Fund Op La Sty
This document was uploaded by user and they confirmed that they have the permission to share it. If you are author or own the copyright of this book, please report to us by using this DMCA report form. Report DMCA
Overview
Download & View Fund Op La Sty as PDF for free.
More details
- Words: 705
- Pages: 5
FUNDOPLASTY REASON FOR VISIT: •
Esophagitis
•
Hiatus hernia
•
Gastro esophageal reflux
•
Heart burn
•
Regurgitation
RISK ASSESSMENT •
Old age
•
Prior heart diseases
•
kidney diseases
•
Diabetes
•
Hypertension
•
History of bleeding disorders
•
Taking aspirin and other anticoagulants
•
History of allergy to medications
•
History of allergy to anesthesia
PREPARATION OF THE PATIENT •
Blood tests
•
Urine tests
•
Chest x-ray
•
Barium x-ray
•
EKG/ECG
•
Endoscopy
•
Patient was on fasting for ____hrs before the procedure
•
Enema was given
•
Aspirin and other blood-thinning medications were stopped for
•
several days before the surgery Preoperative antibiotics were administered to the patients with diseases of the heart valves
•
Part was prepared and draped in sterile fashion
ANESTHESIA: General anesthesia POSITION OF THE PATIENT Supine position THE PROCEDURE Methods •
Open surgery
•
Laparoscopic surgery
OPEN SURGERY •
An external incision given in the lower part of chest and upper
•
part of the abdomen of the patient ________cm. abdomen is opened in layers
•
The gastrohepatic and phrenoesophageal ligaments were divided
•
to exposing the GE junction. The stomach was freed from its attachment to the spleen.
•
The right crura had been dissected free, and the esophagus was
•
recognized. The portion of the esophagus in the abdomen was freed of its
•
attachments. An arterial vessel was divided between clips to allow better
•
mobilization of the stomach The upper region of the stomach was wrapped around the lower
•
esophageal sphincter to increase pressure on the lower esophageal sphincter The wrapped portion was then sewn into place so that the lower part of the esophagus passes through a small hole in the stomach muscle.
•
A large rubber dilator was placed inside the esophagus to reduce
•
the overly tight wrap. Hiatus hernia was repaired
•
Abdomen was sutured in layers
LAPAROSCOPIC SURGERY •
Several small incisions are created in the abdomen.
•
The laparoscope was then passed into the abdomen through one
•
of the incisions. The other instruments were passed into the abdomen through
•
other incisions The abdomen was inflated with carbon dioxide.
•
The contents of the abdomen can now be viewed on a video
•
monitor that receives its picture from the laparoscopic camera. The gastrohepatic and phrenoesophageal ligaments were divided
•
to exposing the GE junction. The stomach was freed from its attachment to the spleen.
•
The right crura were dissected free, and the esophagus is being
•
recognized. The portion of the esophagus in the abdomen was freed from its
•
attachments. An esophageal dilator was then passed through the mouth into
•
the esophagus. This dilator keeps the stomach from being wrapped too tightly around the esophagus. The portion of the esophagus in the abdomen was freed from its
•
attachments. The top portion of the stomach (the fundus) was passed behind
•
the esophagus, wrapped around it 360°, and sutured in place. If a hiatus hernia was present, the hiatus (the hole in the
•
diaphragm through which the esophagus passes) was made smaller with one to three sutures so that it fits around the esophagus snugly. The sutures keep the fundoplication from protruding into the
•
chest cavity. The laparoscope and instruments were removed
•
The skin incisions were closed in layers by sutures
•
Dressing was done
AFTER PROCEDURE: • • •
Immediately after surgery the patient was taken to a recovery area The blood pressure/pulse/temperature was monitored Nothing is taken for _____hr
DURATION ________minutes POSTOPERATIVE CARE •
Take antibiotic treatment as prescribed
•
Take pain medications prescribed
•
Observe for in discharge from suture site
•
Surgical wound dressings will be kept clean and dry
•
Take liquid diet for _____days
COMPLICATIONS • • • • • • • •
Heartburn recurrence Swallowing difficulties caused by an overly tight wrap of the stomach on the esophagus Failure of the wrap to stay in place so that the LES is no longer supported Normal risks associated with major surgical procedures and the use of general anesthesia Increased bloating and discomfort due to a decreased ability to expel excess gas Infection Breathing difficulties and pneumonia Adverse reactions to anesthesia
