and trocars are used to remove the gallbladder either through several small incisions using laparoscopic techniques or through a single larger incision in an open procedure.
Urinary diversion
Urinary diversion involves redirecting the urinary pathway from the bladder due to conditions like muscle invasive bladder cancer. There are various types including continent, incontinent, internal, and external diversions. The ileal conduit is the most common non-continent diversion and involves using a segment of ileum as a urinary conduit connected to an abdominal stoma. Continent diversions like the Indiana pouch create an internal pouch that allows intermittent self-catheterization. Complications of urinary diversion can include metabolic abnormalities, infections, stone formation, and nutritional deficiencies depending on the bowel segment used.
Urinary diversion
Urinary diversion procedures are performed to divert urine from the bladder to a new exit site, usually through a surgically created opening (stoma) in the skin.
These procedures are primarily performed when a bladder tumor necessitates removal of the entire bladder (cystectomy).
Urinary diversion has also been used in managing pelvic malignancy, birth defects, strictures, trauma to ureters and urethra, neurogenic bladder, chronic infection causing severe ureteral and renal damage, and intractable interstitial cystitis and as a last resort in managing incontinence.
There are two categories of urinary diversion:
1. Cutaneous urinary diversion : in which urine drains through an opening created in the abdominal wall and skin.
2. Continent urinary diversion : in which a portion of the intestine is used to create a new reservoir for urine.
Laparoscopic cholecystectomy
This document provides guidelines for laparoscopic cholecystectomy. It outlines indications for the procedure including symptomatic gallstones and acute cholecystitis. High-risk patients for bile duct stones are evaluated preoperatively with ERCP. The basic operative technique is described including abdominal access and establishing the critical view of safety. Intraoperative cholangiography is routinely performed to detect common bile duct stones which may be treated endoscopically or with exploration. Conversion to open surgery should be considered for infected or scarred gallbladders or if the anatomy cannot be clearly defined. Major complications are bile duct injury and bleeding.
Urinary Diversion
This document provides an overview of urinary diversion and urinary bladder substitution techniques. It discusses the history and types of urinary diversion, including temporary vs. permanent, external vs. internal, continent vs. incontinent, and definitive vs. palliative diversions. Common techniques described include ileal conduits, colonic conduits, cutaneous continent diversions like Kock pouches, and orthotopic neobladders. Complications of different diversion methods are outlined. Factors in selecting the appropriate diversion type include the patient's age, comorbidities, renal function, and tumor extent/location. The goal is to maximize tumor control while minimizing complications and optimizing quality of life.
Cutaneous urinary Stoma
This document describes cutaneous urinary diversion, which involves creating an artificial opening in the skin for urinary elimination when the bladder has been removed or damaged. It defines urinary diversion and lists indications. It describes types of diversions based on elevation from the skin surface and shape. It discusses incontinent diversions like ileal conduits and continent diversions using techniques like Mitrofanoff appendicovesicostomy. Early and late complications of stomas are outlined, including ischemia, hemorrhage, stenosis, prolapse, hernia, and skin issues. Management strategies are provided for various complications that may arise.
Procedure of ercp and t tube cholangiography
The document describes the procedure of ERCP and T-tube cholangiography, outlining the anatomy, indications, contraindications, equipment, patient preparation, technique, and potential complications. ERCP allows endoscopes and other tools to be passed through the duodenum to visualize and treat the biliary and pancreatic ducts using techniques like sphincterotomy, stone removal, stent placement, and biopsy. A T-tube cholangiogram involves injecting contrast through a surgical T-tube in the bile ducts to image them after gallbladder removal.
T-tube Cholangiogram
A T-tube cholangiogram is an x-ray of the biliary duct system used to detect blockages. Contrast material is injected through a T-tube, which is sometimes placed during liver or gallbladder surgery, allowing visualization of the ducts. It can show remaining gallstones or fragments after surgery and help doctors determine when to remove the T-tube. There are other cholangiogram methods like MRCP that do not require contrast injection.
Difficult Laparoscopic Cholecystectomy-When and Where is the Need to Convert?
Laparoscopic cholecystectomy has now become the treatment of choice for the gall bladder stone. With increasing experience, surgeon has started to take more difficult cases which were considered relative contra indications for laparoscopic removal of gall bladder few years back.
We conducted this study at our hospital and included all laparoscopic cholecystectomy done from May'08 to January'10. Total time taken in surgery, conversion rate and complication rate were analysed. Factors making laparoscopic cholecystectomy difficult were also analysed. We defined difficult laparoscopic cholecystectomy when we found -dense fibrotic adhesions in and around Callot's triangle, gangrenous gall bladder, empyma, large stone impacted at gall bladder neck, contracted gall bladder, Mirrizi's syndrome, h/o biliary pancreatitis, CBD stones, acute cholecystitis of <72 hrs duration.
Out of 206 cases done during above period, 56 cases were considered difficult. Only two cases were converted to open.
With growing experience and technical advancement surgery can be completed in most of the difficult cases. This is important because recently it is shown in literature that laparoscopic cholecystectomy is associated with less morbidity than open method irrespective of duration of the surgery.
How to do - Abdominal Trauma
1) The document provides guidelines for conducting an exploratory laparotomy for abdominal trauma. It indicates that an unstable patient requires an immediate laparotomy as part of primary survey while stable patients may first undergo diagnostic tests like ultrasound, CT scan, and diagnostic peritoneal lavage.
