Intra operative Management of Ovarian Neoplasia
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This document discusses the intra-operative management of ovarian cancer. It outlines the objectives, primary treatment, and surgery for early and advanced stage ovarian cancer. Primary treatment involves exploratory laparotomy, total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and random peritoneal biopsies. For advanced stages, cytoreduction or debulking may be performed. The surgery involves a vertical incision, sampling of ascites and peritoneal washings, and resection of involved organs. FIGO staging criteria from Stage I to IV are also provided. Interval surgery or debulking after chemotherapy is an option for some patients. The duty of physicians is to cure when possible, treat often, and
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Presentation 8
This document provides information about the digestive system and various diagnostic and therapeutic procedures related to it. It defines the digestive system and describes tests like colonoscopy, serum bilirubin tests, and imaging that are used to diagnose conditions. Therapeutic procedures discussed include dental extraction, gastric lavage to remove stomach contents, hernioplasty to repair hernias, and more. Steps for colonoscopy and gastric lavage procedures are outlined.
Gastric tumors- By Sai Swaroop H
- Gastric cancer is a major cause of cancer mortality worldwide, though prognosis has improved with early detection and treatment. Incidence varies globally, being highest in Eastern Europe, Japan, and some parts of China.
- Risk factors include H. pylori infection, pernicious anemia, gastric polyps, and surgery for peptic ulcers or gastric reflux. Symptoms include abdominal pain, vomiting, anemia, weight loss, and obstruction.
- Treatment depends on cancer staging and may include radical surgery such as total or subtotal gastrectomy, chemotherapy, and radiation therapy. Complications of surgery can include leakage, fistula formation, and obstruction.
Total Gastrectomy 4
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Surgery Stomach & Duodenum Tg
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Golden steps to perform laparoscopic sleeve gastrectomy
This document summarizes the key steps in a laparoscopic sleeve gastrectomy procedure. It outlines the patient positioning, placement of ports for instruments, mobilization of the stomach including the greater curvature and short gastric vessels, use of staplers to excise the fundus and calibrate the remaining stomach, tests to check for leaks, and techniques for addressing any bleeding or issues with the staple line. The summary provides an overview of the surgical procedure and highlights some controversies at the end such as use of buttress material or drains.
Abdomen Radiography ppt . Daniel J.P. Radiology Technologist , Khorfakhan hos...
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2) Acute appendicitis requires surgical removal of the inflamed appendix, either through laparoscopy or laparotomy.
3) Gastric bypass surgery reduces the size of the stomach and reroutes part of the small intestine to help with weight loss. Risks include infection, bleeding, and reactions to anesthesia.
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This document provides information about the digestive system and various diagnostic and therapeutic procedures related to it. It defines the digestive system and describes tests like colonoscopy, serum bilirubin tests, and imaging that are used to diagnose conditions. Therapeutic procedures discussed include dental extraction, gastric lavage to remove stomach contents, hernioplasty to repair hernias, and more. Steps for colonoscopy and gastric lavage procedures are outlined.
Gastric tumors- By Sai Swaroop H
- Gastric cancer is a major cause of cancer mortality worldwide, though prognosis has improved with early detection and treatment. Incidence varies globally, being highest in Eastern Europe, Japan, and some parts of China.
- Risk factors include H. pylori infection, pernicious anemia, gastric polyps, and surgery for peptic ulcers or gastric reflux. Symptoms include abdominal pain, vomiting, anemia, weight loss, and obstruction.
- Treatment depends on cancer staging and may include radical surgery such as total or subtotal gastrectomy, chemotherapy, and radiation therapy. Complications of surgery can include leakage, fistula formation, and obstruction.
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The document provides information on the anatomy, physiology, and common diseases of the stomach. It describes the stomach's layers, blood supply, innervation, and motor activity. It discusses acid secretion and the roles of parietal cells, gastrin, and histamine. Common benign diseases mentioned include peptic ulcer disease and gastric lymphoma. Gastric adenocarcinoma risk factors and staging are outlined. Post-gastrectomy syndromes such as dumping syndrome and afferent loop obstruction are also summarized.
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Radiation protection.
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The document discusses several common gastrointestinal procedures and conditions:
1) Gastrointestinal bleeding, peptic ulcer disease, delayed gastric emptying, gastric cancer, enterocutaneous fistulas, and acute abdominal pain are among the most common reasons for gastrointestinal procedures.
2) Acute appendicitis requires surgical removal of the inflamed appendix, either through laparoscopy or laparotomy.
3) Gastric bypass surgery reduces the size of the stomach and reroutes part of the small intestine to help with weight loss. Risks include infection, bleeding, and reactions to anesthesia.
