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دانلود کتاب Chassin's Operative Strategy in General Surgery: An Expositive Atlas
دانلود کتاب استراتژی عملیاتی Chassin در جراحی عمومی: یک اطلس آشکار
مشخصات کتاب
Chassin's Operative Strategy in General Surgery: An Expositive Atlas
ویرایش: [5 ed.] نویسندگان: Carol E. H. Scott-Conner, Andreas M. Kaiser, Ninh T. Nguyen, Umut Sarpel, Sonia L. Sugg سری: ISBN (شابک) : 9783030814144, 3030814149 ناشر: Springer سال نشر: 2022 تعداد صفحات: [1091] زبان: English فرمت فایل : PDF (درصورت درخواست کاربر به PDF، EPUB یا AZW3 تبدیل می شود) حجم فایل: 111 Mb
قیمت کتاب (تومان) : 60,000
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توجه داشته باشید کتاب استراتژی عملیاتی Chassin در جراحی عمومی: یک اطلس آشکار نسخه زبان اصلی می باشد و کتاب ترجمه شده به فارسی نمی باشد. وبسایت اینترنشنال لایبرری ارائه دهنده کتاب های زبان اصلی می باشد و هیچ گونه کتاب ترجمه شده یا نوشته شده به فارسی را ارائه نمی دهد.
توضیحاتی در مورد کتاب استراتژی عملیاتی Chassin در جراحی عمومی: یک اطلس آشکار
این ویرایش پنجم از استراتژی عملیاتی Chassin در جراحی عمومی یک تجدید نظر اساسی است که در تلاش است تا به هدف و لحن متن اصلی دکتر Chassin وفادار بماند. این کتاب درسی منحصر به فرد تاکیدی بر استراتژی جراحی دارد که با سایر کتاب های درسی تکنیک جراحی بی نظیر است. متن مبانی مفهومی هر عملیات را توضیح می‌دهد، راهبردهایی را برای اجتناب از دام‌های رایج ترسیم می‌کند، و مراحل فنی هر عملیات را به دقت توصیف و به زیبایی نشان می‌دهد. نسخه پنجم ضمن ارائه به روز رسانی جامع، کیفیت های منحصر به فرد نسخه قبلی خود را حفظ می کند. این جلد به روز شده همچنین دارای تعداد زیادی از آثار هنری با جزئیات فراوان و عکس های عملیاتی است که به ترسیم تکنیک های عملیاتی گام به گام کمک می کند. هیچ متن دیگری با موفقیت تکنیک عمل را با مفهوم استراتژی ترکیب نمی کند - یعنی اصول کلیدی حاکم که جراحی ایمن و اجتناب از عوارض را دیکته می کند. کتاب‌های تکنیک، کتاب‌هایی در مورد عوارض، و کتاب‌هایی درباره منطق دخیل در درمان انواع مختلف آسیب‌شناسی جراحی وجود دارد. Chassin هر سه را با هم ترکیب می کند. استراتژی عملیاتی Chassin در جراحی عمومی: نسخه پنجم اطلس توضیحی به طور جامع تمام اعمال غیر عروقی که معمولاً توسط جراحان عمومی انجام می شود را پوشش می دهد. این نسخه این مرجع جامع جراحی عمومی را گسترش می دهد و در عین حال به ویژگی خاص کار وفادار می ماند. این تجدید نظر بر روی رویه هایی که در نسخه قبلی پوشش داده نشده اند گسترش می یابد و تکنیک های جدید را در بسیاری از فصل های دیگر گنجانده است.
توضیحاتی درمورد کتاب به خارجی
This fifth edition of Chassin's Operative Strategy in General Surgery is a major revision that strives to remain faithful to the purpose and tone of Dr. Chassin’s original text. This unique textbook provides an emphasis on surgical strategy that is unmatched by other textbooks of surgical technique. The text explains the conceptual basis of each operation, outlines strategies to avoid common pitfalls, and carefully describes and beautifully illustrates the technical steps of each operation. The fifth edition preserves the unique qualities of its previous edition while providing a comprehensive update. This updated volume also features a vast amount of richly detailed artwork and operative photographs, which help depict operative techniques step-by-step. No other text so successfully combines operative technique with the concept of strategy – that is, key governing principles that dictate safe surgery and avoidance of complications. There are books of technique, there are books about complications, and there are books about the rationale involved in the treatment of various kinds of surgical pathology. Chassin’s combines all three. Chassin’s Operative Strategy in General Surgery: An Expositive Atlas Fifth Edition comprehensively covers all non-vascular operations commonly performed by general surgeons. This edition expands this comprehensive general surgery reference while remaining true to the special character of the work. The revision expands upon procedures not covered in the previous edition and incorporates new techniques into many other chapters.
فهرست مطالب
Foreword to the Third Edition Preface to the Fifth Edition Contents Contributors Part I: General Principles 1: Concepts and Strategies of Surgery Developing a Concept Establishing Strategy Making the Operation Easy Further Reading 2: Mechanical Basics of Operative Technique Introduction Before You Scrub Preoperative Verification Process Importance of Surgeon’s Foot and Body Position Use of Instruments Scalpel Metzenbaum Scissors Electrocautery as a Cutting Device Forceps Needle Holder Hemostat Further Reading 3: Incision, Exposure, Closure Achieving Exposure Incisions for Abdominal Surgery Avoiding Wound Dehiscence and Hernia Operative Technique for a Midline Incision Making the Incision Open Surgery Port Insertion During Laparoscopic Surgery Closure of Midline Incision Modified Smead-Jones Technique Standard Running Closure Interrupted Closure Skin Closure Further Reading 4: Dissecting and Suturing Art of Dissecting Planes Sewing Technique Use of a Needle Holder Selection of Needle Size of Bite Distance Between Sutures Size of Suture Material Continuous Versus Interrupted Sutures How Tight the Knot? Catching Both Walls of Intestine with One Pass of the Needle Holder Types of Stitches Simple Everting Skin Stitch Vertical Mattress (Stewart) Stitch Continuous Subcuticular Stitch Skin Staples Simple Interrupted Fascial Stitch Continuous Simple Over-and-Over Stitch Smead-Jones Stitch Horizontal Mattress Stitch Hemostatic Figure-of-Eight Stitch Single-Layer Bowel Anastomosis Seromuscular Lembert Stitch Cushing Stitch Halsted Stitch Continuous Locked Stitch Connell Stitch Technique of Successive Bisection Intestinal Anastomoses One Layer or Two? End-to-End or End-to-Side Technique? Sutured or Stapled Anastomosis? Suture Material Absorbable Sutures Plain Catgut Chromic Catgut Polyglycolic Synthetics Nonabsorbable Sutures Natural Nonabsorbable Sutures Synthetic Nonabsorbable Braided Sutures Synthetic Nonabsorbable Monofilaments Monofilament Stainless Steel Wire Knot-Tying Technique Further Reading 5: Surgical Stapling: Principles and Precautions Characteristics of Staples Surgical Stapling Technology Linear Stapling Device Linear Cutting Stapling Device Circular Stapling Device Tissue Properties of the Stapled Anastomosis Causes of Failure Following Stapled Anastomosis Ischemia Tension Tissue Quality Instrument Failure Technical Error Microbiology Patient Factors Stapled vs. Hand-Sewn Anastomosis Reducing Anastomotic Complications in Practice Hemostasis Intraoperative Leak Testing Perfusion Testing Summary Further Reading 6: Control of Bleeding General Principles of Resuscitation Control of Hemorrhage Thoracic Hemorrhage Upper Mediastinum and Pulmonary Hilum Lung Parenchymal Injuries Abdominal Hemorrhage Abdominal Aorta, IVC, and Their Branches Zones of the Retroperitoneum Medial Visceral Rotations Solid Abdominal Viscera Spleen and Kidney Liver Pelvic