2) The indications for an exploratory laparotomy include penetrating wounds, signs of peritonitis, need for fluid resuscitation with no other bleeding source, presence of air under the diaphragm, and CT evidence of blood or ruptured organs.
3) Before opening the abdomen, the surgeon should ensure blood is available, prevent hypothermia, insert NG tube and Foley's catheter, administer antibiotics,
Cholecystectomy
A cholecystectomy involves the surgical removal of the gallbladder. The gallbladder stores and concentrates bile produced by the liver to aid in fat digestion. Cholecystectomy is commonly performed to treat gallstones and related complications like gallbladder inflammation. The surgery can be performed through traditional open surgery or through laparoscopic methods involving small incisions. Conditions that may require open rather than laparoscopic cholecystectomy include severe inflammation, abdominal lining inflammation, liver cirrhosis, late-stage pregnancy, or bleeding disorders.
Less-than-total laparoscopic cholecystectomy: how I do it, 2018, by R. Lunevi...
Less-than-total laparoscopic cholecystectomy: how I do it, 2018, by R. Lunevi...Raimundas Lunevicius
This document discusses techniques for performing less-than-total laparoscopic cholecystectomy (LC). The key principles are to remove as much gallbladder wall and all gallstones as possible. Variants include circular subtotal excision and fundectomy. Completion can be reconstituting or fenestrating. Less-than-total LC is recommended when a total LC cannot be achieved safely, such as in cases of intrahepatic gallbladder or inflammatory masses. It has lower morbidity than open surgery and no reported bile duct injuries or visceral injuries in over 300 cases by the author.Urinary diversion by dr burhan kaydawla
The document discusses various types of urinary diversion procedures. It begins with a brief history, noting that the first urinary diversion was performed by Simon in 1852, while the ileal conduit became the gold standard in the 1990s. The main types of diversion discussed are non-continent diversions like ileal conduits, and continent diversions like orthotopic neobladders and heterotopic reservoirs that are catheterized through an abdominal stoma. Key aspects like indications, surgical techniques, and complications are summarized.
Operative Cholangiogram
An operative cholangiogram is performed during gallbladder surgery to inject radiopaque dye into the biliary tract and take x-rays to reveal images of the tract. It is used when other less invasive tests have not provided enough information and can reveal gallstones, investigate the biliary tract, determine function of an organ, and demonstrate lesions or abnormalities. The procedure requires radiopaque dye, a catheter, cannula, and C-arm for fluoroscopy during laparoscopic surgery to view the biliary tract.
ERCP
An ERCP involves inserting an endoscope through the mouth and stomach into the duodenum, then inserting a thin tube through the endoscope into the biliary tract to inject radiopaque dye and take x-rays of the biliary tract and pancreatic duct. ERCPs are used diagnostically to detect gallstones, cancer, and other pathologies and to remove stones or lesions or repair narrow ducts. Patients must not eat or drink for 8-10 hours before the exam, which typically lasts 30 minutes to 2 hours. Required supplies include an endoscope, oral anesthetic, contrast media, films, and a C-arm may be used to take images.
Ercp
ERCP is an endoscopic procedure that combines endoscopy and fluoroscopy to diagnose and treat issues in the duodenum, bile ducts, pancreatic duct, and gallbladder. During ERCP, an endoscope is inserted and a catheter is used to inject radiocontrast dye to identify any blockages. If needed, a wire can enlarge the opening to the bile duct to remove gallstones or perform other procedures like stent placement. Potential but rare complications include infection, pancreatitis, bleeding, and perforation of the GI tract. ERCP requires an experienced physician due to its risks.
PTBD
PTC and PTBD are procedures used to examine and drain the bile duct system. PTC involves inserting a thin needle through the skin and liver into the bile ducts to inject dye and outline the ducts on x-rays. PTBD places a small drainage tube through the skin and liver if a blockage is found, allowing bile to drain externally. These procedures are used to investigate biliary stones, strictures, jaundice, and pancreatic or lymph node cancers. Complications can include pain, infections, and bleeding. Preparation involves tests and antibiotics before inserting the needle or tube under imaging guidance while monitoring vitals.
GIT Kurdistan Board GEH Journal club: Post ERCP Pancreatitis prophylaxis.
This document provides guidelines from the European Society of Gastrointestinal Endoscopy (ESGE) for prophylaxis of post-ERCP pancreatitis. It defines post-ERCP pancreatitis and notes an incidence of 4.4% with mild, moderate, and severe types occurring in 69%, 23%, and 8% of cases, respectively. The main recommendations are to administer rectal NSAIDs before or after ERCP, consider prophylactic pancreatic stenting for high-risk patients, minimize cannulation attempts, and use needle-knife fistulotomy as the preferred precut technique.
Biliary Anatomy and Reconstruction of the Biliary Tract
This document discusses various biliary conditions and procedures. It begins by listing different bile duct abnormalities and causes of gallstone disease. Various biliary reconstruction procedures are then described such as end-to-end anastomosis, choledochojejunostomy, and hepaticojejunostomy. Key steps for biliary reconstruction surgery are outlined including exposure, adhesiolysis, and irrigation. Complications are noted and T-tube placement is described as a option for distal bile duct injuries or palliation.
Hernia by Dr Hatem Elgohary
- A hernia is a protrusion of an organ or tissue through an abnormal opening in the walls of its containing cavity. Common types include congenital, indirect inguinal, direct inguinal, and femoral hernias.