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Colonoscopy with polypectomy
Colonoscopy with polypectomy (CWP) involves visually examining the colon using an endoscope and removing any polyps found. A colonoscopy allows the colonoscopist to identify polyps in the colon. Medical indications for CWP include removing polyps that were previously identified, as polyps have unpredictable behavior and could potentially lead to bowel cancer if not removed. The procedure involves cleaning out the colon the night before using a laxative. Then the colonoscopist guides the endoscope through the rectum and colon, visually examining it and removing any polyps found. After the procedure, the endoscope must be thoroughly cleaned and either chemically disinfected or undergo low temperature sterilization before being properly stored.
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1. During embryonic development, the stomach rotates along its longitudinal and anteroposterior axes, causing its final adult position with the cardiac portion on the left and pylorus on the right.
2. The adult stomach is located in the left upper quadrant and extends across the midline, with the greater curvature forming the anterior wall and lesser curvature the posterior wall.
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Post gastrectomy syndrome
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This document provides information on principles of gastrectomy, including:
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- Details on the anatomy, blood supply, lymph drainage of the stomach as relevant to gastrectomy.
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Gastric outlet obstruction (GOO) occurs when there is a blockage of the pylorus, preventing food from exiting the stomach. Benign causes include peptic ulcers, infections, gallstones, and polyps, while malignant causes are typically cancers of the stomach, pancreas, or lymphomas. The pathophysiology of GOO involves hypertrophy and dilation of the stomach above the obstruction. This leads to a buildup of undigested food and secretions, causing vomiting, dehydration, electrolyte imbalances, malnutrition, and kidney problems from dehydration. Timely diagnosis and treatment of the underlying condition is important to prevent complications of GOO.
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Barretts oesophagus
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This document discusses the embryology and anatomy of the stomach. It provides the following key points:
1. During embryonic development, the stomach rotates along its longitudinal and anteroposterior axes, causing its final adult position with the cardiac portion on the left and pylorus on the right.
2. The adult stomach is located in the left upper quadrant and extends across the midline, with the greater curvature forming the anterior wall and lesser curvature the posterior wall.
3. Radiological techniques for examining the stomach include barium studies, CT, MRI, and virtual endoscopy, which allow evaluation of stomach morphology, layers, and relationships to surrounding organs.
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This document discusses various bariatric surgery procedures and their associated imaging findings. It describes laparoscopic adjustable gastric banding (LAGB), Roux-en-Y gastric bypass (RYGB), and sleeve gastrectomy procedures. Common complications discussed include band slippage, erosion, or leakage with LAGB and anastomotic leaks or strictures with RYGB. With sleeve gastrectomy, dilatation, leaks, or stenosis may occur. The radiologist plays a key role in preoperative planning and postoperative monitoring for complications on imaging studies.
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Dumping syndrome occurs after gastric surgery when food empties too quickly from the stomach into the small intestine. It has early and late forms. Early dumping causes GI symptoms like nausea within 30 minutes and cardiovascular symptoms like palpitations. Late dumping 2-3 hours later can cause hypoglycemia. Treatment involves dietary changes and medications like octreotide. Other post-gastrectomy syndromes include afferent loop obstruction and vitamin deficiencies. Surgery may be needed to correct mechanical issues or revise reconstructions.
Gastric Outlet Obstruction
Gastric outlet obstruction (GOO) is caused by any disease process that mechanically impedes gastric emptying. Common benign causes include peptic ulcer disease and gastric polyps, while pancreatic cancer is the most common malignant cause. GOO presents with non-bilious vomiting, weight loss, and dehydration. Management involves resuscitation with IV fluids and correcting metabolic abnormalities, then treating the underlying cause surgically if medical management fails or for palliation of malignant obstructions. Diagnosis in resource-limited areas relies on clinical exam findings, while challenges include limited imaging and laboratory resources.
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surgeries involved in gastroenterology: gastrointestinal surgery, conditions treated with gastrointestinal surgeries,procedure and side effects of these surgeries, open gastrointestinal surgeries and minimally invasive gastrointestinal surgeries
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This document summarizes various radiological imaging modalities used to examine the gastrointestinal tract (GIT). It discusses plain X-rays, ultrasound, fluoroscopy, CT scans, nuclear scans, MRI, and angiography. For each method, it provides a brief description of its use, benefits, and limitations. The document aims to outline the different options available to radiologists for investigating gastrointestinal problems and lesions.