Hemorrhage Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) Extremity and Junctional Hemorrhage Techniques to Achieve Hemostasis Hemostat and Ligature Tying in Continuity Suture Ligation Clips Staplers Electrocautery Ultrasonic Shears Further Reading 7: Management of the Contaminated Operation The Challenge Preoperative Considerations Timing of Surgery Resuscitation Before Surgery Antibiotic Management Preoperative Imaging Intraoperative Considerations Supportive Measures and Fluid Management Importance of Surgical Skills and Technique Source Control Containing the Contamination Wound Irrigation Other Considerations Postoperative Considerations Wound Closure Wound Care Further Reading 8: Damage Control Laparotomy Indications Damage Control Strategy and Decision-Making Damage Control Laparotomy in Trauma Damage Control Management of Selected Injuries Damage Control in Nontrauma Temporary Closure of the Open Abdomen Postoperative Management and Return to the Operating Room Further Reading 9: Mechanical Basics of Laparoscopic Surgery Ergonomics and Operating Room Design Equipment Setup and Trouble Shooting Access to Abdomen Laparoscopic Hemostasis and Energy Sources Hemostatic Products and Adjuncts Tissue Approximation Pitfalls and Danger Points Access Injuries Hypotension Hemorrhage Hypoxia Postoperative Bowel Obstruction Laparoscopy in Pregnancy Preoperative Considerations Intraoperative Considerations Laparoscopy in Previous Abdominal Surgery Further Reading 10: Rational Use of Drains Purpose of Drains Various Drains and Their Pros and Cons Penrose Drain Polyethylene or Rubber Tube Drain Silicone Tube Drain Sump Suction Drains Closed Suction Drain Gauze Packing Prevention of Drainage Tract Infection Management of Intraperitoneal Sepsis Percutaneous Drainage of Abdominal Abscesses with Computed Tomography or Ultrasound Guidance Negative Pressure Wound Therapy (NPWT) Other Indications and Methods of Drainage Abscess Blood and Serum Bile Pancreatic Secretions Anastomosis Further Reading 11: Illustrated Glossary of Surgical Instruments Introduction 12: Surgical Documentation, Informed Consent, and Operative Note Defining Value of Documentation Elements of Surgical Documentation Provider Chart Entry Informed Written Consent Operative Note Operative Note Teaching Documentation References Part II: Esophagus 13: Concepts in Esophageal Surgery Gastroesophageal Reflux Disease and Type I Paraesophageal Hernia Anti-reflux Operations Wrap Choice Alternatives to Traditional Surgery Paraesophageal Hiatus Hernia Achalasia Esophageal Perforation Esophageal Diverticulum Cricopharyngeal Diverticulum Epiphrenic Diverticulum Barrett’s Esophagus Workup of Esophageal Cancer Esophagectomy Choice of Esophagectomy Technique Anastomotic Leakage References 14: Laparoscopic and Thoracoscopic Ivor Lewis Esophagectomy Indications Preoperative Preparation Pitfalls and Danger Points Abdominal Phase Thoracic Phase Documentation Operative Strategy Abdominal Tumor Dissection, Lymphadenectomy, and Mobilization of the Gastric Conduit Abdominal Adjunct Procedures Thoracic Resection Thoracic Anastomosis Operative Technique Position and Incisions for the Abdominal Phase Laparoscopic Lymphadenectomy and Gastric Mobilization Pyloric Drainage and Feeding Jejunostomy Transhiatal Dissection and Creation of the Gastric Conduit Positioning for the Thoracic Phase Thoracoscopic Dissection Esophagogastric Anastomosis Postoperative Care Complications Anastomotic Leak Tracheoesophageal Fistula (TEF) Conduit Necrosis Chylothorax Paraconduit Herniation Cardiopulmonary Complications Avoiding Postoperative Complications Anastomotic Leak and Stricture Tracheoesophageal Fistula (TEF) Thoracic Duct Injury Paraconduit Herniation Pyloric Complications Further Reading 15: Transhiatal Esophagectomy Introduction Preoperative Preparation Patient Selection Indications Preoperative Preparation Pitfalls and Danger Points Contraindications Pitfalls Documentation Operative Strategy Avoiding Postoperative Complications Operative Technique Patient Preparation and Initial Steps Abdominal Phase: Laparoscopy/Laparotomy Cervical Phase Transhiatal Mediastinal Dissection Preparation of the Gastric Conduit and Transposition to the Neck Cervical Esophagogastric Anastomosis Handsewn Anastomosis Construction of Anastomosis with an EEA Stapler Total Mechanical Stapling with Modified Collard Technique Hybrid Stapling Approach Postoperative Care Complications Hemorrhage Tracheal Tear Pleural Complications Chylothorax Nerve Injury Anastomotic Leaks Splenectomy Further Reading 16: Laparoscopic Heller Myotomy for Achalasia Preoperative Preparation Workup Preoperative Nutrition and Optimization Pitfalls and Dangers Pseudoachalasia Incomplete Myotomy Bleeding Esophageal Perforation Vagal Injury Gastroesophageal Reflux Documentation Operative Strategy Division of the Short Gastric Vessels and Mobilization of the Fundus Mobilization of the Esophagus and Removal of the Esophageal Fat Pad Esophageal Myotomy Down to the Submucosal Layer Carried Down onto the Gastric Cardia Anti-reflux Procedure Avoiding Postoperative Complications Operative Technique Postoperative Care Complications Further Reading 17: Endoscopic Stent for Management of Esophageal Leaks Indications Preoperative Assessment Pitfalls and Danger Points Operative Strategy Length and Diameter Shape Material Coating Positioning Antibiotics Documentation Basics Operative Technique Postoperative Care Complications Further Reading 18: Laparoscopic Nissen Fundoplication for Gastroesophageal Reflux Disease Indications Preoperative Preparation Pitfalls and Danger Points Documentation Operative Strategy Avoiding Postoperative Complications Operative Technique Room Setup, Trocar Placement, and Exposure of the Hiatus Dissecting the Hiatus Mobilizing the Esophagus Closure of the Hiatus Construction of the Fundoplication Postoperative Care Complications Further Reading 19: Laparoscopic Magnetic Augmentation of the Lower Esophageal Sphincter Preoperative Preparation Pitfalls and Danger Points Operative Strategy Documentation Basics Operative Technique Room Setup and Trocar Placement Exposure of the Hiatus Dissecting the Hiatus Closure of the Hiatus Identification and Dissection of the Posterior Nerve Sizing of the LINX Device Placing and Securing the Linx Device Closure Postoperative Care Postoperative Complications Further Reading 20: Laparoscopic Paraesophageal Hernia Repair Preoperative Preparation Pitfalls and Danger Points Documentation Operative Strategy Reduction/Dissection Diaphragmatic Repair Reconstruction Avoiding Postoperative Complications Operative Technique Postoperative Care Complications Short-Term Complications Bleeding Abscesses Pneumothorax Cardiac Arrhythmias Long-Term Complications Dysphagia Recurrence Gastroparesis Further Reading 21: Laparoscopic Collis Gastroplasty