Common surgical procedures

2021 ◽  
pp. 837-868
Keyword(s):  
Surgical Procedures ◽  
Abdominal Cavity ◽  
Perforated Peptic Ulcer ◽  
Small Bowel Resection ◽  
Right Hemicolectomy ◽  
Minimal Invasive ◽  
Surgical Trauma ◽  
Stoma Formation ◽  
Conventional Open Surgery ◽  
Resection And Anastomosis

This chapter addresses common surgical procedures. These include laparotomy; diagnostic laparoscopy; inguinal hernia repair; appendicectomy; cholecystectomy; perforated peptic ulcer repair; haemorrhoidectomy; and excision of pilonidal sinus. Laparotomy is a surgical incision into the abdominal wall to gain access into the abdominal cavity. Minimal invasive surgery aims to cause at least surgical trauma as possible to patients compared to ‘conventional’ open surgery. Benefits include shorter hospital stay, less pain, quicker functional recovery, and superior cosmesis. Pneumoperitoneum induction is the primary step in performing laparoscopy surgery. The chapter then studies stoma formation; small bowel resection and anastomosis; right hemicolectomy; wide local excision of breast lesion; femoral embolectomy; and below knee amputation.

scholarly journals Ostomy-Related Complications

2019 ◽  
Vol 32 (03) ◽  
pp. 176-182 ◽  
Author(s):  
Douglas Murken ◽  
Joshua Bleier
Keyword(s):  
Gastrointestinal Tract ◽  
Surgical Procedures ◽  
Parastomal Hernia ◽  
Significant Morbidity ◽  
Stoma Formation ◽  
Wide Range ◽  
Peristomal Skin ◽  
Stomal Stenosis

AbstractIleostomy or colostomy formation is an important component of many surgical procedures performed for a wide range of disorders of the gastrointestinal tract. Despite the frequency with which intestinal stomas are created, stoma-related complications remain common and are associated with significant morbidity as well as cost. Some of the most prevalent complications of stoma formation which will be detailed in this article include peristomal skin complications, retraction, stomal necrosis, stomal stenosis, prolapse, bleeding, dehydration from high ostomy output, and parastomal hernia. The authors will review these common complications, detail means to avoid or prevent them, and outline recommendations for management.

scholarly journals MINIMAL-INVASIVE TREATMENT OF HIGH LEVEL RECTOVAGINAL FISTULAS (THE FIRST EXPERIENCE OF «INVAGINATION» METHOD)

2018 ◽  
pp. 39-44
Author(s):  
A. A. Mudrov ◽  
Yu. A. Shelygin ◽  
A. Yu. Titov ◽  
O. Yu. Fomenko ◽  
L. A. Blagodarny ◽  
...  
Keyword(s):  
Minimal Invasive ◽  
Pelvic Surgery ◽  
Fistula Tract ◽  
Invasive Treatment ◽  
Stoma Formation ◽  
Diverting Stoma ◽  
Bowel Diseases ◽  
Minimal Invasive Treatment ◽  
Rectovaginal Fistulas ◽  
High Level

AIM: to evaluate the efficacy of new «invaginative» method for rectovaginal fistulas. MATERIALS AND METHODS: thirty-seven females aged 37.3 (20-73) years with high rectovaginalfistulas (RVF) were included in the study. All patients underwent fistula surgery using novel «invaginative» method, which includes invagination of the fistula tract into the rectum, RVF origin included inflammatory bowel diseases in 7 (18.9%) patients, delivery injury - in 21 (56.7%), pelvic surgery - in 5 (13.5%), other causes - in 4 (10.8 %). Twenty (54.1 %) patients had two previous unsuccessful repairs on average. Diverting stoma formation as a first stage for RVF repair was performed in 4 (10.8%) patients. Meanfollow-up was 14,7± 6,6 months. RESULTS: «invaginative» method has been performed in all patients. Eight (21.6 %) of them produced recurrence after 2-6 weeks after surgery. No postoperative complications occurred. CONCLUSION: «invaginative» method is a safe and effective in treatment of high rectovaginal fistulas. It can be performed without diverting colostomy in most cases.

scholarly journals Surgical Procedures for Neuroendocrine Neoplasms of the Appendix: A Consensus Guideline Review

2017 ◽  
Vol 10 (2) ◽  
pp. 87-89
Author(s):  
Paulina Tr. Vladova ◽  
Sergey D. Iliev ◽  
Savelina L. Popovska
Keyword(s):  
Surgical Procedures ◽  
Surgical Approach ◽  
Survival Rates ◽  
Right Hemicolectomy ◽  
Neuroendocrine Neoplasms ◽  
Consensus Guideline ◽  
Surgical Interventions ◽  
Proliferation Activity ◽  
The Difference ◽  
Well Differentiated