- Hernias can be reducible, irreducible, obstructed, strangulated, or inflamed depending on whether the contents can be pushed back into the cavity, are trapped but not compromised, or if the blood flow is restricted.
- Indirect inguinal hernias are the most common type and can be classified as bubonocele, funicular, or complete depending on their location and contents. Direct inguinal hernias occur through weaknesses in the abdominal
TEP Medline
The document discusses several studies on the use of laparoscopic (TEP) and open preperitoneal (OPM) approaches for repairing recurrent inguinal hernias. The studies found that both approaches had low recurrence rates of around 2%, with the TEP approach having shorter operating times and hospital stays compared to OPM. Overall, the studies concluded that the preperitoneal approaches, whether open or laparoscopic, are good options for repairing recurrent inguinal hernias when performed by experienced surgeons.
TEP
- Laparoscopic repair of recurrent inguinal hernias has low recurrence rates of 0-1.1% and is associated with less pain and faster recovery compared to open repair.
- TEP repair is an effective procedure for treating direct, indirect, pantaloon, and recurrent hernias through small incisions with early return to normal activities and is a reliable technique for recurrent hernia repair after previous endoscopic herniorrhaphy.
- The learning curve for TEP is longer than for open repair, with some studies suggesting surgeons need to perform more than 100-250 laparoscopic procedures before recurrence rates fall below 5%.
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Powerpoint gallbladder
Cholecystectomy is a surgical procedure to remove the gallbladder. Over half a million people in the US undergo cholecystectomy each year. During the procedure, instruments such as a laparoscope, grasper, needle driver, and trocars are used to remove the gallbladder either through several small incisions using laparoscopic techniques or through a single larger incision in an open procedure.
Urinary diversion
Urinary diversion involves redirecting the urinary pathway from the bladder due to conditions like muscle invasive bladder cancer. There are various types including continent, incontinent, internal, and external diversions. The ileal conduit is the most common non-continent diversion and involves using a segment of ileum as a urinary conduit connected to an abdominal stoma. Continent diversions like the Indiana pouch create an internal pouch that allows intermittent self-catheterization. Complications of urinary diversion can include metabolic abnormalities, infections, stone formation, and nutritional deficiencies depending on the bowel segment used.
Urinary diversion
Urinary diversion procedures are performed to divert urine from the bladder to a new exit site, usually through a surgically created opening (stoma) in the skin.
These procedures are primarily performed when a bladder tumor necessitates removal of the entire bladder (cystectomy).
Urinary diversion has also been used in managing pelvic malignancy, birth defects, strictures, trauma to ureters and urethra, neurogenic bladder, chronic infection causing severe ureteral and renal damage, and intractable interstitial cystitis and as a last resort in managing incontinence.
There are two categories of urinary diversion:
1. Cutaneous urinary diversion : in which urine drains through an opening created in the abdominal wall and skin.
2. Continent urinary diversion : in which a portion of the intestine is used to create a new reservoir for urine.
Laparoscopic cholecystectomy
This document provides guidelines for laparoscopic cholecystectomy. It outlines indications for the procedure including symptomatic gallstones and acute cholecystitis. High-risk patients for bile duct stones are evaluated preoperatively with ERCP. The basic operative technique is described including abdominal access and establishing the critical view of safety. Intraoperative cholangiography is routinely performed to detect common bile duct stones which may be treated endoscopically or with exploration. Conversion to open surgery should be considered for infected or scarred gallbladders or if the anatomy cannot be clearly defined. Major complications are bile duct injury and bleeding.
Urinary Diversion
This document provides an overview of urinary diversion and urinary bladder substitution techniques. It discusses the history and types of urinary diversion, including temporary vs. permanent, external vs. internal, continent vs. incontinent, and definitive vs. palliative diversions. Common techniques described include ileal conduits, colonic conduits, cutaneous continent diversions like Kock pouches, and orthotopic neobladders. Complications of different diversion methods are outlined. Factors in selecting the appropriate diversion type include the patient's age, comorbidities, renal function, and tumor extent/location. The goal is to maximize tumor control while minimizing complications and optimizing quality of life.
Cutaneous urinary Stoma
This document describes cutaneous urinary diversion, which involves creating an artificial opening in the skin for urinary elimination when the bladder has been removed or damaged. It defines urinary diversion and lists indications. It describes types of diversions based on elevation from the skin surface and shape. It discusses incontinent diversions like ileal conduits and continent diversions using techniques like Mitrofanoff appendicovesicostomy. Early and late complications of stomas are outlined, including ischemia, hemorrhage, stenosis, prolapse, hernia, and skin issues. Management strategies are provided for various complications that may arise.
Procedure of ercp and t tube cholangiography
The document describes the procedure of ERCP and T-tube cholangiography, outlining the anatomy, indications, contraindications, equipment, patient preparation, technique, and potential complications. ERCP allows endoscopes and other tools to be passed through the duodenum to visualize and treat the biliary and pancreatic ducts using techniques like sphincterotomy, stone removal, stent placement, and biopsy. A T-tube cholangiogram involves injecting contrast through a surgical T-tube in the bile ducts to image them after gallbladder removal.