Indications Preoperative Preparation Pitfalls and Danger Points Documentation Operative Strategy Operative Technique Postoperative Care Complications Further Reading 22: Endoscopic Antireflux Procedures Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Nonablative Radiofrequency Therapy (Stretta) Transoral Incisionless Fundoplication (TIF) Documentation Operative Technique Nonablative Radiofrequency Therapy (Stretta) Transoral Incisionless Fundoplication (TIF) Complications Nonablative Radiofrequency Therapy (Stretta) Postoperative Care Transoral Incisionless Fundoplication (TIF) Further Reading 23: Peroral Endoscopic Myotomy for Achalasia Preoperative Preparation Pitfalls and Danger Points Documentation Operative Strategy Avoiding Postoperative Complications Mucosal Injuries and Tears of the Mucosotomy Operative Technique Endoscopic Measurements Submucosal Tunnel Circular Myotomy Mucosotomy Closure Postoperative Care Complications Gastroesophageal Reflux Disease (GERD) Further Reading Part III: Stomach and Duodenum 24: Concepts in Surgery of the Stomach and Duodenum Operation for Morbid Obesity Operation for Gastric Cancer Subtotal Versus Total Gastrectomy Extent of Lymphadenectomy EUS and Diagnostic Laparoscopy Laparoscopic Gastrectomy Gastrointestinal Stromal Tumors (GISTs) Surgery for Peptic Ulcer Operation for Perforated Peptic Ulcer The Role of Vagotomy in Peptic Ulcer Surgery The Choice of Drainage Operation The Role of Resection in Peptic Ulcer Surgery Reconstruction after Distal Gastrectomy Billroth I Versus Billroth II Billroth II Versus Roux-En-Y Other Reconstruction Options Operation for Obstructing Peptic Ulcer Operation for Bleeding Peptic Ulcer Operation for Nonhealing Peptic Ulcer Operation for Postoperative Recurrent Ulcer or Marginal Ulcer Gastrostomy and Duodenostomy Gastrostomy Duodenostomy Stapling the Stomach and Duodenum Postoperative Complications Pulmonary Problems Anastomotic Leak Wound Problems Pancreatitis Early Gastric Stasis Dumping Syndrome Diarrhea Bile Reflux Gastritis Chronic Gastric Stasis and Roux Syndrome Metabolic Problems after Gastric Operation References 25: Truncal Vagotomy: Surgical Legacy Technique Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Avoiding Esophageal Trauma Avoiding Splenic Trauma Preventing Incomplete Vagotomy Hiatus Hernia Documentation Basics Operative Technique Incision and Exposure Left (Anterior) Vagal Trunks Identification of the Right (Posterior) Vagus Suture of Crural Musculature Postoperative Care Complications Further Reading 26: Proximal Gastric Vagotomy: Surgical Legacy Technique Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Exposure Prevention of Hematoma and Injury to Gastric Lesser Curve Preserving Innervation of the Antrum Adequacy of Proximal Vagotomy Postoperative Gastroesophageal Reflux Documentation Basics Operative Technique Incision and Exposure Identification of Right and Left Vagal Trunks Identification of Crow’s Foot Dissection of the Anterior Nerve of Latarjet Dissection of Posterior Nerve of Latarjet Repair of the Lesser Curvature Postoperative Care Complications Further Reading 27: Pyloroplasty (Heineke-Mikulicz and Finney), Operation for Bleeding Duodenal Ulcer: Surgical Legacy Technique Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Control of Bleeding Choice of Pyloroplasty Documentation Basics Operative Technique Kocher Maneuver Pyloroduodenal Incision for Heineke-Mikulicz Pyloroplasty Emergency Procedure for Bleeding Ulcer Heineke-Mikulicz Pyloroplasty Stapling Finney Pyloroplasty Postoperative Care Complications Reversal of Pyloroplasty or Gastrojejunostomy Further Reading 28: Gastrojejunostomy Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Documentation Basics Operative Technique: Open Incision Freeing the Greater Curvature Preparing the Jejunal Limb Open Handsewn Technique Open Stapled Technique Operative Technique: Laparoscopic Access Preparation of the Jejunal Limb Gastrojejunal Anastomosis: Laparoscopic Stapled Technique Postoperative Care Complications Further Reading 29: Partial Gastrectomy Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Type of Resection Choice of Reconstruction Duodenal Stump Leak Splenic Trauma Documentation Basics Operative Technique Gastric Wedge Resection Indications Minimally Invasive Wedge Resection Equipment Laparoscopic Setup and Positioning Operative Steps Entry and Port Placement Tumor Localization and Entry into Lesser Sac Tumor Mobilization and Resection, Specimen Extraction, and Closure Robotic Gastric Wedge Resection Open Wedge Resection Intragastric Resection Distal Gastrectomy with Billroth I or II Reconstruction Open Distal Gastrectomy Incision and Exposure Division of Left Gastric Vessels Division of Stomach Duodenal Dissection Division of Duodenum Billroth I Gastroduodenal Anastomosis Billroth II: Closure of Duodenal Stump Duodenal Closure with Surgical Staples Billroth II Gastrojejunal Anastomosis, Handsewn Billroth II Gastrojejunal Anastomosis, Stapled Drainage and Closure Postoperative Care Complications Duodenal Fistula Gastric Outlet Obstruction Afferent Loop Obstruction and Afferent Loop Syndrome Dumping Syndrome Marginal Ulcer Further Reading 30: Perforated Duodenal Ulcer Indications Perforated Duodenal Ulcer Preoperative Preparation Pitfalls and Danger Points Operative Strategy Documentation Basics Operative Technique Incision Identification of Perforation Patch Repair of Perforation Abdominal Closure Postoperative Care Complications Further Reading 31: Laparoscopic Plication of Perforated Duodenal Ulcer Indications Preoperative Preparation Potential Pitfalls and Dangers Points Documentation Tips Operative Strategy Operative Technique Securing the Omental Patch Omental Onlay Patch after Primary Closure Omental Plug Technique Omental Radial Patch Technique Testing the Integrity and Security of the Perfortion Repair Postoperative Care Role of EGD Complications Further Reading 32: Enteral Access Indications Percutaneous Gastrostomy Surgical Gastrostomy Jejunostomy Pitfalls and Danger Points Operative Strategy Operative Technique Percutaneous Endoscopic Gastrostomy (PEG) Tube Placement Stamm Gastrostomy Witzel Jejunostomy Further Reading 33: Distal Gastrectomy with D2 Nodal Dissection Indications Preoperative Preparation Pitfalls and Danger Points Documentation Basics Operative Strategy Extent of Resection Pancreatico-Splenectomy, Splenectomy Blood Supply to Residual Gastric Pouch Duct of Santorini Operative Technique Incision and Exposure Resection Omentectomy and Infrapyloric Nodal Dissection Dissection of Suprapyloric Nodes Division of the Duodenum Hepatic Artery Node Dissection Celiac Axis Dissection and Division of Left Gastric Vessels Postoperative Care Complications Further Reading 34: Total Gastrectomy Indications Preoperative Preparation Pitfalls and Danger Points Documentation Basics