Summary According to the consensus and the recommendations of the European Neuroendocrine Tumor Society (ENETS), the frequency of appendicular neuroendocrine tumors (NETs) is 0.15-0.6/100 000 a year. They are found a little more often in women aged between 40 and 50. Neuroendocrine neoplasms of the appendix are about 30 to 80% of all appendicular tumors. Their evolution is usually asymptomatic. They are diagnosed accidentally during a conventional or laparoscopic appendectomy. In the past, the surgical approach used to depend on the localization of the tumor. Currently, its localization is not a significant factor in the choice of a surgical approach. Our purpose wass to present the consensus guideline and the recommendations of ENETS 2017 for surgical procedures in neuroendocrine neoplasms of the appendix and analyze the difference in the survival rate in different surgical interventions. The literature overview includes studies on surgical treatment of neuroendocrine neoplasms of the appendix and takes into consideration the last consensus guideline of ENETS 2017 on the topic. ENETS recommends a simple appendectomy in well- differentiated appendix tumors smaller than 2 cm, regardless of their localization. Right hemicolectomy is performed for in tumors sized between 1 cm and 2 cm with positive resection lines, with deep mesoappendiceal invasion, high proliferation activity (G2) and vascular invasion. For tumors over larger than 2 cm – right hemicolectomy is recommended. Although current studies have pointed out no significant differences in survival rates between appendectomy for neuroendocrine neoplasms of the appendix and right hemicolectomy, ENETS 2017 suggests that the latest consensus guidelines should be followed.

scholarly journals Perforated Peptic Ulcer Combined with Posttraumatic Diaphragmatic Hernia in Third Gestation Trimester: a Clinical Case

2021 ◽  
Vol 11 (3) ◽  
pp. 251-255
Author(s):  
V. S. Panteleev ◽  
I. B. Fatkullina ◽  
A. Kh. Mustafin ◽  
R. S. Khalitova ◽  
A. S. Petrov
Keyword(s):  
Peptic Ulcer ◽  
Pregnant Women ◽  
Diaphragmatic Hernia ◽  
Clinical Case ◽  
Abdominal Cavity ◽  
Perforated Peptic Ulcer ◽  
Favourable Outcome ◽  
Duodenal Perforation ◽  
Duodenal Ulcers ◽  
In Pregnancy

Background. Gastric and duodenal ulcers are extremely rare in pregnancy, according to published literature. Peptic ulcer is found in 1 per 4,000 pregnant women, a figure probably underestimated due to its hampered diagnosis in pregnancy. Pregnancy peptic ulcer is considered less expected. Perforated gastric and duodenal ulcers comprise about 1.5 % of total acute abdominal diseases, and the perforation rate in ulcer patients ranges within 5–15 %. This complication afflicts the ages of 20–40 years in men much more frequently than in women. Three perforation types occur: free into abdominal cavity (87 %), contained (9 %), into lesser omentum and retroperitoneal tissue (4 %).Materials and methods. The clinical case describes surgical management of posttraumatic diaphragmatic hernia-comorbid perforated gastric ulcer in a pregnant woman in third trimester. Surgery with postoperative patient management enabled for a favourable outcome.Results and discussion. Perforation-entailing gastric and duodenal ulcers in pregnant women have received negligible attention due to rarity in clinical practice. Paul et al. described 14 cases of duodenal perforation in pregnancy, all fatal.Conclusion. Early diagnosis of surgical pathology during gestation is still difficult contributing to the development of severe complications associated with high mortality. The patient’s admission to a level III interspecialty hospital was key to enable a timely consilium-driven decision of caesarean intervention for saving the child, diagnosing intraoperatively life-threatening complicated surgical diseases and opting for radical surgery that ended in a favourable outcome.

EP.TU.533A rare clinical presentation of Goblet Cell Adenocarcinoma of the appendix: Recommendations for safe & effective management

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ganeshan Ramsamy ◽  
Zoe Slack ◽  
Giovanni Tebala
Keyword(s):  
Small Bowel ◽  
Goblet Cell ◽  
Clinical Presentation ◽  
Histopathological Examination ◽  
Clinical Signs ◽  
Operative Management ◽  
Small Bowel Resection ◽  
Right Hemicolectomy ◽  
Bowel Ischaemia ◽  
Operative Recovery

