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Questions and Answers
What is the primary purpose of gastrointestinal (GI) surgery?
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?
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?
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?
Which of the following statements about surgical staplers is true?
What role does the inferior mesenteric artery play in gastrointestinal blood supply?
What role does the inferior mesenteric artery play in gastrointestinal blood supply?
Which of the following should be considered when discussing the risk of injury in GI surgery?
Which of the following should be considered when discussing the risk of injury in GI surgery?
What is an important consideration regarding bowel isolation techniques in GI procedures?
What is an important consideration regarding bowel isolation techniques in GI procedures?
What is the correct function of GI surgery in terms of disease management?
What is the correct function of GI surgery in terms of disease management?
What percentage of the stomach is typically removed during a Sleeve Gastrectomy?
What percentage of the stomach is typically removed during a Sleeve Gastrectomy?
Which stapler is required for a Sigmoid Colectomy during an Anterior Resection?
Which stapler is required for a Sigmoid Colectomy during an Anterior Resection?
What is the primary initial sign of colorectal cancer?
What is the primary initial sign of colorectal cancer?
In colorectal surgeries, which artery is primarily involved in the blood supply for bowel segments?
In colorectal surgeries, which artery is primarily involved in the blood supply for bowel segments?
Which surgical intervention involves the removal of the right portion of the colon?
Which surgical intervention involves the removal of the right portion of the colon?
What is the primary advantage of using a side-to-side anastomosis with a GIA stapler?
What is the primary advantage of using a side-to-side anastomosis with a GIA stapler?
Which type of anastomosis is characterized by a circular cutting and stapling mechanism?
Which type of anastomosis is characterized by a circular cutting and stapling mechanism?
In the surgical procedure involving a GIA stapler, what occurs after the resection of the bowel?
In the surgical procedure involving a GIA stapler, what occurs after the resection of the bowel?
Which of the following types of anastomoses is often referred to as a Roux-en-Y?
Which of the following types of anastomoses is often referred to as a Roux-en-Y?
What is a notable clinical outcome of employing EEA technology in surgical procedures?
What is a notable clinical outcome of employing EEA technology in surgical procedures?
During a side-to-side anastomosis, what is the primary action taken by the surgeon after placing the GIA stapler?
During a side-to-side anastomosis, what is the primary action taken by the surgeon after placing the GIA stapler?
Which anatomical sites can EEA staplers be used on during surgeries?
Which anatomical sites can EEA staplers be used on during surgeries?
What is the main purpose of the small hole created by the GIA stapler during a side-to-side anastomosis?
What is the main purpose of the small hole created by the GIA stapler during a side-to-side anastomosis?
What typically follows the firing of the GIA stapler in terms of wound closure?
What typically follows the firing of the GIA stapler in terms of wound closure?
What is a primary consideration when performing a Nissen fundoplication?
What is a primary consideration when performing a Nissen fundoplication?
What is the purpose of a pyloromyotomy in pediatric surgery?
What is the purpose of a pyloromyotomy in pediatric surgery?
What distinguishes a Roux-en-Y gastric bypass from other weight loss surgeries?
What distinguishes a Roux-en-Y gastric bypass from other weight loss surgeries?
Which type of gastrectomy involves anastomosis to the duodenum?
Which type of gastrectomy involves anastomosis to the duodenum?
What is the primary goal of a percutaneous endoscopic gastrostomy (PEG)?
What is the primary goal of a percutaneous endoscopic gastrostomy (PEG)?
In bariatric surgery, what effect does bypassing part of the intestine have?
In bariatric surgery, what effect does bypassing part of the intestine have?
What is a potential complication of a Nissen fundoplication if the wrap is too tight?
What is a potential complication of a Nissen fundoplication if the wrap is too tight?
What surgical technique is typically utilized to create a gastrostomy tube?
What surgical technique is typically utilized to create a gastrostomy tube?
Which option describes a total gastrectomy?
Which option describes a total gastrectomy?
What is a common feature of most bariatric surgeries?
What is a common feature of most bariatric surgeries?
What is the primary purpose of mesenteric repair during bowel surgery?
What is the primary purpose of mesenteric repair during bowel surgery?
Which type of suture is recommended for repairing the internal serosa?
Which type of suture is recommended for repairing the internal serosa?
What vital step is taken before conducting an open Nissen Fundoplication to prevent accidental suturing of the esophagus shut?
What vital step is taken before conducting an open Nissen Fundoplication to prevent accidental suturing of the esophagus shut?
What is the main goal of the Nissen Fundoplication procedure?
What is the main goal of the Nissen Fundoplication procedure?
Which material is used for external serosa suturing in a Nissen Fundoplication?
Which material is used for external serosa suturing in a Nissen Fundoplication?
What complication can occur if the mesenteric defect is not repaired during surgery?
What complication can occur if the mesenteric defect is not repaired during surgery?
During the Nissen Fundoplication, what is the role of the permanent sutures used?
During the Nissen Fundoplication, what is the role of the permanent sutures used?
What anatomical feature does Nissen Fundoplication aim to reposition?
What anatomical feature does Nissen Fundoplication aim to reposition?
In the context of stapling during bowel surgery, what does the term 'anastomosis' refer to?
In the context of stapling during bowel surgery, what does the term 'anastomosis' refer to?
What happens to the cardiac sphincter following a successful Nissen Fundoplication?
What happens to the cardiac sphincter following a successful Nissen Fundoplication?
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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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