Operative Strategy Exposure Esophageal Anastomosis Prevention of Reflux Alkaline Esophagitis Extent of the Operation Operative Technique Incision and Exposure Exploration and Determination of Operability Omentectomy, Lymph Node Dissection, and Division of Duodenum Splenectomy Splenic Nodal Dissection without Splenectomy Dissection of the Esophagocardiac Junction: Vagotomy Preparation of the Roux-En-Y Jejunal Segment End-to-Side Sutured Esophagojejunostomy End-to-Side Stapled Esophagojejunostomy Roux-En-Y Jejunojejunostomy Sutured Version Stapled Version Modifications of Operative Technique for Patients with Benign Disease Wound Closure Postoperative Care Complications Further Reading 35: Management of Gastrointestinal Stromal Tumor of the Stomach Introduction Preoperative Preparation Pitfalls and Danger Points Operative Strategy and Management Documentation Operative Strategy and Technique Laparoscopic Wedge Resection Postoperative Care Complications References 36: Exposure of the Third and Fourth Portions of the Duodenum Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Documentation Basics Operative Technique Incision Liberation of Right Colon Liberation of Small Bowel Mesentery Intraoperative Endoscopy Resection of Duodenum Closure Minimally Invasive Approach Postoperative Care Complications Further Reading 37: Laparoscopic Sleeve Gastrectomy Indications Contraindications Relative Contraindications Preoperative Preparation Preoperative Optimization to Enhance Effectiveness and Decrease Complications Pitfalls and Danger Points Operative Strategy Avoiding Operative Bleeding Avoiding Postoperative Stenosis and Leak Documentation Basics Operative Technique Positioning and Port Placement Mobilization of the Stomach Creation of the Sleeve Leak Test Postoperative Care Complications Further Reading 38: Laparoscopic Roux-en-Y Gastric Bypass Preoperative Preparation Indications Preoperative Examination Pitfalls and Danger Points Documentation Operative Strategy Operative Technique Trocar Placement Division of the Jejunum and Creation of Jejunojejunostomy Creation of the Gastric Pouch Creation of the Gastrojejunostomy Postoperative Care Avoiding Complications Late Complications Further Reading 39: Laparoscopic Reoperative Bariatric Surgery Introduction Preoperative Preparation Pitfalls and Danger Points Documentation Operative Strategy Preoperative Preparation Abdominal Entry and Initial Exposure Adhesiolysis Left Liver Lobe Mobilization Diaphragmatic Hiatus Exposure Avoiding Postoperative Complications Operative Technique (Step by Step) Patient Positioning and Trocar Placement Exploration Critical Anatomy Exposure Gastroesophageal Junction Mobilization Types of Reoperations Postoperative Care Complications Further Reading 40: Endoscopic Intragastric Balloon Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Operative Technique Placement Diagnostic Endoscopy Insertion of the Uninflated Balloon Confirmatory Endoscopy Balloon Filling Endoscopic Reevaluation Removal Diagnostic Endoscopy Balloon Deflation Removal of the Balloon System Postoperative Care Avoiding Postoperative Complications Complications Minor Complications Major Complications Further Reading Part IV: Small Intestine and Appendix 41: Concepts in Surgery of the Small Intestine and Appendix Introduction Diagnostics Nonsurgical Treatments Surgical Tools Perioperative Management Diseases Small Bowel Obstruction Small Bowel Tumors Crohn’s Disease Appendicitis Small Bowel Diverticula Mesenteric Ischemia Gastrointestinal Bleeding from Small Bowel Trauma Further Reading 42: Small Bowel Resection and Anastomosis Indications Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Open Versus Laparoscopic Technique Successful Bowel Anastomosis Requirements Contraindications to Anastomosis Documentation Basics Operative Technique Small Bowel Anastomosis by Suturing Access and Incision Division of Mesentery and Bowel Resection Open Two-Layer Anastomosis Open One-Layer Anastomosis Closure of Mesentery Small Bowel Anastomosis Using Stapling Technique Postoperative Care Complications Further Reading 43: Enterolysis for Intestinal Obstruction Indications Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Open Versus Laparoscopic Technique Timing of Intervention Dissection Bowel Decompression Adhesion Prevention Documentation Basics Operative Technique Access, Incision, and Bowel Mobilization Approach to Dense Adhesions Early Re-laparotomy Operative Intestinal Decompression Repair of Damage to Bowel Wall Closure Postoperative Care Complications Further Reading 44: Baker Tube Stitchless Plication: Surgical Legacy Technique Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Operative Technique Postoperative Care Postoperative Complications Further Reading 45: Appendectomy (Open, Laparoscopic) Indications Possible Indications Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Documentation Basics Operative Technique Laparoscopic Appendectomy Positioning Incision and Exposure Creating a Window Division of the Meso-appendix Division of Appendix Base Specimen Removal Management of the Retrocecal Appendix Closure Open Appendectomy Incision Delivery of Appendix Division of Meso-Appendix Division of Appendix and Ligation/Inversion of Appendiceal Stump Closure of Incision Postoperative Care Complications Further Reading 46: Management of Appendicostomy for Malone Antegrade Continence Enema (MACE) Introduction Indications Primary Indication for MACE Procedure Indications for Secondary MACE Management Evaluation and Preparation Pitfalls and Danger Points Operative Strategy Decision-Making Definition of Access Closure of Appendicostomy Preoperative Marking Anesthesia and Positioning Documentation Basics Operative Technique General Considerations MACE Creation: Open Approach MACE Creation: Laparoscopic Approach ACE Creation in Absence of Appendix Revision for Appendicostomy Stricture Appendicostomy Takedown Postoperative Care Complications Further Reading 47: Management of Enterocutaneous and Enteroatmospheric Fistulas Definitions and Classifications Indications Preoperative Preparation Delineate Fistula Anatomy and Manage Any Intra-abdominal Infections Reduce and Divert Fistula Output Optimize Metabolic and Nutritional Status Pitfalls and Danger Points Operative Strategy Documentation Basics Operative Technique Anesthesia, Positioning, and Instruments Incision and Entering the Abdominal Cavity Abdominal Exploration, Adhesiolysis, and Resection of Enteric Fistulas Abdominal Wall Closure Postoperative Care Complications Further Reading 48: Stricturoplasty in Crohn’s Disease Indications Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Documentation Basics Operative Technique Access and Exploration Heineke-Mikulicz Stricturoplasty Finney Stricturoplasty Isoperistaltic Side-to-Side Stricturoplasty Wound Closure and Reconstruction