Abstract Background Goblet cell carcinoma (GCC) is a rare mixed neoplasm arising from the appendix, consisting of glandular and neuroendocrine tissue. It typically presents in adults with a mean age of 55-65 years old. Diagnosis is usually incidental via histopathological examination after 0.3% to 0.9% of all appendicectomies. Literature remains sparse on classification and prognosis of GCC, and cases documented in younger patients. Aims To highlight an interesting clinical presentation and intra- and post-operative management of GCC. To increase awareness for future practice when managing patients with GCC. Methods A 37 year-old male presented with left sided abdominal pain, constipation and fresh rectal bleeding. Computed Tomography demonstrated extensive SMV thrombus causing small bowel ischaemia. On the Intensive Care Unit, he underwent thrombolysis through a Transjugular Intrahepatic Porto-Systemic Shunt. A few days later, he developed bowel obstruction, necessitating a small bowel resection secondary to an ischaemic stricture. 9 months later, he presented with clinical signs of appendicitis. After an uneventful appendicectomy, he was diagnosed with GCC upon histopathological examination of the specimen. Results The patient made an uneventful post-operative recovery. A multidisciplinary team (MDT) decision was made to perform a completion right hemicolectomy, with histology confirming pT3N1M0 GCC. Adjuvant chemotherapy with 5-Fluorouracil was started. Conclusion This case highlights GCC with a preceding clinical course not yet published in the literature. It stresses the importance of the MDT in managing GCC. Although primarily diagnosed histologically, a clinical suspicion of GCC of the appendix is worth considering in pro-thrombotic patients.

scholarly journals Synchronous robotic right hemicolectomy and subtotal gastrectomy

2020 ◽  
Vol 72 (4) ◽  
pp. 1273-1277
Author(s):  
Fabio Carbone ◽  
Ugo Pace ◽  
Vittorio Albino ◽  
Maddalena Leongito ◽  
Paolo Delrio
Keyword(s):  
Cancer Diagnosis ◽  
Minimal Invasive Surgery ◽  
Subtotal Gastrectomy ◽  
Right Hemicolectomy ◽  
Minimal Invasive ◽  
Right Colon ◽  
Minimal Invasiveness ◽  
Synchronous Colorectal Cancer ◽  
The Right ◽  
Robotic Resection

AbstractAbout 4% of patients with stomach cancer diagnosis have synchronous colorectal cancer and some of these patients may require a synchronous surgical resection. So far, only few minimally invasive series of synchronous resections have been described. We investigated the feasibility and safety of the synchronous robotic resection of the right colon and stomach malignancies, trying to identify a standardised and reproducible technique. It is essential to carefully plan the operation and the trocars positioning to minimise the number of robotic dockings and be able to operate comfortably. Herein, we describe our approach, which is safe and effective in terms of minimal invasiveness and oncological radicality. Robotic surgery could be used with even more advantage in complex multi-organ resections, providing the surgeon with a better vision, a more accurate dissection and longer instruments, to offer the patient all the benefits of a minimal invasive surgery.

Transgastric gastro-jejunal anastomosis with flexible endoscope on a biosynthetic model

2007 ◽  
Vol 148 (4) ◽  
pp. 161-164 ◽  
Author(s):  
Péter Lukovich ◽  
Balázs Kádár ◽  
Attila Jónás ◽  
Mehdi Sadatakhavi ◽  
Gábor Váradi ◽  
...  
Keyword(s):  
Porcine Model ◽  
Single Channel ◽  
Rapid Development ◽  
Abdominal Cavity ◽  
Gastric Wall ◽  
Minimal Invasive ◽  
Invasive Procedures ◽  
Plastic Frame ◽  
Human Use ◽  
Needle Knife

Introduction: In the last few years the rapid development of flexible endoscopies has opened new possibilities in minimal invasive procedures. With the help of these techniques the exposure, the risk of complications and the healing period of the patient might be reduced. One of these procedures is the transgastric intervention. Through an incision on the wall of the stomach, the endoscope could be led into the abdominal cavity, where several interventions can be performed. The aim of the study was to examine the technical feasibility and the success of the formation of gastro-jejunal anastomosis. Meanwhile the difficulties of the method could be explored in order to introduce this method in human use. Method: A lifelike biosynthetic model was made from a slaughtered domestic pig’s gastrointestinal tract (stomach and the first few jejunum loops) which was fixed onto a plastic frame. Two single-channel gastroscopes were inserted into the stomach. On the wall of the stomach an approximately 2 centimetres wide incision was made by the electrocoagulator with a needle-knife. Through it the first jejunum loop was grasped by a foreign-body forceps and then was retracted into the stomach. Subsequently the jejunum loop was held safely with the first endoscope. Parallel to it an incision was made on the jejunum by the electrocoagulator. The authors managed to securely unite the open edges of the gastric wall and the jejunum with endoclips. Result: The model was good for practising. The anastomosis is technically feasible and was successfully made on biosynthetic porcine model using the transgastric route. Although the incisions both on the gastric wall and on the jejunum loop were made easily, the fixing of the anastomosis might be questionable. Conclusion: It was revealed that more experiments and the development of new, special instruments are needed in order to conduct the anastomosis safely.