T-tube Cholangiogram
A T-tube cholangiogram is an x-ray of the biliary duct system used to detect blockages. Contrast material is injected through a T-tube, which is sometimes placed during liver or gallbladder surgery, allowing visualization of the ducts. It can show remaining gallstones or fragments after surgery and help doctors determine when to remove the T-tube. There are other cholangiogram methods like MRCP that do not require contrast injection.
Difficult Laparoscopic Cholecystectomy-When and Where is the Need to Convert?
Laparoscopic cholecystectomy has now become the treatment of choice for the gall bladder stone. With increasing experience, surgeon has started to take more difficult cases which were considered relative contra indications for laparoscopic removal of gall bladder few years back.
We conducted this study at our hospital and included all laparoscopic cholecystectomy done from May'08 to January'10. Total time taken in surgery, conversion rate and complication rate were analysed. Factors making laparoscopic cholecystectomy difficult were also analysed. We defined difficult laparoscopic cholecystectomy when we found -dense fibrotic adhesions in and around Callot's triangle, gangrenous gall bladder, empyma, large stone impacted at gall bladder neck, contracted gall bladder, Mirrizi's syndrome, h/o biliary pancreatitis, CBD stones, acute cholecystitis of <72 hrs duration.
Out of 206 cases done during above period, 56 cases were considered difficult. Only two cases were converted to open.
With growing experience and technical advancement surgery can be completed in most of the difficult cases. This is important because recently it is shown in literature that laparoscopic cholecystectomy is associated with less morbidity than open method irrespective of duration of the surgery.
How to do - Abdominal Trauma
1) The document provides guidelines for conducting an exploratory laparotomy for abdominal trauma. It indicates that an unstable patient requires an immediate laparotomy as part of primary survey while stable patients may first undergo diagnostic tests like ultrasound, CT scan, and diagnostic peritoneal lavage.
2) The indications for an exploratory laparotomy include penetrating wounds, signs of peritonitis, need for fluid resuscitation with no other bleeding source, presence of air under the diaphragm, and CT evidence of blood or ruptured organs.
3) Before opening the abdomen, the surgeon should ensure blood is available, prevent hypothermia, insert NG tube and Foley's catheter, administer antibiotics,
Cholecystectomy
A cholecystectomy involves the surgical removal of the gallbladder. The gallbladder stores and concentrates bile produced by the liver to aid in fat digestion. Cholecystectomy is commonly performed to treat gallstones and related complications like gallbladder inflammation. The surgery can be performed through traditional open surgery or through laparoscopic methods involving small incisions. Conditions that may require open rather than laparoscopic cholecystectomy include severe inflammation, abdominal lining inflammation, liver cirrhosis, late-stage pregnancy, or bleeding disorders.
Less-than-total laparoscopic cholecystectomy: how I do it, 2018, by R. Lunevi...
Less-than-total laparoscopic cholecystectomy: how I do it, 2018, by R. Lunevi...Raimundas Lunevicius
This document discusses techniques for performing less-than-total laparoscopic cholecystectomy (LC). The key principles are to remove as much gallbladder wall and all gallstones as possible. Variants include circular subtotal excision and fundectomy. Completion can be reconstituting or fenestrating. Less-than-total LC is recommended when a total LC cannot be achieved safely, such as in cases of intrahepatic gallbladder or inflammatory masses. It has lower morbidity than open surgery and no reported bile duct injuries or visceral injuries in over 300 cases by the author.Urinary diversion by dr burhan kaydawla
The document discusses various types of urinary diversion procedures. It begins with a brief history, noting that the first urinary diversion was performed by Simon in 1852, while the ileal conduit became the gold standard in the 1990s. The main types of diversion discussed are non-continent diversions like ileal conduits, and continent diversions like orthotopic neobladders and heterotopic reservoirs that are catheterized through an abdominal stoma. Key aspects like indications, surgical techniques, and complications are summarized.
Operative Cholangiogram
An operative cholangiogram is performed during gallbladder surgery to inject radiopaque dye into the biliary tract and take x-rays to reveal images of the tract. It is used when other less invasive tests have not provided enough information and can reveal gallstones, investigate the biliary tract, determine function of an organ, and demonstrate lesions or abnormalities. The procedure requires radiopaque dye, a catheter, cannula, and C-arm for fluoroscopy during laparoscopic surgery to view the biliary tract.
ERCP
An ERCP involves inserting an endoscope through the mouth and stomach into the duodenum, then inserting a thin tube through the endoscope into the biliary tract to inject radiopaque dye and take x-rays of the biliary tract and pancreatic duct. ERCPs are used diagnostically to detect gallstones, cancer, and other pathologies and to remove stones or lesions or repair narrow ducts. Patients must not eat or drink for 8-10 hours before the exam, which typically lasts 30 minutes to 2 hours. Required supplies include an endoscope, oral anesthetic, contrast media, films, and a C-arm may be used to take images.
Ercp
ERCP is an endoscopic procedure that combines endoscopy and fluoroscopy to diagnose and treat issues in the duodenum, bile ducts, pancreatic duct, and gallbladder. During ERCP, an endoscope is inserted and a catheter is used to inject radiocontrast dye to identify any blockages. If needed, a wire can enlarge the opening to the bile duct to remove gallstones or perform other procedures like stent placement. Potential but rare complications include infection, pancreatitis, bleeding, and perforation of the GI tract. ERCP requires an experienced physician due to its risks.
