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General Surgery
Stomach Surgery, The Surgeon, Peptic Ulcer Disease, and Gastric Malignancy
Built from Skandalakis' Surgical Anatomy: The Embryologic and Anatomic Basis of Modern Surgery
What’s inside
13 sections · 148 slides
Overview
- Scope of this topic
- Billroth on the surgeon's training
Gastric operations: a diagrammatic review
- Gastrorrhaphy
- Gastrorrhaphy
- Gastrotomy
- Indications for gastrostomy
- Named techniques of gastrostomy
- Complications of gastrostomy and duodenostomy
- Catheter duodenostomy for the doubtful duodenal stump
- Catheter placement in the duodenal stump
- Drainage of the duodenostomy tract
- Duodenoduodenostomy
- Gastropexy
- Posterior gastropexy and its complications
- Operations for cardiospasm
- Cardioplasty and oesophagomyotomy
- Bleeding peptic ulcer
- Deep suture and the duct of Santorini
- Closure of perforated peptic ulcer
- Indications for pyloroplasty
- Named pyloroplasty procedures
- Complications of pyloroplasty
- Pyloromyotomy
- Anatomy of pyloromyotomy
- Gastrojejunostomy: a drainage procedure
- Classification of gastrojejunostomy
- Named gastrojejunostomy procedures
- Drainage procedures compared
- Antecolic gastrojejunostomy, antiperistaltic loop
- Antecolic gastrojejunostomy, isoperistaltic loop
- Posterior gastrojejunostomy, antiperistaltic loop
- Posterior gastrojejunostomy, isoperistaltic loop
- Jejunogastric intussusception
Surgical anatomy of gastric mobilisation
- The periesophageal space
- Mobilisation of the left lobe of the liver
- Structures at risk at the cardia
- Accessory versus replaced hepatic artery
- Exposure of the periesophageal space
- Mobilisation for benign disease
- Protecting the spleen during mobilisation
- Ligation of the left gastric vessels
- Mobilisation for malignant disease
- Evidence on resection for gastric malignancy
- First part of the duodenum: peritoneal relations
- Posterior relations of the first part of the duodenum
- Blood supply of the first part of the duodenum
- Principles of dissection in the gastroduodenal area
- Surgical Anatomy of Gastric Resection: procedure
- Surgical Anatomy of Gastric Resection: reason
Gastrectomy and reconstruction
- Node groups and the extent of gastrectomy
- N1 and N2 node groups by tumour site
- Lymph Node Groups for Gastric Cancer
- Lymph Node Groups for Gastric Cancer (continued)
- Technical variations of Billroth I gastrectomy
- Billroth I versus Billroth II in gastric malignancy
- Billroth II gastric resection and its variations
- Gastrojejunal anastomosis after gastric resection
- Gastric resection with Roux-en-Y anastomosis
- Billroth II resection with Roux-en-Y reconstruction
- Reconstruction options after partial gastrectomy
- Miscellaneous gastric operations
- Indications for total gastrectomy
- Total gastrectomy
- Reconstruction after total gastrectomy
- The Ulm pouch
- Esophagogastrectomy
Vagotomy
- Types of vagotomy
- The case for highly selective vagotomy
- Laparoscopic vagotomy and surgical training
- Complications after vagotomy
Gastric surgery for colossal and morbid obesity
- Origins of bariatric surgery
- Gastric bypass for obesity
- Gastric bypass with Roux-en-Y gastroenterostomy
- Stapled pouch gastric bypass
- Vertical banded gastroplasty
- Pancreatobiliojejunal bypass
- Resectional gastric bypass
- Complications of bariatric gastric surgery
Gastric transposition
- Gastric transposition as oesophageal replacement
- Complications Directly Related to Gastric Transposition
Gastric cancer: aetiologic factors
- Burden and proposed aetiologic factors
- Intestinal metaplasia and Helicobacter pylori
- The metaplasia-carcinoma sequence as proposed
- Acid suppression, gastric resection and cancer risk
The surgeon and peptic ulcer disease
- Place of surgery in modern peptic ulcer disease
- Choice of operation for duodenal ulcer
The surgeon and gastric malignancy
- Questions facing the surgeon in gastric cancer
- Extent of lymphadenectomy: evidence for
- Extent of lymphadenectomy: evidence against
- Meyer and Jahne on lymphadenectomy
- Splenectomy and pancreatectomy in gastric cancer
- Resection margins in gastric cancer
- Function-preserving surgery for early gastric cancer
- Nodal status in early gastric cancer
- Gastric lymphoma and stromal tumours
- Laparoscopic resection of gastric stromal tumours
- Types of gastric neuroendocrine tumour and treatment
- Carcinoma of the gastric remnant
- Behaviour of remnant carcinoma
- Summary of surgical treatment for gastric malignancy
Anatomic complications of gastric surgery
- Anatomic complications: general principles
- Pickleman on anastomotic dehiscence
- Anatomic Complications of Some Gastric, Duodenal, and Pancreatic Procedures: vascular injury
- Anatomic Complications of Some Gastric, Duodenal, and Pancreatic Procedures: vascular injury (continued)
- Anatomic Complications of Some Gastric, Duodenal, and Pancreatic Procedures: organ injury
- Anatomic Complications of Some Gastric, Duodenal, and Pancreatic Procedures: organ injury (continued)
- Anatomic Complications of Some Gastric, Duodenal, and Pancreatic Procedures: inadequate procedure
- Anatomic Complications of Some Gastric, Duodenal, and Pancreatic Procedures: inadequate procedure (continued)
- Complications after gastrectomy
- Retroanastomotic hernias after gastrojejunostomy
- Hernia following retrocolic and antecolic gastrojejunostomy
- The retroanastomotic space
- Afferent loop syndrome
- Mechanism of afferent loop obstruction
- Duodenal stump blowout in proximal loop syndrome
- Causes of afferent loop obstruction
- Efferent loop syndrome
- Fibrinous adhesions obstructing the distal loop
- Gastroileostomy
- Revision for dumping syndrome
- Interposition operations
- Pouches for dumping symptoms
- Gastrojejunocolic fistula
- Operations for reflux gastritis
- Surgical applications in reflux gastritis
Reoperation after gastric surgery
- Deciding on reoperation
- Preparation for reoperative gastric surgery
- Gastric stasis after gastric surgery
Summary
- Key anatomical traps
- Recurring principles in gastric surgery
- Where the evidence remains unsettled
- Sources cited in the text and figures
- Sources cited in the text and figures (continued)
- Sources cited in the text and figures (continued)
- Skandalakis' Surgical Anatomy: The Embryologic and Anatomic Basis of Modern Surgery
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