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This document discusses morbid obesity and bariatric surgery options. It defines obesity based on Body Mass Index (BMI) and notes the medical comorbidities associated with obesity like metabolic, mechanical, and psychological issues. Several bariatric surgery procedures are described including restrictive procedures like adjustable gastric banding, sleeve gastrectomy, and vertical banded gastroplasty, as well as malabsorptive procedures like biliopancreatic diversion and Roux-en-Y gastric bypass. The document compares the procedures and notes their advantages and disadvantages, expected weight loss, long-term outcomes, and potential complications.
SURGERY OF THE COLON
This document summarizes right and extended left hemiocolectomies. It describes the anatomy of the colon and indications for surgery. It outlines the pre-operative assessment and preparation, surgical techniques including mobilization, resection, and anasthomosis of the colon. Key steps are the mobilization of the right or left colon along specific planes while protecting surrounding structures like the ureter. Resection involves dividing the ileum, transverse colon, or other portions of the colon depending on the extent of disease. Reconstruction is typically via hand-sewn or stapled anasthomosis.
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1. The document discusses various meconium syndromes that can cause intestinal obstruction in newborns, including meconium ileus.
2. Meconium ileus is characterized by thick, viscous meconium causing an obstruction, often in the distal ileum, and is linked to cystic fibrosis.
3. Treatment options for meconium ileus include non-operative management with enemas or hyperosmolar irrigation, or operative interventions like enterotomy, resection, and stoma or anastomosis formation.
Gastroscope
Esophagogastroduodenoscopy (EGD) is an endoscopic examination of the esophagus, stomach, and duodenum used for both diagnostic and therapeutic purposes. It allows visualization of these areas as well as obtaining biopsies. Common indications include unexplained anemia, gastrointestinal bleeding, and dyspepsia. Potential complications are rare at 1 in 1000 and include aspiration pneumonia, bleeding, and perforation. Limitations include inability to fully examine gastrointestinal function or areas beyond the duodenum. Contraindications include recent heart issues or hypotension. Capsule endoscopy allows noninvasive imaging of the small intestine by using a swallowed capsule with a camera.
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Gastric outlet obstruction is caused by benign or malignant diseases that obstruct gastric emptying. Common benign causes include peptic ulcer disease while pancreatic cancer is a frequent malignant cause. Patients experience nausea, vomiting and weight loss. Diagnosis involves distinguishing functional from mechanical causes and identifying the underlying etiology. Treatment focuses on rehydration and correcting metabolic abnormalities as well as addressing the mechanical obstruction through endoscopic or surgical interventions.
Principes of gastrectomies
This document provides information on principles of gastrectomy, including:
- A brief history of gastrectomy procedures from the early 19th century to modern developments.
- Details on the anatomy, blood supply, lymph drainage of the stomach as relevant to gastrectomy.
- Descriptions of different types and techniques of gastrectomy for treating conditions like cancer, ulcers, and obesity.
- Information on pre-operative preparation, surgical techniques for different procedures like Billroth I and II reconstructions, and post-operative care and complications.
Pathology and pathophysiology of Gatric Outlet Obstruction (GOO)
Gastric outlet obstruction (GOO) occurs when there is a blockage of the pylorus, preventing food from exiting the stomach. Benign causes include peptic ulcers, infections, gallstones, and polyps, while malignant causes are typically cancers of the stomach, pancreas, or lymphomas. The pathophysiology of GOO involves hypertrophy and dilation of the stomach above the obstruction. This leads to a buildup of undigested food and secretions, causing vomiting, dehydration, electrolyte imbalances, malnutrition, and kidney problems from dehydration. Timely diagnosis and treatment of the underlying condition is important to prevent complications of GOO.
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This document discusses procedures for ulcerative colitis. It outlines indications for both emergency and elective surgery to treat ulcerative colitis. Emergency operations are needed for fulminant colitis, toxic megacolon, massive hemorrhage, or perforation. Elective operations are considered for chronic symptoms, steroid dependency or refractoriness, dysplasia or cancer risk, or strictures. The goal of emergency surgery is to remove diseased colon to improve the patient's condition, while elective operations can cure intestinal manifestations through removal of the entire large intestine.
Barretts oesophagus
Barrett's esophagus is a condition where the lining of the lower esophagus is replaced by abnormal columnar cells due to chronic acid exposure from gastroesophageal reflux disease (GERD). This puts patients at risk for developing esophageal adenocarcinoma. The condition is diagnosed via endoscopy with biopsy showing columnar epithelium in place of the normal squamous lining. Treatment depends on the presence and grade of any dysplasia, ranging from medication and endoscopic procedures to surgery.