PTBD
PTC and PTBD are procedures used to examine and drain the bile duct system. PTC involves inserting a thin needle through the skin and liver into the bile ducts to inject dye and outline the ducts on x-rays. PTBD places a small drainage tube through the skin and liver if a blockage is found, allowing bile to drain externally. These procedures are used to investigate biliary stones, strictures, jaundice, and pancreatic or lymph node cancers. Complications can include pain, infections, and bleeding. Preparation involves tests and antibiotics before inserting the needle or tube under imaging guidance while monitoring vitals.
GIT Kurdistan Board GEH Journal club: Post ERCP Pancreatitis prophylaxis.
This document provides guidelines from the European Society of Gastrointestinal Endoscopy (ESGE) for prophylaxis of post-ERCP pancreatitis. It defines post-ERCP pancreatitis and notes an incidence of 4.4% with mild, moderate, and severe types occurring in 69%, 23%, and 8% of cases, respectively. The main recommendations are to administer rectal NSAIDs before or after ERCP, consider prophylactic pancreatic stenting for high-risk patients, minimize cannulation attempts, and use needle-knife fistulotomy as the preferred precut technique.
Biliary Anatomy and Reconstruction of the Biliary Tract
This document discusses various biliary conditions and procedures. It begins by listing different bile duct abnormalities and causes of gallstone disease. Various biliary reconstruction procedures are then described such as end-to-end anastomosis, choledochojejunostomy, and hepaticojejunostomy. Key steps for biliary reconstruction surgery are outlined including exposure, adhesiolysis, and irrigation. Complications are noted and T-tube placement is described as a option for distal bile duct injuries or palliation.
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Difficult Laparoscopic Cholecystectomy-When and Where is the Need to Convert?
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GIT Kurdistan Board GEH Journal club: Post ERCP Pancreatitis prophylaxis.
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Biliary Anatomy and Reconstruction of the Biliary Tract
Biliary Anatomy and Reconstruction of the Biliary Tract
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Hernia by Dr Hatem Elgohary
- A hernia is a protrusion of an organ or tissue through an abnormal opening in the walls of its containing cavity. Common types include congenital, indirect inguinal, direct inguinal, and femoral hernias.
- Hernias can be reducible, irreducible, obstructed, strangulated, or inflamed depending on whether the contents can be pushed back into the cavity, are trapped but not compromised, or if the blood flow is restricted.
- Indirect inguinal hernias are the most common type and can be classified as bubonocele, funicular, or complete depending on their location and contents. Direct inguinal hernias occur through weaknesses in the abdominal
TEP Medline
The document discusses several studies on the use of laparoscopic (TEP) and open preperitoneal (OPM) approaches for repairing recurrent inguinal hernias. The studies found that both approaches had low recurrence rates of around 2%, with the TEP approach having shorter operating times and hospital stays compared to OPM. Overall, the studies concluded that the preperitoneal approaches, whether open or laparoscopic, are good options for repairing recurrent inguinal hernias when performed by experienced surgeons.
TEP
- Laparoscopic repair of recurrent inguinal hernias has low recurrence rates of 0-1.1% and is associated with less pain and faster recovery compared to open repair.
- TEP repair is an effective procedure for treating direct, indirect, pantaloon, and recurrent hernias through small incisions with early return to normal activities and is a reliable technique for recurrent hernia repair after previous endoscopic herniorrhaphy.
- The learning curve for TEP is longer than for open repair, with some studies suggesting surgeons need to perform more than 100-250 laparoscopic procedures before recurrence rates fall below 5%.
Laparoscopic Inguinal Hernia Repair Where Are We in 2009?
1. Laparoscopic inguinal hernia repair using TAPP or TEP is effective for both primary and recurrent hernias, with benefits including reduced pain, earlier return to work/activity, and reduced recurrence rates compared to open surgery.
2. Recurrent hernias make up about 10-15% of a general surgeon's hernia caseload. While laparoscopy allows full visualization to detect occult hernias, repair of recurrent hernias, especially after a prior laparoscopic procedure, remains technically challenging.
3. For recurrent hernias after an initial laparoscopic procedure, laparoscopy may be attempted by experienced surgeons but open techniques are preferred by some due to
Chapter 8 presentation
The document summarizes four medical procedures: hernioplasty is the surgical repair of a hernia using a mesh or plug; extraction is the removal of a tooth; anastomosis is the linkage of two structures like blood vessels or loops of intestine; and choledocholithotripsy is the crushing of a gallstone in the bile duct without opening the duct.
Cholelithiaisis
Cholelithiasis, or gallstones, can be either cholesterol stones or pigment stones. Cholesterol stones form when bile becomes supersaturated with cholesterol, while pigment stones are caused by elevated bilirubin levels. Risk factors for cholesterol stones include obesity, rapid weight loss, female sex hormones, and certain genetic disorders. Risk factors for pigment stones include chronic hemolytic anemias and infections of the biliary tract. Gallstones may be asymptomatic but can also cause pain, inflammation of the gallbladder or bile ducts, and other complications if they obstruct ducts or erode into other organs.
Laparoscopic repair of hernia- A Guide to Laparoscopic Hernia Surgery
It includes all the essential details a Surgeon or Post graduate should know about the Laparoscopic Inguinal Hernia Anatomy and step by step Surgery along with illustrative pictures.
