By P. Marco Fisichella, Marco G. Patti
This Atlas specializes in the outline of techniques and surgical innovations used to regard the full spectrum of esophageal ailments. Surgical “pearls” and find out how to decide upon and practice the proper operation are integrated and dependent either on evidence-based info and the event of the Editors.
Step-by-step descriptions of 14 operative tactics in esophageal surgical procedure are supplied. each one bankruptcy describes the present symptoms, perioperative administration ideas, and an in depth operative technique with proper technical concerns.
The description of techniques and surgical recommendations utilized in esophageal surgical procedure are defined in an simply comprehensible demeanour for the categorical target market.
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Extra resources for Atlas of Esophageal Surgery
12 Taking down the short gastric vessels 50 B. Borraez et al. • The short gastric vessels are taken down all the way to the left pillar of the crus, starting at the level of the middle portion of the gastric body and continuing upward until the most proximal short gastric vessel is divided. Possible complications during this step of the procedure are bleeding, either from the short gastric vessels or from the spleen, and damage to the gastric wall. Step 4 Creation of a window between gastric fundus, esophagus, and diaphragmatic crura; placement of Penrose drain around the esophagus (Figs.
Edu M. M. G. 1007/978-3-319-13015-6_6 45 46 B. Borraez et al. a b c Fig. 1 (a) Barium swallow shows 3-cm sliding hiatal hernia. (b) High-resolution esophageal manometry shows hypotensive lower esophageal sphincter (LES) and normal esophageal peristalsis. (c) On ambulatory pH monitoring, two sensors show distal and proximal reflux. 1 Positioning of the Patient and Placement of Trocars • The patient lies supine on the operating table in low lithotomy position with the lower extremities extended on stirrups with knees flexed 20–30° • A bean bag is inflated to avoid sliding of the patient as a consequence of the steep reverse Trendelenburg position used during the entire procedure.
In addition, the bands obscure lateral vision, decreasing the field of view. Some experts usually recommend preinjection of a dilute solution of epinephrine with saline, both to confirm the pliability of the tissue and to decrease any bleeding that may obscure vision . In C-EMR, after the tissue is captured within the prepositioned snare, the tissue is pushed out of the cap and the reaction of the wall of the gastrointestinal tract is assessed to determine whether the captured tissue represents primarily mucosa.
Atlas of Esophageal Surgery by P. Marco Fisichella, Marco G. Patti