Gastrointestinal Surgery Module 14 Quiz

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Questions and Answers

What is the primary purpose of gastrointestinal (GI) surgery?

To exclusively target diseases of the esophagus

To establish a diagnosis, prevent disease, relieve symptoms, or provide palliative care (correct)

To improve cosmetic appearance

To enhance the digestive process without addressing underlying issues

Which artery primarily supplies the intestine from the duodenum to the left colic flexure?

Inferior mesenteric artery

Femoral artery

Celiac trunk

Superior mesenteric artery (correct)

What is a crucial aspect of perioperative nursing considerations in GI surgery?

Focusing solely on the patient's emotional support

Minimizing surgical time to prevent complications

Assessment of the patient's skin for breakdown risk (correct)

Routine procedures without risk of unexpected outcomes

Which of the following statements about surgical staplers is true?

Different surgical staplers have specific implications for open and minimally invasive surgeries Signup and view all the answers

What role does the inferior mesenteric artery play in gastrointestinal blood supply?

It supplies the large intestine from the left colic flexure to the upper part of the rectum Signup and view all the answers

Which of the following should be considered when discussing the risk of injury in GI surgery?

Every procedure carries an equal risk of unexpected outcomes Signup and view all the answers

What is an important consideration regarding bowel isolation techniques in GI procedures?

Isolation techniques should be adapted based on specific patient needs and procedural requirements Signup and view all the answers

What is the correct function of GI surgery in terms of disease management?

GI surgery helps to cure disease, relieve symptoms, or provide nutrition through surgical methods Signup and view all the answers

What percentage of the stomach is typically removed during a Sleeve Gastrectomy?

85% Signup and view all the answers

Which stapler is required for a Sigmoid Colectomy during an Anterior Resection?

GIA stapler Signup and view all the answers

What is the primary initial sign of colorectal cancer?

Polyps Signup and view all the answers

In colorectal surgeries, which artery is primarily involved in the blood supply for bowel segments?

Inferior mesenteric artery Signup and view all the answers

Which surgical intervention involves the removal of the right portion of the colon?

Right Hemicolectomy Signup and view all the answers

What is the primary advantage of using a side-to-side anastomosis with a GIA stapler?

It can join segments of different size lumens effectively. Signup and view all the answers

Which type of anastomosis is characterized by a circular cutting and stapling mechanism?

Intraluminal Signup and view all the answers

In the surgical procedure involving a GIA stapler, what occurs after the resection of the bowel?

The GIA stapler is fired, joining the bowel segments and creating a hole. Signup and view all the answers

Which of the following types of anastomoses is often referred to as a Roux-en-Y?

End-to-Side Signup and view all the answers

What is a notable clinical outcome of employing EEA technology in surgical procedures?

Reduced number of permanent colostomies needed. Signup and view all the answers

During a side-to-side anastomosis, what is the primary action taken by the surgeon after placing the GIA stapler?

The stapler is fired to staple the segments and create a passage. Signup and view all the answers

Which anatomical sites can EEA staplers be used on during surgeries?

For both end-to-end and end-to-side anastomoses. Signup and view all the answers

What is the main purpose of the small hole created by the GIA stapler during a side-to-side anastomosis?

It serves as a passage for bowel contents between segments. Signup and view all the answers

What typically follows the firing of the GIA stapler in terms of wound closure?

The insertion sites are closed by manual suturing or TA stapler. Signup and view all the answers

What is a primary consideration when performing a Nissen fundoplication?

The correct tension of the suturing around the esophagus Signup and view all the answers

What is the purpose of a pyloromyotomy in pediatric surgery?

To increase the diameter of the pyloric sphincter Signup and view all the answers

What distinguishes a Roux-en-Y gastric bypass from other weight loss surgeries?

It involves both restrictive and malabsorptive techniques Signup and view all the answers

Which type of gastrectomy involves anastomosis to the duodenum?

Billroth 1 Signup and view all the answers

What is the primary goal of a percutaneous endoscopic gastrostomy (PEG)?

To create an access point for nutritional support Signup and view all the answers

In bariatric surgery, what effect does bypassing part of the intestine have?

Reduces the calories absorbed and promotes early satiety Signup and view all the answers

What is a potential complication of a Nissen fundoplication if the wrap is too tight?

Difficulty in swallowing food Signup and view all the answers

What surgical technique is typically utilized to create a gastrostomy tube?

Endoscopic technique with a flexible gastroscope Signup and view all the answers

Which option describes a total gastrectomy?

Complete removal of the stomach and esophagus connection to jejunum Signup and view all the answers

What is a common feature of most bariatric surgeries?

They involve laparoscopic procedures Signup and view all the answers

What is the primary purpose of mesenteric repair during bowel surgery?