Hernia
This document discusses the management of inguinal hernias. It covers investigations including routine blood tests and imaging studies. Treatment involves addressing underlying conditions, use of trusses, and surgical repair options like herniotomy, herniorrhaphy, and hernioplasty. Lichtenstein tension-free hernioplasty using a prolene mesh is commonly used. Complications of hernia surgery can be intraoperative, immediate postoperative, late, or related to laparoscopic techniques. Prevention focuses on maintaining a healthy weight, diet, avoiding heavy lifting and straining, and not smoking.
Krok 1 - 2014 Path-Physiology Base (General Medicine)
A 27-year-old woman experienced an allergic reaction after using penicillin eye drops, developing itching, burning, lip and eyelid swelling, coughing, and dropping blood pressure. IgE and IgG antibodies were involved in this allergic reaction.
Kidney urine
Here are the key steps in urinalysis testing:
1. Inspect urine for color, clarity, odor
2. Test pH using strips or meter
3. Test specific gravity using refractometer or strips
4. Test for glucose using Benedict's solution
5. Test for protein using sulfosalicylic acid
6. Test for ketones using sodium nitroprusside
7. Test for bilirubin using alcoholic iodine
The urinalysis provides important information about the functioning of the kidneys and other body systems. Abnormal results could indicate infections, metabolic disorders like diabetes, or kidney dysfunction. A thorough urinalysis is an essential diagnostic tool.
Vitamins in animals
The document discusses vitamins, specifically fat soluble vitamins. It provides definitions of vitamins and details the history of vitamin A discovery. Vitamin A, also known as retinol, is derived from carotenoids in plants and is essential for vision, epithelial cell maintenance, and bone development. The document outlines the digestion, absorption, transport, storage and excretion of vitamin A as well as requirements for different animal classes.
Abdominal surgeries
This document discusses various abdominal operations including indications, investigations, pre-op preparation, anesthesia types, common incisions, and procedures for operations like cholecystectomy, appendicectomy, hernia repair, prostatectomy, and nephrectomy. It provides an overview of anatomy and procedures for different abdominal surgeries.
Cholinergic blockers
The document discusses cholinergic agents and cholinergic blocking agents that affect the autonomic nervous system. Cholinergic agents stimulate the parasympathetic nervous system by mimicking acetylcholine and cause effects like increased salivation and gastrointestinal motility. They are used to treat conditions like glaucoma and Alzheimer's disease. Cholinergic blocking agents antagonize acetylcholine in the parasympathetic nervous system and cause effects like decreased salivation and urinary retention. They are used to treat conditions like asthma, Parkinson's disease, and peptic ulcers.
Krok 1 2014 - path physiology
A woman experienced an allergic reaction after dropping penicillin eye drops. Her symptoms included itching, burning skin, swollen lips and eyelids, wheezing cough, and decreased blood pressure. This reaction was caused by IgE and IgG antibodies. A cyst surgery patient later developed hemorrhagic syndrome due to activation of the fibrinolytic system. A 43-year-old patient presented with thrombocytopenia, reduced fibrinogen, blood coagulation abnormalities, petechiae, and septic shock, indicating disseminated intravascular coagulation (DIC) syndrome.
Gastric Lavage Procedure Animation
This animation can be used to demonstrate how this sensitive procedure is performed to medical students.
This resource can be used to illustrate the gastric lavage procedure. Gastric lavage is the standard method of obtaining specimens for Tuberculosis (TB) diagnosis in young children. It is generally carried out only in infants and children below the age of two years. In older children specimens for TB microscopy and culture are better obtained by sputum induction, or voluntary coughing.
There are two items included here:
Gastric lavage Presentation.PPT - presentation that illustrates and explains the procedure with text
Gastric lavage Animation sequence.PPT - Animation which demonstrates how this procedure can be performed
Art work in this animation should be attributed to Stacey Stent. Conceptualisation and the description of the content in the teaching materials should be attributed to Rupesh Daya and Professor Maurice Kibel.
Case study on inguinal hernia
This is a case study done by me as a part of my in-service education progamme in my institution...hope this may help all nurses who wants to do a case study.
Inguinal hernia ppt
This document discusses hernias, including their anatomy, types, causes, diagnosis, and treatment options. It provides details on the layers of the abdominal wall and inguinal canal. There are two main types of hernias - indirect and direct. Treatment options include open repair techniques like Shouldice repair as well as laparoscopic techniques like TAPP and TEP which involve placing a mesh to reinforce the abdominal wall. Complications of hernia repair can include recurrence, chronic pain, infection, and injury to surrounding structures.
Hernia
1. Hernias occur when an organ or tissue protrudes through a weakness in the muscle or surrounding tissue wall. Common childhood hernias include inguinal, umbilical, diaphragmatic, omphalocele, and gastroschisis.
2. Inguinal hernias occur when abdominal contents protrude through the inguinal canal. Umbilical hernias involve protrusion through the abdominal wall near the navel and often close on their own.
3. Omphalocele and gastroschisis are congenital defects where abdominal organs protrude outside the body. They require surgical repair to return organs to the abdominal cavity.
Hernia
An inguinal hernia occurs when abdominal contents protrude through the abdominal wall in the groin region. There are two types - direct and indirect. Direct hernias develop through the posterior wall of the inguinal canal, while indirect hernias develop through the internal ring. Treatment involves surgical repair to remove the hernia sac and reinforce the abdominal wall defect to prevent recurrence. Other types of hernias include femoral, umbilical, epigastric, and incisional hernias which develop through weaknesses in the abdominal wall.
