By Steven D. Wexner MD FACS FRCS FRCS(Ed), James W. Fleshman MD
Master concepts usually surgical procedure: Colon and Rectal surgical procedure: belly Operations is a quantity in a sequence that provides universal and complicated systems within the significant subspecialities of basic surgery. The sequence is overseen through Josef F. Fischer, MD, editor of the vintage two-volume reference Mastery of Surgery.
Master suggestions regularly surgical procedure: Colon and Rectal surgical procedure: belly Operations is written through said grasp surgeons, emphasizes surgeries, and is lavishly illustrated with unique full-color drawings. The members absolutely clarify their most well liked strategies in step by step, completely illustrated aspect, check symptoms and contraindications, supply directions on preoperative making plans, and speak about results, problems, and follow-up.
Coverage contains left and correct colon resections played open and laparoscopically, colectomies, proctocolectomies, restorative and reconstructive options for proctocolectomy and pelvis reconstruction, stoma development and the way to fix issues of stoma development, and remedy of rectal prolapse.
A better half web site will provide absolutely searchable content material of the booklet, a picture financial institution, and procedural videos.
Read or Download Colon and Rectal Surgery: Abdominal Operations PDF
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Extra resources for Colon and Rectal Surgery: Abdominal Operations
Sample text
L. Dividing the mid-transverse colon. M. Dividing the terminal ileum. N. Creating the end-to-side ileocolic anastomosis using the circular stapler introduced through the end of the colon. With the lymphovascular drainage of the right colon now interrupted, the tumor may be manipulated without fear of disseminating malignant cells. Attention is turned to the omentum and its attachments to the transverse colon. Beginning at the anticipated site of division in the mid-transverse colon, the omentum is separated from the transverse colon itself and the transverse mesocolon by developing the avascular plane (Fig.
The open end of the colonic stump is then closed with a linear stapler. The mesentery of the ileum and transverse colon are reapproximated with a running absorbable suture and the omentum is laid over the anastomosis. Incorporating the tip of the omentum into the tie at the end of the mesentery closure suture line will ensure that it stays in place over the anastomosis. POSTOPERATIVE MANAGEMENT Postoperative management of the patient should follow an accelerated care pathway. Nasogastric tubes are not used routinely.
A recent Cochrane review found no beneficial effect in terms of reduced rates of wound infection or anastomotic leak in patients undergoing segmental colectomy (6). SURGERY The patient is placed on the operating table in the supine position. After insertion of a Foley catheter, the skin of the abdomen is prepped and draped. After intravenous administration of a broad-spectrum antibiotic, the peritoneal cavity is entered via a midline incision and a self-retaining retractor is placed. The abdomen is explored to determine the presence and extent of any metastatic disease and to also rule out unexpected pathology.