Step 1: Surgical Anatomy ♦ Preoperatively, the patient’s upper gastrointestinal anatomy should be evaluated. Screen the patient for symptoms of reflux, dysphagia, or peptic ulcer disease. The patient should undergo…

Step 1: Surgical Anatomy ♦ The arterial blood supply to the stomach is rich and comes from multiple sources. These include the left gastric artery (branch of the celiac axis),…

Step 1: Surgical Anatomy ♦ Division of the vagus nerves is an important part of any operation whose goal is to control gastric acid secretion. The left vagus nerve that…

Step 1: Surgical Anatomy ♦ None. Step 2: Preoperative Considerations ♦ The most common laparoscopic resection for Crohn disease is unquestionably ileocecal resection. The conduct and intraoperative steps vary depending…

Step 1: Surgical Anatomy ♦ Due to the multiplicity of gastric operations performed both for benign and malignant diseases, it is imperative that the reoperative surgeon obtain and review all…

Step 1: Surgical Anatomy ♦ Surgery of the stomach and duodenum requires an understanding of both the blood supply of the stomach and duodenum and the anatomical relationships to the…

Step 1: Surgical Anatomy ♦ Patients with bulky mid-esophageal tumors, especially those who have undergone neoadjuvant chemoradiation, are best treated with a transthoracic approach. ♦ The transhiatal approach is useful…

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….