Diarrhea ppt
The document discusses diarrheal diseases, including definitions, causes, and approaches. It covers acute diarrhea, which is usually infectious and self-limited, as well as chronic diarrhea, which is often non-infectious. For acute diarrhea, fluid and electrolyte replacement is important. Evaluation involves stool analysis. Antibiotics may reduce severity and duration. Chronic diarrhea has many potential causes including secretory, osmotic, steatorrheal, inflammatory, dysmotile, and iatrogenic factors.
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Similar to Chapter 8 presentation
Digestive System Procedures
The document discusses various endoscopic procedures including colonoscopy, hernioplasty, and gastric lavage. It provides details on how each procedure is performed, what conditions they are used to treat, and potential risks involved. Choledocholithotripsy is highlighted as a non-surgical alternative to cholecystectomy for treating gallstones using shock waves to shatter stones in the gallbladder.
Incidental appendectomy
Incidental appendectomy is the removal of the appendix during another operation when there is no evidence of appendicitis. It may be performed during operations for malrotation to prevent future diagnostic confusion, as well as during hernia repairs and gynecologic or trauma surgeries. While it prevents future appendicitis, it increases operative time and risk of contamination. The appendix can also be useful for urologic reconstruction like ureteral repairs or the Mitrofanoff procedure to create a continent urinary stoma. It is also used in some cases of biliary reconstruction or for a Malone antegrade continence enema procedure to allow bowel evacuation through an abdominal stoma. The decision to remove the appendix
Pres 8
Tooth extraction is the removal of a tooth from its socket in the bone. Teeth are often extracted because they are impacted, cannot be restored due to decay or damage, or to make room for orthodontic treatment. Potential risks of extraction include infection, numbness, jaw fracture, and jaw pain.
Mesenteric and omental cyst.pptx
This document discusses mesenteric and omental cysts, which are rare fluid-filled structures caused by blockages in lymphatic drainage. They can occur in the mesentery, which connects the intestines to the body, or the omentum, folds of fatty tissue around the intestines. Symptoms include abdominal pain or distention. Ultrasound and CT scans are used to identify the cysts. Surgical removal is often needed if they cause obstruction or other issues. Enucleation or excision with possible intestinal resection are the main treatment options. Prognosis is generally favorable after surgery.
Mesenteric and omental cyst.pptx
This document discusses mesenteric and omental cysts, which are rare fluid-filled structures caused by blockages in lymphatic drainage. They can occur in the mesentery, which connects the intestines to the body, or the omentum, folds of fatty tissue around the intestines. Symptoms include abdominal pain or distention. Ultrasound and CT scans are used to identify the cysts. Surgical removal is often needed if they cause obstruction or other issues. Enucleation or excision with possible intestinal resection are the main treatment options. Prognosis is generally favorable after surgery.
Gastrostomy
Gastrostomy is commonly used as a temporary procedure to avoid discomfort from prolonged nasogastric suction after major abdominal surgery. It can also be used permanently when the esophagus is obstructed to nonresectable cancer. The Stamm gastrostomy is most common temporary procedure where a catheter is placed through the stomach wall and anchored to the skin. The Janeway gastrostomy is a permanent alternative where a flap of stomach is brought through the abdominal wall and attached to form a mucosal lined tube to prevent regurgitation. Postoperative care involves gradual advancement to oral intake as the stomach heals and functions return to normal.
Gastrostomy
Gastrostomy is commonly used as a temporary procedure to avoid discomfort from prolonged nasogastric suction after major abdominal surgery. It can also be used permanently when the esophagus is obstructed to nonresectable cancer. The Stamm gastrostomy is most common temporary procedure where a catheter is placed through the stomach wall and anchored to prevent leakage. The Janeway gastrostomy is a permanent alternative where a flap of stomach is brought through the abdominal wall and lined with mucosa to form a permanent opening, preventing regurgitation. Postoperative care involves gradual advancement to oral intake as the stomach and bowel recover function.
Module 2 Anatomy & Diseases
This document provides definitions for various anatomy and medical terms related to the stomach, gallbladder, colon, female reproductive system, and surgical procedures. It defines terms like gastrectomy, gastroenterostomy, fundoplication, vagotomy, cholecystectomy, cholecystitis, cholecystolithiasis, total colectomy, episiotomy, salpingectomy, oophrectomy, myomectomy, D&C, and Caesarean section. The document serves as a reference for common anatomy, diseases, and surgical procedures involving the listed organ systems.
Complications of acute panctratitis
Local complications of pancreatitis include pancreatic pseudocysts and pancreatic necrosis. Pancreatic pseudocysts are localized fluid collections that develop 4 weeks after pancreatitis. They are typically treated with endoscopic or surgical drainage if symptomatic. Necrosis involves tissue death and requires drainage and possibly necrosectomy. Complications are managed based on their type, location, and severity with options including endoscopic, percutaneous, or surgical interventions. Close monitoring is needed as complications can include fistulas, vascular issues, or bowel obstructions.
Barium enema
The document describes the procedures for performing a barium enema exam, including:
1) Preparing the patient by thoroughly cleansing their large bowel with laxatives to empty it.
2) Inserting the enema tip into the patient's rectum after lubricating it and having the patient exhale.
3) Hanging the closed barium enema bag system no higher than 24 inches above the patient and beginning fluoroscopy to examine the large intestine and detect any abnormalities while infusing the barium sulfate contrast.