Postoperative Care Complications Further Reading 49: Placement of Feeding Tube Jejunostomy Indications Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Anesthesia and Positioning Mobilization of the Small Bowel and Purse-String Placement Feeding Tube Placement and Securing the Jejunum to the Abdominal Wall Documentation Basics Operative Technique Open Placement of Feeding Jejunostomy Tube Laparoscopic Placement of Feeding Jejunostomy Tube Postoperative Care Complications Further Reading 50: Creation of Ileostomy (Loop, End) Indications Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Choice of Procedure and Site Access Proper Ileostomy Configuration Documentation Basics Operative Technique End Ileostomy Creation Preoperative Selection of Ileostomy Site Incision and Creation of a Passage Fashioning the Ileal Mesentery Exteriorization and Closure of Mesenteric Gap “Brooking” the Ileostomy (Eversion and Mucocutaneous Fixation) Loop Ileostomy Creation Incision and Creation of a Passage Exteriorization and Proper Orientation “Brooking” of the Afferent Limb Postoperative Care Complications Further Reading 51: Closure of Loop Ileostomy Indications Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Documentation Basics Operative Technique Incision Fascial Dissection Peritoneal Dissection Stapled Resection and Anastomosis of Ileostomy Hand-Sewn Closure of Enterotomy Closure of Abdominal Wall Management of Skin Wound Postoperative Care Complications Further Reading 52: Management of Problems Related to an Existing Continent Ileostomy Indications Evaluation and Preparation Pitfalls and Danger Points Operative Strategy Difficult Stoma Intubation Management During Non-related Surgeries or Incapacitation Considerations for Unrelated Abdominal Surgery Acute Pouch Surgery Chronic Pouch Dysfunction Documentation Basics Operative Technique Endoscopic Pouch Decompression Pouchoscopy Pouch Revision Postoperative Care Complications Further Reading Part V: Large Intestine 53: Concepts in Surgery of the Large Intestine Introduction Diagnostics Nonsurgical Treatments Surgical Tools Perioperative Management Diseases Colorectal Polyps Colorectal Cancer Colon Cancer Rectal Cancer Hereditary Cancer Syndromes Carcinomatosis Colorectal Cancer Superimposed on Inflammatory Bowel Disease Anal Cancer Diverticulitis Large Bowel Obstruction Fistulization (Bladder, Vagina, Skin) Lower GI Bleeding Ischemia Inflammatory Bowel Disease Ulcerative Colitis Crohn Disease Indeterminate Colitis C. difficile Colitis and Other Colitides Volvulus Pelvic Floor Dysfunction and Organ Prolapse Stoma Creation and/or Takedown References 54: Minimally Invasive Surgery (MIS) in Colorectal Surgery Implementation and Benefits of MIS How Is MIS Approach Different From Open Surgery? Minimally Invasive Surgery (MIS) Platforms Conventional Laparoscopic Surgery (CLS) Hand-Assisted Laparoscopic Surgery (HALS) Three-Dimensional Laparoscopic Surgery Single Incision Laparoscopic Surgery (SILS) Robotic Surgery Strategies About Selection of the Surgical Approach Challenges Training Aspects Conclusion Further Reading 55: Endoscopic Techniques for Colorectal Lesions Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Polyp Detection Dye-Assisted Chromocolonoscopy New Colonoscope Technology Endoscopic Mucosal Resection Documentation Basics Operative Technique EMR Technique Recurrent or Remaining Adenoma Hemostasis Perforation Tattoo Placement Endoscopic Submucosal Dissection Colonic Stent Placement Postoperative Care Complications Further Reading 56: Right and Extended Right Hemicolectomy (Open, Laparoscopic) Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Localization of Target Lesion Surgical Approach Extent of the Resection Vascular Transection Colon Mobilization Colon Resection Documentation Basics Operative Technique Positioning Operative Approach and Incisions Minimally Invasive Surgery Open Approach Exploration Identification of the Ureter Division of the Ileocolic Vessels Colon Mobilization Division of the Middle Colic Vessels Mesentery and Omentum Roundup Division of Ileum and Colon Ileo-colonic Anastomosis Hand-Sewn End-to-End Stapled Functional End-to-End Anastomosis Stapled Isoperistaltic Side-to-Side Anastomosis Wound Closure Postoperative Care Complications Further Reading 57: Sigmoid Resection and Left Hemicolectomy (Open, Laparoscopic) Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Localization of Target Lesion Surgical Approach Extent of the Resection Vascular Transection Colon Mobilization Colon Resection The Difficult Reach Technique of Anastomosis Documentation Basics Operative Technique Positioning Operative Approach and Incisions Minimally Invasive Surgery Open Approach Exploration Identification of the Ureter Division of the Inferior Mesenteric Artery Pedicle Colon Mobilization Medial to Lateral Approach Lateral to Medial Approach Splenic Flexure Mobilization Division of the Middle Colic Vessels Mesentery and Omentum Roundup Division of the Bowel Anastomosis Stapled End-to-End Anastomosis Hand-Sewn End-to-End Reversed Stapled Circular Stapler Anastomosis Wound Closure Postoperative Care Complications Further Reading 58: Discontinuous Colon Resection (Hartmann Procedure) Indications Acute Elective Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Surgical Approach Extent of the Resection Bowel Control and Decompression Colon Mobilization Vascular Transection Colon Resection The Difficult Reach Documentation Basics Operative Technique Positioning Incision Exploration Colon Mobilization Identification of the Ureter Division of the Inferior Mesenteric Artery Pedicle Division of Mesentery and Bowel Hartmann’s Pouch Versus Mucous Fistula End Colostomy Wound Closure Postoperative Care Complications Further Reading 59: Total Mesorectal Excision/Low Anterior Resection (Open, Laparoscopic) Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Localization of Target Lesion Surgical Approach Oncologic Extent of Resection Mesorectal Dissection Avoiding Collateral Damage Prevention of Anastomotic Complications The Difficult Reach Technique of Anastomosis Indications for Diverting Stoma (Colostomy or Ileostomy) Documentation Basics Operative Technique Positioning Operative Approach and Incisions Minimally Invasive Surgery Open Approach Exploration Initial Colorectal Mobilization Identification of the Ureters Division of the Blood Supply (IMA Pedicle, Mesentery) Proximal Bowel Transection Splenic Flexure Mobilization Pelvic and Presacral Dissection Pelvic Hemostasis Distal Rectal Transection Irrigation of Rectal Stump Anastomosis Double Stapled Anastomosis (Abdominal and Perineal Access) Hand-Sewn Colo-anal Anastomosis (Perineal Access) Reversed Stapled Circular Stapler Anastomosis (Abdominal Access) Variations of Colo-anal Anastomosis (To Improve Short-Term Function) Pitfalls, Danger Points, and