Inguinal Hernia: Open Approaches
■ Using electrocautery, the soft tissue is dissected to the superficial epigastric vessels, which are ligated. The dissection is then carried down through Camper’s fascia and the more fibrous Scarpa’s fascia….
Feeding Jejunostomy
Incision ■ If the open J-tube placement is being done as a stand-alone operation, the incision should be centered in the midline at the level of the LOT. ■ The supraumbilical vertical…
Incisional Hernia: Open Approaches
■ Dissection proceeds directly down to the hernia sac, being careful not to enter the sac. If the incision is longer than the hernia defect, only the skin and subcutaneous tissues…
Minimally Invasive Esophagectomy
Mary T. Hawn DEFINITION ■ The incidence of esophageal cancer, especially adenocarcinoma, has increased dramatically over the past decades. This phenomenon is secondary to the increasing incidence of obesity contributing to…
Redo Fundoplication
■ The 360-degree fundoplication (Nissen fundoplication) is the most popular of the various fundoplication techniques. ■ Although fundoplication, when done by an experienced surgeon, results in control of GERD and significant improvement…
Treatment of Esophageal Perforation: Cervical, Thoracic, and Abdominal
■ Cervical and thoracic computed tomography (CT) scans with oral contrast can be performed to diagnose esophageal perforations. An extraluminal leak of contrast medium can be seen in the prevertebral or…
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…
