Operative Surgery Manual, 1e by Vijay P. Khatri MD FACS, Juan A. Asensio MD FACS FCCM

By Vijay P. Khatri MD FACS, Juan A. Asensio MD FACS FCCM FRCS KM

This ebook offers useful counsel at the most typical non-obligatory and emergency strategies. each one concise bankruptcy follows an analogous layout and comprises standardized headings: place, incision, publicity and operative procedure, and closure. a number of illustrations aspect the strategies, supplying readability at a glance.

  • Each bankruptcy concisely summarizes a selected operation's suitable anatomy · sufferer place · incision · publicity and operative strategy · and closure.
  • Illustrations display the main steps of every procedure.
  • Consistent headings and succinct chapters facilitate swift evaluation.
  • Coverage comprises very important tactics similar to tracheostomy · breast biopsy · axillary dissection · laparoscopic Nissen fundoplication · hepatectomy · pancreatoduodenectomy · subtotal colectomy and J-pouch reconstruction · carotid endarterectomy · nephrectomy · and lots of more.

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At this point the external ring is identified on the medial aspect. With a no. 15 scalpel an incision is made into the external oblique fascia along its fibers. The edges of this incision are grasped with Kelly clamps, and the external oblique fascia is carefully dissected free from the underlying areolar tissue and both the ilioinguinal and genitofemoral nerves. While these two nerves are protected, the inguinal canal is opened by extending the incision toward the external ring. The two nerves are then carefully freed, preserved, and retracted out of the way.

For this the gastric fundus is mobilized by dividing the esophagophrenic ligament. After completion of the procedure, one of the nasogastric tubes is removed. A Jackson-Pratt drain is placed near the hiatus. Finally, a feeding jejunostomy is placed. CLOSURE The abdomen is closed in the standard fashion. Chapter 10 – Breast Biopsy Operative Procedure POSITION The patient lies in the supine position with the ipsilateral arm abducted to 90 degrees. The entire breast is prepped, and sterile drapes are placed.

Posteriorly and starting from above downward, it is related to the thoracic duct, the hemiazygos vein, the right posterior intercostal arteries, and finally the descending aorta. Below the trachea, the esophagus is crossed anteriorly by the left main-stem bronchus and then the pericardium, which separates it from the atrium. The mediastinum is present on the lateral aspect bilaterally. On the right side the azygos vein arches forward above the lung root. On the left side it is separated from the mediastinal pleura by the left subclavian artery, the thoracic duct, the aortic arch, and the descending aorta.

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