Troubleshooting Stapled Anastomoses Wound Closure Postoperative Care Complications Further Reading 60: Abdominoperineal Resection (Open, Laparoscopic) Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Extent of the Perineal Resection Abdominal Phase Surgical Approach Colostomy Perineal Dissection Pelvic Defect Management Documentation Basics Operative Technique Positioning Operative Approach and Incisions Minimally Invasive Surgery Open Approach Abdominal Dissection and Colostomy Creation Cylindrical Abdominoperineal Resection (Malignant) Abdominal Part Perineal Dissection Management of Pelvic Floor Abdominoperineal Resection (Benign) Abdominal Part Perineal Dissection Closure of the Perineal Wound Abdominal Wound Closure Colostomy Postoperative Care Complications Further Reading 61: Multivisceral Resections (Pelvic Exenteration) Indications Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Anesthesia and Patient Positioning Operative Phases Documentation Basics Operative Technique Incision and Exploration Peritoneal Incision and Identification of the Ureters Ligation of the Inferior Mesenteric Artery Proximal Division of the Sigmoid Colon Pelvic Dissection Posterior Pelvic Dissection Lateral Pelvic Sidewall Dissection Anterior Dissection Distal Transection Versus Abdomino-Perineal Resection Harvest of VRAM Flap and Abdominal Wall Reconstruction Urinary Reconstruction Creation of Intestinal Stoma Wound Closure and Reconstruction Postoperative Care Complications Further Reading 62: (Sub-)Total Colectomy with Ileostomy or Ileo-Rectal Anastomosis (Open, Laparoscopic) Indications Emergency Staged Elective Preoperative Preparation All Elective Emergency Pitfalls and Danger Points Operative Strategy General Surgical Approach Bowel Manipulation Extent and Steps of the Resection Anastomosis Versus Ileostomy Documentation Basics Operative Technique Positioning Operative Approach and Incisions Open Approach Minimally Invasive Surgery Exploration Evacuation of Stool Mobilization and Resection Total Colectomy Distal Bowel Transection Anastomosis Versus Ileostomy Ileo-Rectal (Ileo-Sigmoid) Anastomosis End Ileostomy Ileostomy and Mucous Fistula Drains Wound Closure Postoperative Care Complications Further Reading 63: Proctocolectomy with Ileal Pouch-Anal Anastomosis (IPAA) or End Ileostomy (Open, Laparoscopic) Indications for Proctocolectomy Contraindications for Pouch Creation Preoperative Preparation Pitfalls and Danger Points Operative Strategy Surgical Approach Extent and Steps of the Resection Terminal Ileal Dissection Rectal Dissection Continence Factors The Difficult Reach Constructing the Ileal Reservoir (Pouch) Technique of Pouch-Anal Anastomosis Indications for Diverting Ileostomy Documentation Basics Operative Technique Positioning Operative Approach and Incisions Minimally Invasive Surgery Open Approach Exploration Mobilization and Resection Total Colectomy Proctectomy Constructing the Ileal Reservoir (J-Pouch) Ileoanal Anastomosis Pitfalls, Danger Points, and Troubleshooting Stapled Anastomoses Loop Ileostomy Wound Closure Postoperative Care Complications Further Reading 64: Cecostomy: Surgical Legacy Technique Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Documentation Basics Operative Technique Tube Cecostomy Skin-Sutured Cecostomy Incision Exploration of Cecum Cecal Fixation Mucocutaneous Suture Postoperative Care Complications Further Reading 65: Creation of Transverse Colostomy (Loop, Prasad-Type) Indications Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Choice of Procedure Access Diversion of Fecal Stream Documentation Basics Operative Technique Incision Identification and Exteriorizing of Transverse Colon Choice of Bridge Maturation of Colostomy Prasad-Type Colostomy Postoperative Care Complications Further Reading 66: Laparoscopic Versus Open Creation of Sigmoid Colostomy (Loop, Prasad-Type, End) Indications Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Choice of Procedure and Site Access Type of Fecal Diversion Documentation Basics Operative Technique Incision, Identification, and Mobilization of the Sigmoid Colon Open—Through Laparotomy Open—Through Colostomy Site Only Laparoscopic Stoma Orientation Abdominal Wall Reinforcement (Hernia Prevention) Choice of Bridge Maturation of Colostomy Loop Colostomy Prasad-Type Colostomy End Colostomy Postoperative Care Complications Further Reading 67: Closure of Temporary Loop Colostomy or Ileostomy Indications Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Documentation Basics Operative Technique Anesthesia and Positioning Incision Fascial Dissection Peritoneal Dissection Strategies for the Difficult Dissection Bowel Anastomosis Resection with Stapled Side-to-Side (Functional End-to-End) Anastomosis Simple Closure of Antimesenteric Bowel Wall Opening Resection and End-to-End Anastomosis Resection and Isoperistaltic Side-to-Side Anastomosis Closure of Abdominal Wall Management of Skin Wound Postoperative Care Complications Further Reading 68: Hartmann Reversal (Open, Laparoscopic) Indications Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Decision to Offer Hartmann Reversal Choice of Approach: Open Versus Laparoscopic Laparoscopic Access Open Access Colonic Mobilization Rectal Stump Mobilization Diverting Fecal Stream Documentation Basics Operative Technique Open Hartmann Reversal Laparoscopic Hartmann Reversal Postoperative Care Complications Further Reading 69: Surgeries for Large Bowel Obstruction Introduction Preoperative Preparation Pitfalls and Danger Points Stenting Non-resective Approach (Stent, Diverting Stoma) Resection Operative Strategy Conservative Management Decision for Surgery Choice of the Platform Specific Considerations for the Stated Options Are as Follows Setup and Patient Positioning Documentation Basics Operative Technique Positioning Colonic Stenting Creation of Colostomy Discontinuous Resection with Creation of a Stoma Segmental or Subtotal Resection Segmental Resection with Intraoperative Colonic Lavage and Anastomosis Postoperative Care Complications Further Reading 70: Surgery for Colonic Fistula to Bladder, Vagina, or Skin Indications Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Decision for Surgery Definitive Surgery Access Diversion Documentation Basics Operative Technique Access Definitive Bowel Resection Management of the Other Organ Malignant Benign Diversion Postoperative Care Complications Further Reading 71: Abdominal Repair of Rectal Prolapse and Pelvic Organ Descent (Open, Laparoscopic) Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Concept of the Repair Surgical Approach Rectal Mobilization Posterior Anterior Avoiding Collateral Damage Selection of Implant Documentation Basics Operative Technique Positioning Operative Approach and Incisions Minimally Invasive Surgery Open Approach Posterior Rectal Mobilization and Fixation