Gastrostomy
■ Ensure that the sight is at least 2 to 3 cm from the left costal margin for patient comfort. ■ Mark the spot with a marking pen or press the needleless…
Umbilical, Epigastric, Spigelian, and Lumbar Hernias
■ Primary ventral hernias are classified according to the diameter of the hernia defect as shown in Table 1.2 DIFFERENTIAL DIAGNOSIS ■ Subcutaneous lesions at the site where primary ventral hernias occur,…
Splenectomy (Open and Laparoscopic Techniques)
Frederick A. Moore DEFINITION ■ Splenectomy is defined as the surgical removal of the spleen. DIFFERENTIAL DIAGNOSIS/INDICATIONS ■ Traumatic rupture ■ Autoimmune disorders ■ Red blood cell disorders ■ Genetic disorders ■ Lymphomas/leukemias/myeloproliferative disorders ■ Vascular disorders…
Incisional Hernia: Laparoscopic Approaches
■ Advantages of CT imaging for the evaluation of incisional hernias are multifactorial: accurate diagnosis in cases of obscure or small defects; proper identification of hernia contents (small bowel, colon, solid…
Esophagectomy: Transhiatal and Reconstruction
■ Squamous cell carcinomas (SCCs) of the lower third of the esophagus may also be approached via THE, whereas tumors of the middle and upper third of the esophagus usually require…
The Minimally Invasive Surgical Approach to Gastroesophageal Reflux Disease
■ Because there are few physical exam findings associated with GERD, the physical exam should focus on conditions that might suggest an alternative explanation for the patient’s symptoms. These include recent…
Total Gastrectomy for Cancer
Waddah B. Al-Refaie DEFINITION ■ Total gastrectomy is removal of the stomach in its entirety including the gastroesophageal (GE) junction. This is typically performed for patients with proximal gastric cancer, including…
Ivor Lewis Esophagectomy
■ Endoscopic ultrasound (EUS) is a critical staging technique for esophageal cancer (FIG 2). The EUS determines the depth of invasion of the tumor into the esophageal wall (T stage). Esophageal…
Transthoracic Hiatal Hernia Repair
PATIENT HISTORY AND PHYSICAL FINDINGS ■ A detailed history and physical must be performed focusing on heartburn and reflux symptoms, response to medical treatment as well as the characteristics and degree…
Laparoscopic Gastric Band
■ The AGB differs from other bariatric procedures in three main ways: It is adjustable, reversible, and involves no cutting or stapling of the stomach. ■ The AGB is an exclusively restrictive…
