Surgical Procedures PDF

SURGICAL PROCEDURES. Dogma Of Nutrition In Surgery  Stress Factor Minor : 1.0-1.1 Major: 1.3-1.9 LSCS- LOWER SEGMENT CEASERIAN SECTION Commonly known as C-section. Lower segment Caesarean section (LSCS): Caesarean delivery is defined as the delivery of a fetus through surgical incis...

SURGICAL PROCEDURES. Dogma Of Nutrition In Surgery  Stress Factor Minor : 1.0-1.1 Major: 1.3-1.9 LSCS- LOWER SEGMENT CEASERIAN SECTION Commonly known as C-section. Lower segment Caesarean section (LSCS): Caesarean delivery is defined as the delivery of a fetus through surgical incisions made through the abdominal wall (laparotomy) and the uterine wall. A C-section may be needed to protect the health of your or your baby. In these cases, a C-section may be safer than vaginal birth. It can be done with epidural, general, or spine anaesthesia. Why IT’s Done? Labour does not progress Baby size is large Baby isn’t in a head down position for birth Prolapsed umbilical cord Baby is in distress (oxygen or heart beat ) Premature baby Complications during gestation and after lscs GDM PIH Preecmplsia Gas or bloating Constipation Wound infection low production of milk Excess bleeding which leads to anaemia  MNT of LSCS  CHO 45-60%  fat 25-30%  Protein 20-25% Diet order: Progressive diet Type of diet: High protein, High iron diet,Vit C Therapeutic Nutrients Key nutrients to help the healing process Iron – Iron is important after a C-section, especially if you suffered from major blood loss. Choosing iron-rich foods can help produce hemoglobin and reduce the risk of iron deficiency anemia. Sufficient iron stores may even help combat fatigue Pairing plant based iron-rich foods with a Vitamin C source allows for better absorption of the iron. Fiber – Constipation is a common discomfort postpartum. Your recent abdominal surgery, pain medications and prenatal vitamins can all contribute to constipation. Aiming for at least 25 grams of fiber daily can help keep you regular. Sources of fiber include vegetables, fruits, whole grains, nuts, beans, and other legumes Fluid – Consuming enough fluid helps to prevent dehydration and constipation. Your body will have an even higher demand for fluid if you are breastfeeding. Role of protein, vitamin c, iron after C-section. Protein helps the healing process and is needed for the growth of new tissue. Vitamin C plays an important role in healing and fighting infection. Iron helps the immune system and is needed for haemoglobin. Your body loses iron when it loses blood. Lap chole / lap surgery / cholecystectomy Laparoscopic cholecystectomy, commonly referred to as a lap chole, involves the removal of the gallbladder through a laparoscopic approach.  The gallbladder normally stores bile produced in the liver until it is needed for digestion. Unfortunately, the gallbladder often forms gallstones.  A cholecystectomy is most commonly performed by inserting a tiny video camera and special surgical tools through four small incisions to see inside your abdomen and remove the gallbladder. TYPES Why lap chole is performed Complications after lap chole  Difficulty digesting fat  Diarrhea and flatulence  Constipation  Jaundice or fever  MNT for lap chole High fiber Low fat Low calorie diet Plant based diet For Cholecystectomy: Type of diet : Fat Restricted Diet Diet Order: Progressive diet level (acc to pt condition)  Nutrition Considerations Plant-based diets. Both animal fat and animal protein may contribute to the formation of gallstones. Up to 90% of gallstones are cholesterol stones (≥ 20% cholesterol composition). Vegetarian women have a lower risk for gallstones compared with no vegetarian women. Vitamin C, which is found in plants and is absent from meat, affects the rate-limiting step in the catabolism of cholesterol to bile acids and is inversely related to the risk of gallstones in women Women consuming the most vegetable protein have been shown to have a 20-30% lower risk than those consuming the least. Replacement of sugars and refined starches with high-fiber foods. The cholesterol saturation index of bile, a known risk factor for gallstone formation, is higher with diets that provide carbohydrates in a refined, as opposed to unrefined, Weight cycling (repeatedly intentionally losing and unintentionally regaining weight) increases the likelihood of cholelithiasis. As noted above, very-low-calorie diets (< 800 kcal/day) increase the risk of gallstones, though the explanation for this remains unclear. Including a small amount of fat (10 g/day) provides maximal gallbladder emptying and prevents gallstone formation in calorie-restricted dieters. TAH-BSO Total abdominal hysterectomy-bilateral salpingo oophorectomy LAVH- Laproscopically assisted vaginal hysterectomy There are several parts of this surgery: 1. A total abdominal hysterectomy (TAH), is the removal of uterus (womb) and the cervix through an abdominal incision. 2. Bilateral salpingo-oophorectomy (BSO), is the removal of both fallopian tubes and ovaries. Diet after Tah-bso Eat a well-balanced diet, including protein which will help with healing after surgery. Drink about 8-10 glasses of fluids a day (especially water) to keep your body well hydrated. Fruits and fruit juices for first few weeks. Avoid high fibre for first few weeks. Eat high protein, high iron and progressive diet.  FESS Functional endoscopic sinus surgery is a minimally invasive procedure which uses nasal endoscopes to enlarge the nasal drainage pathways of the paranasal sinuses to improve sinus ventilation and allow access of topical medications MNT in FESS Warm liquids Low fat intake Diet order: Nutrient dense diet Type of diet: Liquid diet TKR- Total Knee Replacement A total knee replacement is considered a major operation, and the decision to undergo total knee replacement is not a trivial one. People usually decide to undergo surgery when they feel they can no longer live with the pain of their arthritis. THR- Total Hip Replacement Hip replacement is the removal and replacement of portions of the pelvis and femur (thighbone) that form your hip joint. It is performed primarily to relieve hip pain and stiffness caused by hip arthritis. This procedure is also sometimes used to treat injuries such as a broken or improperly growing hip.  MNT  Type of diet: Anti-inflammatory  Diet order: soft or Regular acc to pt condition  High protein (1.2g/kg)  Complex CHO  Calcium (2500mg for 19-50yrs and >50yrs Calcium)  Phosphate (2-3g/day)  Vit D (1000-2000IU/day)  Vit A (Caratoneiods) upper limit 30,000IU Case Study Pt name: Kiran Mr: 310293 Room: SICU B2 Diagnosis: Cholelithiaisis + choledocholilithiasis Operation ? Pt name: Kiran Mr: 310293 Room: SICU B2 Diagnosis: Cholelithiaisis + choledocholilithiasis Operation: Lap Chole + ERCP (Endosccopic Retrograde Cholangiopancreatography Procedure ANY QUESTIONS?