Posterior Rectopexy with Mesh (Wells) Posterior Suture Rectopexy (without Implant) Legacy Procedure: Ripstein Rectopexy (Obsolete) Ventral Mesh Rectopexy Segmental Colon Resection with Rectopexy Multicompartmental Resuspension Wound Closure Postoperative Care Complications Further Reading Part VI: Anus, Rectum, and Pilonidal Region 72: Concepts in Surgery of the Anus, Rectum, and Pilonidal Region Introduction Anatomy and Physiology Diagnostics Anorectal Examination Imaging Functional Testing Management Nonsurgical Treatments Surgical Tools Anesthesia and Positioning Perioperative Management Clinical Conditions Anorectal Pain Hemorrhoids Anal Fissure Anorectal Suppurative Diseases Pilonidal Disease Hidradenitis Suppurativa Rectal Prolapse Anorectal Stricture Functional Disorders Anorectal Skin Pathology Further Reading 73: Office Procedures for Internal Hemorrhoids (Sclerotherapy, Infrared Coagulation, and Rubber Band Ligation) Indications Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Documentation Basics Operative Technique Sclerotherapy Infrared Coagulation Rubber Band Ligation Postoperative Care Complications Further Reading 74: Excisional Hemorrhoidectomy (Ferguson, Milligan-Morgan, Whitehead) Indications Contraindications Evaluation and Preparation Pitfalls and Danger Points Operative Strategy Considering Alternative Pathologies Anesthesia and Positioning Avoiding Anal Stenosis Achieving Hemostasis Avoiding Fecal Incontinence Documentation Basics Operative Technique General Setting Positioning and Setup Local Anesthetic Block Excisional Hemorrhoidectomy Ferguson Technique (Closed Wounds) Milligan-Morgan Technique (Open Wounds) Whitehead Hemorrhoidectomy Postoperative Care Complications Further Reading 75: Stapled Hemorrhoidectomy/-opexy Indications Contraindications Evaluation and Preparation Pitfalls and Danger Points Operative Strategy Anesthesia and Positioning Placement of the Retractor and Reduction of Prolapse Purse-String Suture Placement and Transection of the Rectal Mucosa Avoiding Postoperative Complications Documentation Basics Operative Technique Stapler Sets and Instruments Placement of the Retractor and Reduction of Prolapse Purse-String Suture Placement and Transection of the Rectal Mucosa Inspection for Hemostasis and Removal of Retractor Postoperative Care Complications Further Reading 76: Doppler-Guided Hemorrhoidal Artery Ligation Indications Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Selection of the Treatment Method Anesthesia and Positioning Documentation Basics Operative Technique Doppler-Guided Ligation Mucopexy Postoperative Care Complications Further Reading 77: Surgical Management of Anorectal Abscess and Fistula Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Choice of Anesthesia Positioning Localizing Fistula Tracts Preserving Fecal Continence Combining Fistula Surgery with Drainage of Anorectal Abscess Anorectal Infections in Crohn’s Disease and Leukemia Documentation Basics Operative Technique Perianal and Ischioanal Abscess Intersphincteric Abscess Supralevator Abscess Anorectal Fistula Fistulotomy Versus Seton Placement Endorectal Advancement Flap (ERAF) Insertion of Fistula Plug Ligation of Intersphincteric Fistula Tract (LIFT) More Extensive Surgeries Postoperative Care Complications Further Reading 78: Rectovaginal Fistula Repair Indications Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Timing of the Repair Immediate Symptom Control Common Local Rectovaginal Repairs Radical Local Repair Operations Abdominal Approach Documentation Basics Operative Technique Perineal Approaches General Considerations Endorectal Advancement Flap (ERAF) Episioproctotomy with Layered Closure Perineal Access and Muscle Interposition Miscellaneous Perineal Approaches Abdominal Approach Postoperative Care Complications Further Reading 79: Rectourinary Fistula Repair Indications Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Immediate Symptom Control Perineal Local Rectourinary Repair Abdominal Local Rectourinary Repair Abdominal and Abdomino-perineal Resection Documentation Basics Operative Technique Perineal Approach Transanal Access Parasacral-Transsphincteric Access (York-Mason) Perineal Access and Muscle Interposition Abdominal Approach Postoperative Care Complications Further Reading 80: Lateral Internal Sphincterotomy with/Without Fissurectomy for Chronic Anal Fissure Indications Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Patient Selection Goal of Surgery Optional Steps Documentation Basics Operative Technique Anesthesia and Positioning Closed Sphincterotomy Open Sphincterotomy Fissurectomy and Removal of the Sentinel Pile and/or Hypertrophic Anal Papilla Concomitant Hemorrhoidectomy Postoperative Care Complications Further Reading 81: Anoplasty for Anal Stenosis Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Documentation Basics Operative Technique Mucosal Advancement Flap Anocutaneous Advancement Flap (V-Y Plasty) Postoperative Care Fluids Wound Care Regular Diet Stool Management Pain Management Complications Further Reading 82: Perineal Operations for Rectal Prolapse Indications Contraindications Preoperative Preparation Pitfalls and Danger Points Altemeier Procedure Delorme Procedures Thiersch Procedure: Pitfalls and Danger Points Operative Strategy Choice of Procedure Patient Positioning Anesthesia Operative Tactics Perineal Proctosigmoidectomy (Altemeier Procedure) Mucosal Sleeve Resection with Muscular Cuff Plication (Delorme Procedure) Thiersch Operation (Surgical Legacy Procedure) Documentation Basics Operative Technique Altemeier Procedure: Perineal Proctosigmoidectomy Delorme Procedure: Mucosal Sleeve Resection with Muscular Plication Thiersch Operation (Surgical Legacy Procedure) Postoperative Care Complications Further Reading 83: Operations for Pilonidal Disease Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Documentation Basics Operative Technique Abscess Drainage Without Excision Excision of Sinus Pits with Lateral Drainage Primarily Wide Open Excision with/Without Marsupialization Excision with Primary Closure Excision with Flap Closure Postoperative Care Complications Further Reading 84: Overlapping Sphincteroplasty Indications Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy General Considerations Timing of the Repair Technical Considerations Measuring the Results Persistent Incontinence Documentation Basics Operative Technique General Setting Positioning and Setup Incision Mobilization Reconstruction Wound Closure Postoperative Care Complications Further Reading 85: Sacral Nerve Stimulation for Fecal and Urinary Incontinence Indications Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy General Considerations Anesthesia and Positioning Phase 1 Phase 2 Documentation Basics Operative Technique Phase 1 Plan Incision Localizing the Foramina Confirming Needle Position