Module 14: GI Surgery Techniques
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Module 14: GI Surgery Techniques

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Questions and Answers

What is the primary purpose of using bowel/isolation technique during surgery?

  • To prevent cross-contamination with bowel organisms (correct)
  • To facilitate faster closure of the wound
  • To enhance the healing process of the incision
  • To reduce the amount of anesthesia needed
  • When does the bowel technique begin during a surgical procedure?

  • Once the patient is anesthetized
  • Before any instruments are used
  • As soon as the GI tract is clamped and opened (correct)
  • Immediately after the incision is made in the skin
  • What type of stapling device is used for side-to-side anastomoses?

  • TA Stapler
  • GIA Stapler (correct)
  • Manual Stapler
  • Endoscopic GIA Stapler
  • What is a characteristic feature of the TA stapler?

    <p>It requires manual cutting</p> Signup and view all the answers

    What additional measure is taken during bowel technique after completing the anastomosis?

    <p>The surgical team changes gloves and gowns if necessary</p> Signup and view all the answers

    What is the function of the GIA stapler in surgical procedures?

    <p>To create side-to-side anastomoses</p> Signup and view all the answers

    In which scenario is the GIA stapler's no-knife version utilized?

    <p>In endoscopic versions for gynecological surgeries</p> Signup and view all the answers

    What is a potential consequence of not using bowel/isolation technique during the surgery?

    <p>Increased chance of mechanical metastasis</p> Signup and view all the answers

    What is the primary function of the GIA stapler in gastrointestinal procedures?

    <p>To create side-to-side anastomosis</p> Signup and view all the answers

    Why is it important to ensure the blood supply of the superior and inferior mesenteric arteries is intact during bowel surgery?

    <p>To maintain bowel viability</p> Signup and view all the answers

    What type of suture is recommended for the repair of the internal serosa?

    <p>Absorbable vicryl suture</p> Signup and view all the answers

    What is the purpose of the dilator used in the open Nissen Fundoplication procedure?

    <p>To prevent suturing the esophagus shut</p> Signup and view all the answers

    What structural adaptation does Nissen Fundoplication accomplish for GERD management?

    <p>Wraps the upper stomach around the lower esophagus</p> Signup and view all the answers

    What is the primary indication for performing a mesenteric defect repair?

    <p>To avoid bowel obstruction</p> Signup and view all the answers

    In open Nissen Fundoplication, how many permanent sutures are typically used to secure the stomach?

    <p>3-4 sutures</p> Signup and view all the answers

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

    <p>Bowel obstruction</p> Signup and view all the answers

    What is the primary mechanism of Sleeve Gastrectomy?

    <p>By restricting the amount of food that can be consumed.</p> Signup and view all the answers

    Which type of surgery involves the placement of an adjustable band around the stomach?

    <p>Adjustable Laparoscopic Band</p> Signup and view all the answers

    At what age group is colorectal cancer most commonly diagnosed?

    <p>Adults aged 50 and older</p> Signup and view all the answers

    What is the initial sign of colorectal cancer?

    <p>Polyps</p> Signup and view all the answers

    Which surgical intervention requires the stapler type 'GIA' for right hemicolectomy?

    <p>Right Hemicolectomy</p> Signup and view all the answers

    Which mesenteric artery is involved with the removal of bowel segments during colorectal surgery?

    <p>Inferior Mesenteric Artery</p> Signup and view all the answers

    What is typically required after an Abdominal Peroneal Resection of the colon?

    <p>Colostomy</p> Signup and view all the answers

    Which of the following staplers is used in the sigmoid colectomy procedure?

    <p>EEA</p> Signup and view all the answers

    What is the primary use of the EEA technology in gastrointestinal procedures?

    <p>To reduce the need for permanent colostomies</p> Signup and view all the answers

    What type of anastomosis allows for the connection between two different sized lumens?

    <p>Side-to-Side Anastomosis</p> Signup and view all the answers

    Which device is specifically mentioned for performing a Side-to-Side Anastomosis?

    <p>GIA Stapler</p> Signup and view all the answers

    What is a key step in executing a Side-to-Side Anastomosis after bowel resection?

    <p>A GIA stapler is fired to staple the two bowel segments</p> Signup and view all the answers

    What type of anastomosis is often referred to as a Roux-en-Y?

    <p>End-to-Side Anastomosis</p> Signup and view all the answers

    What happens to the bowel after a Side-to-Side Anastomosis has healed?

    <p>It straightens out and functions similarly to an end-to-end anastomosis</p> Signup and view all the answers

    Which procedural step follows the insertion of the GIA stapler during a Side-to-Side Anastomosis?