scholarly journals Minimal Invasive Management of Anastomosis Leakage after Colon Resection

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Esin Kabul Gürbulak ◽  
İsmail Ethem Akgün ◽  
Ayhan Öz ◽  
Sinan Ömeroğlu ◽  
Muharrem Battal ◽  
...  
Keyword(s):  
Colon Resection ◽  
Minimal Invasive ◽  
Early Postoperative Period ◽  
Endoscopic Stenting ◽  
Abdominal Drainage ◽  
The Past ◽  
Stoma Formation ◽  
Abdominal Lavage ◽  
Anastomosis Leakage ◽  
Invasive Management

The gold standard of surgical treatment of colorectal anastomotic leak is abdominal drainage of collected fluid and stoma formation. Conventional laparotomy has been the preferred approach for treatment. However, both laparoscopic surgical techniquesand endoscopic stenting have gained popularity over the past years as minimal invasive approaches, especially in the management and treatment of perforations of the gastrointestinal system. We present here a successful treatment with a minimal invasive management of anastomosis leak in the early postoperative period after colon resection in a 62-year-old female patient who had undergone urgent laparoscopic intra-abdominal lavage and drainage followed by endoscopic stenting.

A New Minimal Approach in Cochlear Implant Surgery: The Colombian Experience

2005 ◽  
Vol 133 (1) ◽  
pp. 147-149 ◽  
Author(s):  
Jorge E. Almario ◽  
Jose G. Lora ◽  
Jose A. Prieto
Keyword(s):  
Cochlear Implant ◽  
Surgical Approach ◽  
Minimal Invasive ◽  
Surgical Trauma ◽  
Invasive Approach ◽  
Implant Surgery ◽  
Minimal Invasive Approach ◽  
Cochlear Implant Surgery ◽  
The Mean ◽  
Age Range

OBJECTIVES: To implement a minimal invasive approach in cochlear implant surgery for children and adults. In order to decrease surgical complications and morbidity with the surgery. SUBJECTS AND METHODS: During a 1-year period, 12 consecutive patients (5 female and 7 male; age range, 1.5 to 78 years; mean age, 14.5 years), who had cochlear implantation (1 Nucleus and 11 Clarion) through a new surgical approach, were prospectively evaluated. RESULTS: The surgical approach was accomplished in all the patients with no major complications. The mean surgical time was 3.2 hours and the mean time between surgery and process of programming was 2.7 weeks. CONCLUSION: The surgical trauma and postoperatory edema was decreased and allowed programming of the implant in a shorter period of time.

scholarly journals 1610 Haemangiomas of the Small Intestine: Poorly Known Cause of Abdominal Pain

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
B Mohamed ◽  
I Soric
Keyword(s):  
Small Intestine ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Resection ◽  
Vascular Lesions ◽  
Intestinal Bleeding ◽  
Cavernous Haemangioma ◽  
Quadrant Pain ◽  
Therapeutic Measures ◽  
Resection And Anastomosis

Abstract Background Haemangioma of the small intestine is a rare disease in adult patients and is usually located in the jejunum. The usual clinical features include abdominal pain, bleeding, and obstruction. Acute intestinal bleeding leading to anaemia is the most common presentation in most patients. Intussusception and even perforation caused by cavernous haemangioma are extremely rare Case Summary we report a 31-year-old male with a right upper quadrant pain, nausea, elevated CRP. ultrasound abdomen suggestive of hepatic haemgioma whereas the CT abdomen showed left upper quadrant mass. He had laparoscopy converted the laparotomy showed5*5cm small intestine mass. small bowel resection and anastomosis was done. Histology has confirmed haemangioma. Discussion Small bowel haemangioma accounts for 5 to 10 % of all benign neoplasms of the small intestine. It is thought to be one of the congenital benign vascular lesions. Haemangiomas are classified as cavernous, capillary, or mixed type, and the cavernous type is the most common Malignant change is quite unusual. Multiple lesions are often associated with similar neoplasms in other organs, such as the liver and skin. Conclusions Small intestine haemangioma are often very difficult to diagnose. Early diagnosis and appropriate intervention could provide good outcomes. Diagnostic and therapeutic measures should be taken to avoid further complications.

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