Disposable Hemorrhoidal Stapler of the abdomen stumpby Cihui Chen cch5729
Success of anesthesia, the supine situation, schedule disinfection shop towels, tackle the abdominal incision within the navel, about 20cm layer lower into the stomach. The probe discovered which the ordinary liver condition texture, omentum, colon and pelvis showed no metastatic lesions, and also the lesser surgical clip applierfrom the gastric antrum plus a lump about 5 * 4cm serosal invasion. Chose to line gastrectomy, gastrectomy lymph node dissection. Raise the gastrocolic ligament, the cost-free omentum, off damaged blood vessels during the retina or so, up the separation of your pancreas ahead of the capsule.
Cleaning hepatoduodenal ligament lymph nodes, transection with the tummy appropriate vascular free of charge pyloric duodenal, in the the pyloric less than about 3cm edge resection edge suture the disarticulation duodenal stump embedded. Close to the liver area hepatogastric ligament transection cleansing celiac trunk lymph nodes close to the foundation from the still left gastric artery transection. Lymph node dissection splenic artery. Kocher clamp inside the tummy to get slash on the edge resection edge suture the large Bend aspect to stay 2 cross refers back to the width in the upper intestinal clamp intended for anastomotic use, removing of roughly 3/4 of my belly.
Disposable Linear Cutter Stapler submitted the jejunum remnant stomach line the front aspect with the colon anastomosis with the Treitz ligament about 10cm proximal jejunum in the lesser Disposable Linear Cutter Stapler. Both sides of your anastomosis reinforced stitching. Entire hemostasis. Distilled h2o to wash the stomach cavity, anastomotic disposal of the peritoneal drainage pipe. The proper stock gauze instruments layers and also the abdomen was closed. Smaller quantity of blood loss all through medical procedures goes very well, the surgical treatment, the patient security back again to the ward. Gastrectomy (distal gastrectomy D2 lymphadenectomy Billroth II reconstruction from the digestive tract) in people using this type of supine position, anesthesia is achieved, the the plan disinfection drape catheterization, just take the middle around the umbilical incision of about 25cm skin incision layer by layer to the abdominal exploration see: the tumor is found from the gastric antrum, dimensions about 3cm, had violated the serosal layer mass in the pyloric higher than 3cm, liver, gall bladder, spleen, compact intestine, colon, mesentery, omentum, pelvic, abdominal wall showed no metastases and no ascites.
Decided to line gastrectomy. Together the transverse colon wall separating the gastrocolic ligament up to the splenic flexure, hepatic flexure, and stripped of your shallow the mesocolon layer; and linked stripping pancreas outer envelope. Open Kocher incision isolated duodenum preliminary section, respectively, ligation with the appropriate gastric artery and vein, and amputation; respectively ligation in the suitable gastroepiploic artery and vein, and amputation; separation pyloric peripheral vascular ligation disarticulation until eventually pyloric about 3cm, steer clear of the frequent bile duct, the preliminary phase of your duodenum, a 55mm straight cutter for reducing anastomosis; duodenal stump that has a silk purse embedding.
Separation hepatogastric ligament retractor stomach wall, separating the ligation from the brief gastric vein, and amputation; around 70% from your distal tummy, separation of blood vessels around below abdomen branch ligation and transection; here on 100mm straight line reducing , GIA resection specimens; embedded the lesser curvature pockets with silk, leaving about 5cm, for gastrointestinal reconstruction. Along the hepatic artery separation all over connective adipose tissue (lymph node dissection group 7-9), together the portal vein all over cleansing connective tissue (12, 13 lymph nodes).
About 20cm at a acquire Treitz ligament jejunum about 4cm within the transverse colon in entrance, to generally be done in step with the big Disposable Hemorrhoidal Stapler of the abdomen stump; jejunum and targets set an intestinal clamp, vacant intestinal wall incision, thoroughly disinfected, whichever is the objective of your belly stump curvature of an intestinal clamp, reduce stapling at about 4cm very carefully disinfected with silk was sutured posterior wall of its entrance wall of rope anastomosis; bilateral corners strengthened that has a silk purse, double-check to view The anastomosis can accommodate two cross-refers to double-check anastomotic part locale purse reinforcement. Mindful hemostasis, clean the belly cavity with warm saline the exhaustion after anastomosis, glance askance nest from the residence a drainage tube, inventory gauze, devices are appropriate in levels and also the stomach was closed; medical procedures Chengshun blood reduction about 300ml, specimens and lymph nodes sent to pathology, client basic safety return.
Created on Dec 31st 1969 19:00. Viewed 0 times.