Abdominal Key

Step 1: Surgical Anatomy ♦ The lower portion of the esophagus deviates to the left of the midline and is most easily accessible via the left chest. ♦ Above the…

Step 1: Surgical Anatomy ♦ The minimally invasive esophagectomy incorporates either thoracoscopy, laparoscopy, or both, for dissection and reconstruction of the esophagus. ♦ An EEA anastomosis can be done in…

Step 1: Surgical Anatomy 1. Types of Paraesophageal Hernias ( Figure 7-1ABCDE ) ♦ Type 1: Sliding hiatal hernia in which the gastroesophageal junction moves cephalad, predisposing to gastroesophageal reflux….

Step 1: Surgical Anatomy ♦ Type 1: Sliding hiatal hernia where the gastroesophageal junction herniates within the chest, predisposing to reflux. Step 2: Preoperative Considerations ♦ EGD, esophageal motility, and…

Step 1: Surgical Anatomy ♦ Pyloroplasty consists of dividing the pyloric muscle and reconstructing the pyloric channel to improve gastric emptying. Following truncal vagotomy, impairment of gastric tone results in…

Step 1: Surgical Anatomy ♦ The Finney pyloroplasty is preferred when a longer incision on the duodenum is required to control bleeding. A fibrotic duodenum may require closure with a…

Step 1: Clinical Anatomy ♦ Jaboulay “pyloroplasty” is actually a gastroduodenostomy between the antrum of the stomach and the duodenum. The pylorus is not technically incised. ( Figure 14-1 )…

Step 1: Surgical Anatomy ♦ After giving off the hepatic branch, the anterior nerve of Latarjet courses inferiorly, within the anterior leaflet of the gastrohepatic ligament, medial to the lesser…

Step 1: Surgical Anatomy ♦ Selective vagotomy entails transection of both the descending branch of the anterior vagus nerve (anterior nerve of Latarjet) distal to the hepatic branches, and the…

Step 1: Surgical Anatomy ♦ The anterior or left vagus nerve is a thick, visible structure which lies just right of the midline along the anterior surface of the intraabdominal…