    <p>The GIA stapler is fired by the surgeon</p> Signup and view all the answers

    How is the site left behind after a GIA stapler is removed typically managed?

    <p>It can be sutured closed or stapled with a TA stapler</p> Signup and view all the answers

    What is the primary reason for performing a temporary colostomy?

    <p>To allow the bowel to rest or heal an anastomosis</p> Signup and view all the answers

    Which type of colostomy is indicated when a rectal tumor is too close to the anus?

    <p>Abdominoperineal Resection</p> Signup and view all the answers

    What is the role of the purse-string suture in abdominoperineal resection?

    <p>To close the anus after bowel removal</p> Signup and view all the answers

    What happens to the distal part of the bowel during a Hartmann Colostomy?

    <p>It is closed and forms a mucous fistula</p> Signup and view all the answers

    Which surgical procedure eliminates the need for an ileostomy for patients with ulcerative colitis?

    <p>Ileal Anal Pull Through</p> Signup and view all the answers

    When is a Hartmann Colostomy typically performed?

    <p>In emergency situations</p> Signup and view all the answers

    What structure is typically used for a permanent rosebud colostomy?

    <p>Proximal bowel section</p> Signup and view all the answers

    What is the primary indication for performing an ileostomy?

    <p>Inflammatory bowel disease treatment</p> Signup and view all the answers

    Study Notes

    Operating Room Considerations

    • An OR table must support excessive weight during bariatric surgeries to ensure patient safety.
    • Bowel/isolation technique is crucial to prevent cross-contamination and mechanical metastasis during GI surgeries.

    Bowel Isolation Technique

    • Initiated once the GI tract is clamped, focusing on irrigation before wound closure.
    • Bowel instruments are kept separate from clean instruments; often passed off to the circulating nurse with the specimen.
    • Extra draping around the incisional area is recommended, with surgical team changing gloves post-anastomosis completion.

    Stapling Devices Overview

    • GIA Stapler: Disposable, reloadable, cuts and staples, used for side-to-side anastomoses.
    • TA Stapler: Disposable, reloadable, staples tissues together with manual cutting required.
    • EEA Stapler: Disposable, not reloadable, cuts and staples for end-to-end or end-to-side anastomoses, often used to reduce colostomy needs.

    Types of Anastomoses

    • End-to-End: Directly connects two bowel segments.
    • Side-to-Side (Functional End-to-End): Connects two segments after resection, allows for different lumen sizes, and functions like end-to-end after healing.
    • End-to-Side (Roux-en-Y): Joins one segment to the side of another, often for reconstructive purposes.

    Mesenteric Repair

    • After bowel resection, it's critical to repair corresponding mesenteries to maintain blood supply from Superior and Inferior mesenteric arteries, preventing bowel entrapment and obstruction.

    Procedures in GERD Management

    • Nissen Fundoplication: Addresses mechanical dysfunction of the lower esophageal sphincter; can be performed open or laparoscopically, forming a wrap around the lower esophagus.

    Bariatric Surgical Procedures

    • Sleeve Gastrectomy: Removes 85% or more of the stomach to restrict food intake.
    • Adjustable Laparoscopic Band: Constricts the upper stomach, limiting food intake.

    Colorectal Cancer Insights

    • Commonly occurs in the rectosigmoid area, particularly in those over 50. Early detection of polyps can lead to successful treatment.

    Surgical Interventions for Colorectal Cancer

    • Right Hemicolectomy, Left Hemicolectomy, Transverse Colectomy, Anterior Resection, Sigmoid Colectomy, Abdominal Perineal Resection: Different approaches depending on cancer location and extent.

    Colostomy/Ileostomy Creation

    • Temporary Colostomy: Allows bowel rest or anastomosis healing, often in emergency situations.
    • Permanent Colostomy: Required in cases like Abdominoperineal resection for rectal tumors.

    Closure Techniques

    • Hartmann Colostomy: A colostomy done when a primary anastomosis isn't feasible; involves bringing out the proximal bowel to the skin while closing the distal stump.

    Advanced Procedures

    • Ileal Anal Pull Through: Suitable for ulcerative colitis; removes the large bowel and part of the rectum, creating a pouch from the small bowel attached to the anus, maintaining sphincter control.

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    Description

    This quiz covers essential procedural considerations for bariatric and gastrointestinal surgeries, focusing on the importance of using specialized operating room tables for patient safety. Additionally, it addresses the bowel/isolation technique, which is vital in preventing cross-contamination during surgeries, especially cancer procedures.

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