Damage Control Surgery
This document outlines principles of trauma laparotomy and damage control surgery. It discusses relevant anatomy, indications for laparotomy following penetrating or blunt trauma, and the operative sequence including access, exploration, hemorrhage control, and damage control or definitive repair. It provides details on approaches and management of injuries to various abdominal organs. The goal is to control hemorrhage and contamination while optimizing the patient's physiology for subsequent definitive care.
Laparoscopic Adhesiolysis
This document discusses peritoneal adhesions and laparoscopic adhesiolysis. It begins by introducing peritoneal adhesions as a common cause of bowel obstruction, pelvic pain, and infertility. Adhesions form following abdominal or pelvic surgery as a normal response to peritoneal injury, but can cause morbidity. Laparoscopic adhesiolysis offers advantages over open surgery such as less pain, reduced hernia risk, and shorter recovery. The document then discusses the technique of laparoscopic adhesiolysis in detail, including port placement, dissection methods, and measures to prevent readhesion. Key aspects of pathogenesis and preventing adhesion formation are also reviewed.
Surgery of renal/ urinary system
brief description of renal/ urinary system surgery
including: pyelolithotomy, nephrectomy, nephron-sparing surgery, Ureterotomy, Cystotomy, Nephrolithotomy
including surgical requirement for renal system surgery
224463697 cholelithiasis
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Common Surgical Procedures
This document defines and describes common surgical procedures including herniorrhaphy to correct hernias, amputation to remove limbs, turp to resect the prostate, gastrectomy to remove part of the stomach, thoracostomy to access the thoracic cavity, tonsillectomy to remove the tonsils, colostomy to create a stoma in the colon, hemorrhoidectomy to remove hemorrhoids, dilatation and curettage of the uterus, hysterectomy to remove the uterus and ovaries, pulmonary lobectomy to remove a lung lobe, pneumonectomy to remove an entire lung, and more. It provides indications for each procedure and relevant definitions.
Abdominal-Access-Techniques.pdf
Minimal access surgery (MAS) a new surgical and
interventional approach, was called by different name and
one of the popular is minimally invasive surgery. However,
unique complications are associated with gaining access
to the abdomen for laparoscopic surgery. The technique
of first entry inside the human body with telescope and
instruments is called access technique. The hallmark of the
new approaches is the reduction in the trauma of access.
The technique for access to the peritoneal cavity, choice of
access technique, placement locations, and port placement
is very important in MAS. Technique of access is different for
different minimal access surgical procedures. Thoracoscopy,
retroperitoneoscopy, axilloscopy, and arthroscopy all have
different ways of access. In this chapter, we will discuss
various abdominal access techniques.
It is important to know that approximately 20% of
laparoscopic complications are caused at the time of initial
access. Developing access skill is one of the important
achievements for the surgeon practicing MAS. First entry or
access in laparoscopy is of two types: (1) closed access and
(2) open access.
World's Most Popular Hands-On Laparoscopic Training Institute
World Laparoscopy Hospital is a well-known and highly respected international training center for laparoscopic surgery. It offers a comprehensive laparoscopic surgery training course for general surgeons, gynecologists, and urologists. The training program is designed to provide both basic and advanced theoretical and practical experience to the candidates.
The laparoscopic surgery training course at World Laparoscopy Hospital is completely candidate-centered, with an emphasis on practical laparoscopic surgical problems encountered while operating on patients. The training takes place within an ultramodern laparoscopic HD wet operating room, followed by live exposure of live laparoscopic surgery in the operation theater with expert consultants.
The laparoscopic training program is affiliated with a Government-recognized university, and upon completion of the course, candidates receive a Laparoscopic Fellowship and Diploma Certificate issued by a UGC recognized university and the World Association of Laparoscopic Surgeons.
https://www.laparoscopyhospital.com/SERV01.HTM
Abdominal access-techniques
Minimal access surgery (MAS) a new surgical and interventional approach, was called by different name and one of the popular is minimally invasive surgery. However,unique complications are associated.
ELECTIVE SPLENECTOMY.pptx
This document provides information on elective splenectomy procedures. It discusses the indications for elective splenectomy, including hematological diseases causing splenomegaly or hypersplenism. The document outlines techniques for performing an open splenectomy, including ligating the splenic artery and avoiding injuries to nearby structures. It emphasizes preventing postoperative hemorrhage and sepsis. Accessory spleens should also be sought out and removed before closure to avoid therapeutic issues.
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The Electrocardiogram - Physiologic Principles
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
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2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Chapter 8 presentation
- 1. Chapter 8 PresentationRebecca Ray Four therapeutic procedures for the digestive system Lavage Hernioplasty Choledocholithotripsy Anastomosis
- 2. Gastric Lavage Gastric lavage is popularly known as stomach pumping. After a pH test to ensure the nasogastric tube is correctly inserted into the stomach, water or saline is used to wash away the contents of the stomach—either due to an overdose or as a preparation for surgery.
- 3. Hernioplasty Hernia repair may involve simply removing the herniated tissue (herniotomy) or it may also involve repairing the adjacent tissue with the patient’s own tissue or with heterogenous material such as a mesh. What used to be an inpatient procedure is now an outpatient procedure lasting less than a few hours. With the advances in laparoscopic surgery it can even be a relatively non-invasive approach.
- 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 used to bypass diseased or damaged areas. It is also a somewhat common technique in bariatric surgery. It has the advantage of being done laparoscopically, 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/