To ensure intact blood supply to the remaining bowel Signup and view all the answers

Which type of suture is recommended for repairing the internal serosa?

Absorbable suture such as vicryl or polysorb Signup and view all the answers

What vital step is taken before conducting an open Nissen Fundoplication to prevent accidental suturing of the esophagus shut?

Insertion of a dilator orally into the stomach Signup and view all the answers

What is the main goal of the Nissen Fundoplication procedure?

To repair hernias and prevent gastroesophageal reflux Signup and view all the answers

Which material is used for external serosa suturing in a Nissen Fundoplication?

Permanent silk suture Signup and view all the answers

What complication can occur if the mesenteric defect is not repaired during surgery?

Entrapment of bowel and obstruction Signup and view all the answers

During the Nissen Fundoplication, what is the role of the permanent sutures used?

To anchor the stomach around the lower esophagus Signup and view all the answers

What anatomical feature does Nissen Fundoplication aim to reposition?

Cardiac sphincter located at the esophageal junction Signup and view all the answers

In the context of stapling during bowel surgery, what does the term 'anastomosis' refer to?

The creation of an opening between two structures Signup and view all the answers

What happens to the cardiac sphincter following a successful Nissen Fundoplication?

It stays in the abdomen and does not rise Signup and view all the answers

Study Notes

Learning Objectives

Understand anatomy and procedural considerations for gastrointestinal (GI) surgery.
Differentiate surgical staplers and their use in open versus minimally invasive surgeries.
Apply proper isolation techniques for bowel and GI procedures.
Recognize goals of GI surgery: diagnosis, disease prevention, symptom relief, function restoration, and palliative care.

GI Surgery Overview

Subspecialty within general surgery focused on esophagus, stomach, small intestine, large intestine, and rectum.
Surgery may be indicated for diagnosis, preventative measures, or providing relief and comfort.

Blood Supply

Superior Mesenteric Artery: Supplies intestines from duodenum/pancreas to left colic flexure.
Inferior Mesenteric Artery: Supplies large intestine from left colic flexure to upper rectum.

Nursing Considerations

Risks for injury and unexpected outcomes present in GI surgery.
Preoperative skin assessment for high-risk areas essential.

Anastomosis Types

End-to-End Anastomosis: Joining two bowel segments.
Side-to-Side Anastomosis: Used post-resection for joining different-sized bowel segments.
End-to-Side Anastomosis: Known as Roux-en-Y, used for reconstructing GI tract continuity.

Staplers Used in Procedures

EEA Stapler: Creates end-to-end and end-to-side anastomoses; has reduced permanent colostomy rates.
GIA Stapler: Used for side-to-side anastomosis following bowel resection; creates a small opening for contents passage.

Mesenteric Repair

Repair of mesenteric defects post-resection to maintain blood supply integrity.
Prevention of post-operative bowel entrapment and obstruction with absorbable sutures.

Nissen Fundoplication

Surgical treatment for Gastroesophageal Reflux Disease (GERD).
Can be performed open or laparoscopically; involves wrapping the upper stomach around the lower esophagus to prevent reflux.

Gastric Surgeries

Gastrostomy: PEG method for tube placement via the abdominal wall under local anesthetic.
Gastrotomy: Surgical opening to explore or biopsy the stomach.
Pyloromyotomy: Increases pyloric sphincter diameter, mainly in pediatric cases.

Gastrectomy Types

Total Gastrectomy: Complete removal, reconnected via Roux-en-Y anastomosis.
Partial Gastrectomy: Includes Billroth 1 (to duodenum) and Billroth 2 (to jejunum).

Bariatric Surgery

Surgical options for obesity: malabsorptive and restrictive techniques.
Roux-en-Y Gastric Bypass: Reduces stomach size, bypasses portion of small intestine, decreases calorie absorption.
Sleeve Gastrectomy: Restricts food intake by removing most of the stomach without altering intestinal continuity.
Adjustable Laparoscopic Band: A band placed around stomach's top to control food intake.

Colorectal Cancer

Commonly occurs in the rectosigmoid area, prevalent in individuals aged 50 and over.
Initial sign often presents as polyps; diagnosed via colonoscopy.
Surgical interventions may include hemicolectomies, transverse colectomy, or abdominal peroneal resection.

Key Surgical Tools and Techniques

Recognize staplers per procedure: GIA, TA, and Doyen’s clamps.
Specific blood supply linked to various bowel resections (superior/inferior mesenteric artery).

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Description

Test your knowledge on gastrointestinal surgery as outlined in Alexander’s Care of the Patient in Surgery, Chapter 11. This quiz covers anatomy, procedural considerations, and the use of surgical staplers in both open and minimally invasive procedures. Assess your understanding of the critical aspects of this surgical specialty.