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Acs0533 The Surgical Management Of Ulcerative Colitis 2004
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This document discusses various disorders of the female genital and reproductive systems including menstrual disorders, abnormalities in uterine bleeding and positioning, pelvic prolapse, inflammation, and infection. It describes the causes, signs and symptoms, and treatment approaches for conditions like amenorrhea, dysmenorrhea, cystocele, rectocele, pelvic inflammatory disease, vulvovaginitis, and Bartholinitis.
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Omentum filza
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The omentum is a fold of tissue that hangs down from the stomach and extends over other abdominal organs. It has important functions like immunity, absorbing edema, and limiting spread of infection. The greater omentum develops from the dorsal mesogastrium and extends from the stomach to the transverse colon. The lesser omentum connects the stomach and duodenum to the liver. Pathologies of the omentum include cysts, torsion, and tumors. Clinically, the omentum helps drain collections, access the retroperitoneum surgically, and forms adhesions useful for patching perforations.
gynaecology.Carcinoma of the endometrium.(dr.rojan)
Carcinoma of the endometrium is one of the most common gynecological cancers, especially in postmenopausal white women between the ages of 60-70. There is no effective screening program, but abnormal cervical smears or thickened endometrial lining on ultrasound may indicate further testing is needed. Risk factors include prolonged estrogen exposure without progesterone, obesity, nulliparity, and family history. Postmenopausal bleeding is the most common symptom. Diagnosis involves endometrial biopsy or hysteroscopy. Treatment options depend on staging and include surgery, radiation, chemotherapy, or hormonal therapy. Prognosis depends on stage, with 5-year survival rates ranging from 85% for stage
Diseases of Peritoneum Mesentry and Omentum
This document provides an overview of the anatomy and functions of the peritoneum, mesentery, and omentum. It describes:
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Pre and post operative care for patients undergoing general anesthesia
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This document provides information about ovarian cancer, including:
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Choledochal cyst
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Carcinoma stomach management
Carcinoma of the stomach is usually suspected based on symptoms like abdominal pain or indigestion. Investigations include endoscopy with biopsy, which is the gold standard for diagnosis. Staging involves endoscopic ultrasound, CT, PET scans and laparoscopy. Treatment depends on the stage, and may involve surgery such as gastrectomy with lymph node dissection, adjuvant chemotherapy and/or radiotherapy. Prognosis depends on factors like stage, lymph node involvement and response to treatment, with 5-year survival rates ranging from 95% for early stage to near 0% for metastatic disease.
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This document defines shoulder dystocia and describes the risk factors, diagnosis, management, and complications. Shoulder dystocia is an obstetric emergency where the fetal shoulders are impacted at the birth canal after delivery of the head. Risk factors include previous shoulder dystocia, macrosomia, and prolonged labor. Diagnosis involves failure of shoulder delivery after head delivery. Management begins with non-traction maneuvers like McRoberts position and suprapubic pressure, followed by rotational maneuvers if needed. Complications include brachial plexus injury, fractures, and hypoxic ischemic encephalopathy.
Benign Thyroid Swellings
This document provides information on benign thyroid swellings. It begins with the surgical anatomy of the thyroid gland including its location, parts, coverings, arterial supply, venous drainage, and nerve supply. It then discusses the physiology of the thyroid gland including hormone production and regulation. Various types of thyroid enlargements are described such as simple goiter, clinically discrete swellings, hyperthyroidism, and thyroiditis. Diagnostic tests and treatments are also summarized.
Anatomy and Examination of Ulnar & Sciatic Nerves
The ulnar nerve supplies sensation to the palmar and dorsal surfaces of the little and half of the ring fingers. It can be injured at different levels - high injury near the elbow results in paralysis of all muscles supplied and sensory loss in the hand. Low injury in the forearm causes clawing of the hand. Tardy ulnar palsy occurs later in life due to ischemic changes. Combined low median and ulnar nerve palsy results in intrinsic minus hand. The sciatic nerve supplies the lower limb and injury can cause paralysis and drop foot.
Abnormal CTG
This document discusses various abnormal fetal heart rate patterns seen on a cardiotocography (CTG) tracing during labor and delivery. It describes fetal tachycardia as a heart rate over 160 bpm and potential causes like infection or drugs. Fetal bradycardia below 120 bpm is ominous and can be caused by hypoxia. Early decelerations occur with contractions and recover after, while late decelerations begin with contractions but recover slowly, indicating hypoxia. Variable decelerations can be caused by cord compression. Reduced variability may indicate fetal sleep, acidosis, or drugs. Management depends on whether the CTG is reassuring or pathological, with pathological cases requiring specialist evaluation and potential urgent delivery.