Esophagitis
•
Hiatus hernia
•
Gastro esophageal reflux
•
Heart burn
•
Regurgitation
RISK ASSESSMENT •
Old age
•
Prior heart diseases
•
kidney diseases
•
Diabetes
•
Hypertension
•
History of bleeding disorders
•
Taking aspirin and other anticoagulants
•
History of allergy to medications
•
History of allergy to anesthesia
PREPARATION OF THE PATIENT •
Blood tests
•
Urine tests
•
Chest x-ray
•
Barium x-ray
•
EKG/ECG
•
Endoscopy
•
Patient was on fasting for ____hrs before the procedure
•
Enema was given
•
Aspirin and other blood-thinning medications were stopped for
•
several days before the surgery Preoperative antibiotics were administered to the patients with diseases of the heart valves
•
Part was prepared and draped in sterile fashion
ANESTHESIA: General anesthesia POSITION OF THE PATIENT Supine position THE PROCEDURE Methods •
Open surgery
•
Laparoscopic surgery
OPEN SURGERY •
An external incision given in the lower part of chest and upper
•
part of the abdomen of the patient ________cm. abdomen is opened in layers
•
The gastrohepatic and phrenoesophageal ligaments were divided
•
to exposing the GE junction. The stomach was freed from its attachment to the spleen.
•
The right crura had been dissected free, and the esophagus was
•
recognized. The portion of the esophagus in the abdomen was freed of its
•
attachments. An arterial vessel was divided between clips to allow better
•
mobilization of the stomach The upper region of the stomach was wrapped around the lower
•
esophageal sphincter to increase pressure on the lower esophageal sphincter The wrapped portion was then sewn into place so that the lower part of the esophagus passes through a small hole in the stomach muscle.
•
A large rubber dilator was placed inside the esophagus to reduce
•
the overly tight wrap. Hiatus hernia was repaired
•
Abdomen was sutured in layers
LAPAROSCOPIC SURGERY •
Several small incisions are created in the abdomen.
•
The laparoscope was then passed into the abdomen through one
•
of the incisions. The other instruments were passed into the abdomen through
•
other incisions The abdomen was inflated with carbon dioxide.
•
The contents of the abdomen can now be viewed on a video
•
monitor that receives its picture from the laparoscopic camera. The gastrohepatic and phrenoesophageal ligaments were divided
•
to exposing the GE junction. The stomach was freed from its attachment to the spleen.
•
The right crura were dissected free, and the esophagus is being
•
recognized. The portion of the esophagus in the abdomen was freed from its
•
attachments. An esophageal dilator was then passed through the mouth into
•
the esophagus. This dilator keeps the stomach from being wrapped too tightly around the esophagus. The portion of the esophagus in the abdomen was freed from its
•
attachments. The top portion of the stomach (the fundus) was passed behind
•
the esophagus, wrapped around it 360°, and sutured in place. If a hiatus hernia was present, the hiatus (the hole in the
•
diaphragm through which the esophagus passes) was made smaller with one to three sutures so that it fits around the esophagus snugly. The sutures keep the fundoplication from protruding into the
•
chest cavity. The laparoscope and instruments were removed
•
The skin incisions were closed in layers by sutures
•
Dressing was done
AFTER PROCEDURE: • • •
Immediately after surgery the patient was taken to a recovery area The blood pressure/pulse/temperature was monitored Nothing is taken for _____hr
DURATION ________minutes POSTOPERATIVE CARE •
Take antibiotic treatment as prescribed
•
Take pain medications prescribed
•
Observe for in discharge from suture site
•
Surgical wound dressings will be kept clean and dry
•
Take liquid diet for _____days
COMPLICATIONS • • • • • • • •
Heartburn recurrence Swallowing difficulties caused by an overly tight wrap of the stomach on the esophagus Failure of the wrap to stay in place so that the LES is no longer supported Normal risks associated with major surgical procedures and the use of general anesthesia Increased bloating and discomfort due to a decreased ability to expel excess gas Infection Breathing difficulties and pneumonia Adverse reactions to anesthesia
Related Documents
Fund Op La Sty
November 2019 18
Sty Ron
November 2019 28
Que Sty
October 2019 13
Ion Pribeagu - La Fund
October 2019 19
Nov Op La No
November 2019 4