Wound and Bone healing
Wound and bone healing involve regeneration and repair processes. Wound healing occurs in four stages - hemostasis, inflammation, proliferation, and remodeling. There are three types of wound healing - primary, secondary, and delayed primary. Primary healing involves clean surgical wounds closed with sutures. Secondary healing involves open wounds without sutures that heal from the bottom up. Bone fracture healing similarly occurs through stages of hematoma formation, inflammation and callus formation, consolidation, and remodeling either directly or indirectly through callus formation. Factors like age, bone type, fracture pattern, and immobilization can affect bone healing.
Community Medicine : Housing-related problems
This document discusses several health problems that can be related to housing, including respiratory infections from issues like poor ventilation, skin infections from crowding and unsanitary conditions, rat and insect infestations that can spread diseases, accidents from structural defects, increased mortality and morbidity rates from housing-related illness, and psychosocial effects like isolation and overcrowding that can cause mental health issues.
Chronic Poisoning in Children
Lead poisoning can result from ingesting or inhaling lead from paint, batteries, fishing weights, water pipes, or vehicle exhaust. It causes symptoms like abdominal pain, irritability, anemia, and developmental delays. High lead levels can cause seizures and coma. Diagnosis is made by measuring blood lead levels and looking for lead lines on x-rays. Treatment involves removing the lead source and giving chelating agents to remove lead from the body. Smoking damages lungs and increases health risks like cancer, bronchitis, and SIDS. Education helps reduce smoking, especially in adolescents.
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This document discusses lesions of the menisci, specifically tears. It describes the different types of meniscal tears including vertical/longitudinal, horizontal, and radial tears. It outlines the mechanisms of injury including twisting motions. The clinical features of a meniscal tear are also summarized, including symptoms like pain and locking of the knee. Tests to diagnose a tear are explained, such as McMurray's test and Thessaly test. Treatment options including conservative treatment with immobilization and physical therapy or surgical treatment like arthroscopy are mentioned.
Anatomy of the knee joint
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Syllabus
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Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
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Chapter 6
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Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
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1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
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LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UP
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UP
Intra operative Management of Ovarian Neoplasia
- 2. Objectives • Diagnosis • Staging • Treatment
- 3. Primary Treatment • Exploratory laparotomy • Total abdominal hysterectomy bilateral salphingoophorectomy • Omentectomy • Random peritoneal biopsy Peritoneal fluid Pelvic and para-aortic lymphadenectomy
- 5. Surgery • Vertical midline incision • Ascites/peritoneal washings are sampled • TAHBSO + infracolic omentectomy • Further debulking – resection of bowel, peritoneal stripping, spleenectomy • Lymph node resection
- 9. FIGO Staging STAGE I Ia – limited to 1 ovary, no external tumor, capsule intact, no ascites Ib– limited to both ovary, no external tumor, capsule intact, no ascites Ic– either Ia or Ib, but tumor on surface or with capsule ruptured or with ascites positive for tumor calls Growth limited to ovaries
- 10. IIa – extension and or metastases to uterus or tubes IIb – extension to other pelvic organ IIc – as IIa or IIb, but tumor on surface of ovary or capsule ruptured or with ascites positive for tumor cells Growth limited to pelvis STAGE II
- 11. IIIa – Tumor grossly limited to pelvis with negative nodes, but histologically confirmed microscopic peritoneal implant IIIb – Abdominal implant < 2cm in diameter IIIc – Abdominal implants > 2cm diameter or positive retroperitoneal or inguinal lymph nodes Growth limited to abdominal peritoneal or positive retroperitoneal or inguinal lymph nodes STAGE III
- 12. STAGE IV Growth involving one or both ovaries with distant metastases Must have positive cytology in pleural effusion, liver parenchyma
- 13. I want to have more babies, Dr! • Unilateral salpingo-oophorectomy • Omentectomy • Peritoneal biopsies • Pelvic/paraortic node dissection • Endometrial sampling
- 15. Surgery, NO!!!! • Primary chemotherapy • Interval surgery after 3-6 cycles • Similarly Interval debulking
- 16. Gynae & Onco
- 20. Our Duty as Physicians To cure sometimes. To treat often. To Comfort always. Hippocrates (c.460 - 400 BC).
Editor's Notes
- http://www.atlasofpelvicsurgery.com/5Uterus/10TotalAbdominalHysterectomy/chap5sec10.html
- Interval debulking surgery (IDS), following induction or neoadjuvant chemotherapy, may have a role in treating advanced epithelial ovarian cancer (stage III to IV) where primary debulking surgery is not an option.