Introducing Wire, Dilator, and Lead Wound Closure Phase 2 Removing the Temporary External Lead Extension Connecting the Lead to the Neurostimulator Wound Closure Postoperative Care Complications Further Reading 86: Transanal Local Excision of Rectal Lesions (TEMS, TAMIS, TAE) Indications Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Depth of Excision Choice of the Platform Transanal Excision (TAE) Transanal Endoscopic Microsurgery (TEMS) Transanal Minimally Invasive Surgery (TAMIS) Transanal Total Mesorectal Excision (taTME) Anesthesia Patient Positioning Documentation Basics Operative Technique Positioning Anal Block Surgical Excision Transanal Excision Transanal Endoscopic Microsurgery (TEMS) Transanal Minimally Invasive Surgery (TAMIS) Specimen Handling Postoperative Care Complications Further Reading Part VII: Hepatobiliary Tract 87: Concepts in Hepatobiliary Surgery Biliary Surgery Biliary Colic and Cholecystitis Cholecystitis During Pregnancy Cholecystitis in the Hospitalized Patient Cholecystectomy Intraoperative Cholangiography Use of Drains Iatrogenic Biliary Injury Choledocholithiasis and Cholangitis Ductal Drainage Procedures T-Tube Management Gallbladder Carcinoma Cholangiocarcinoma Hepatic Surgery Hepatocellular Carcinoma Colorectal Liver Metastases Hepatic Trauma Concepts in Liver Resection Determining Resectability Hemostasis Use of Drains Postoperative Management References 88: Open Cholecystectomy Indications Relative Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Anomalies of the Extrahepatic Bile Ducts Avoiding Injury to the Bile Ducts Inadvertent Ligation of the Hepatic Artery Avoiding Hemorrhage Cholangiography Common Errors of Operative Cholangiography Decompressing the Gallbladder Management of the Difficult Cystic Duct Subtotal Cholecystectomy Conversion to Open Cholecystectomy After Failed Laparoscopic Cholecystectomy Operative Technique Incision Dissecting the Cystic Duct Cystic Duct Cholangiography Ligating the Cystic Artery Dissecting the Gallbladder Bed Drainage and Closure Postoperative Care Complications Further Reading 89: Laparoscopic Cholecystectomy Indications Contraindications Preoperative Preparation Choledocholithiasis Pitfalls and Danger Points Operative Strategy Avoiding Bleeding Preventing Bile Duct Damage Aberrant Anatomy Ensuring Good Exposure Intraoperative Cholangiography Conversion to Open Cholecystectomy Operative Technique Initial Inspection of the Peritoneal Cavity Insertion of Secondary Trocar Cannulas Dissecting the Gallbladder to Expose the Cystic Duct Cystic Duct Cholangiogram Removing the Gallbladder Postoperative Care Complications Needle or Trocar Damage Insufflation-Related Complications Bile Duct Damage: Injury of Common and Hepatic Ducts Bile Leak Intraoperative Hemorrhage from Cystic Artery Further Reading 90: Open and Laparoscopic Common Bile Duct Exploration Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Avoiding Postoperative Pancreatitis CBD Perforations Locating and Removing Biliary Calculi Documentation Basics Open CBD Exploration: Operative Technique Cholangiography Kocher Maneuver Choledochotomy Incision Choledochoscopy Transduodenal Sphincterotomy/Sphincteroplasty for Impacted Stones Checking for Ampullary Stenosis Insertion of the T-Tube Completion Cholangiogram Drainage and Closure Laparoscopic CBD Exploration: Operative Technique Postoperative Care Complications Bile Leak and Bile Peritonitis Postoperative Acute Pancreatitis Increasing Jaundice Hemorrhage (Hemobilia) Residual CBD Stone Postoperatively Early Postoperative Treatment Subsequent Postoperative Treatment Further Reading 91: Sphincteroplasty Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Duodenotomy Preventing Duodenal or CBD Leak Identifying and Protecting the Pancreatic Duct Closure of Duodenotomy Operative Technique Incision and Exploration Mobilization of the Gallbladder and Kocher Maneuver Location of the Ampulla of Vater and Duodenotomy Mucosal Resection of Periampullary Adenoma Bile Duct Sphincteroplasty Pancreatic Ductoplasty and Septotomy Completing the Cholecystectomy and Closing the Duodenotomy Drainage and Abdominal Closure Postoperative Care Complications Postoperative Acute Pancreatitis Duodenal Leak and Fistula Intraoperative and Postoperative Hemorrhage References Further Reading 92: Choledochoduodenostomy: Surgical Legacy Technique Indications Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Size of Anastomotic Stoma Location of the Anastomosis Preventing the Sump Syndrome Documentation Basics Operative Technique Incision Choledochoduodenal Anastomosis Alternative Method of Anastomosis Drainage and Closure Postoperative Care Complications Further Reading 93: Transduodenal Diverticulectomy Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Documentation Basics Operative Technique Incision Kocher Maneuver Duodenotomy and Diverticulectomy Closure and Drainage Postoperative Care Complications Further Reading 94: Hepatic Resection Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Anatomic Basis for Liver Resection Extent of Resection Anatomic Liver Resections Principles of Safe Liver Resection Parenchymal Transection Vascular Control Preservation of Bile Ducts Operative Technique Incision and Exposure Wedge (Nonanatomic, Subsegmental, or Peripheral) Resection Anatomic Oriented Segmental Resections Resection of Segments 2 and 3 (Left Lobectomy/Left Lateral Sectionectomy) Anatomic Right Hepatectomy (Right Hepatic Lobectomy) Anatomic Left Hepatectomy (Left Hepatic Lobectomy) Laparoscopic Liver Surgery Indications Pitfalls and Danger Points Special Equipment Positioning Laparoscopic Left Lateral Sectionectomy Position and Port Placement Totally Laparoscopic Right Lobectomy Position and Port Placement Hand-Assisted Laparoscopic Right Hepatectomy Position and Port Placement Postoperative Care Complications Further Reading Part VIII: Pancreas 95: Concepts in Surgery of the Pancreas Surgical Anatomy Trauma Acute Pancreatitis Diagnosis Treatment Chronic Pancreatitis Diagnosis Treatment of Chronic Pancreatitis Choice of Operation Drainage Procedures Resection Procedures Nerve Ablation Adenocarcinoma of the Pancreas Diagnosis Imaging Determination of Resectability Local Invasion Distant Metastasis Treatment Operative Management Neoadjuvant Therapy Islet Cell Tumors Cystic Neoplasms of the Pancreas Complications of Pancreatic Surgery Further Reading 96: Partial Pancreatoduodenectomy Indications Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Assessment of Pathology to Determine Resectability Avoiding and Managing Intraoperative Hemorrhage Vascular Resections Avoiding and Managing Postoperative Hemorrhage Avoiding Leakage from the Pancreatojejunal Anastomosis Operative Technique Diagnostic Laparoscopy Incision and Exposure Kocherization of the Duodenum Dissection of Portal Vein and Superior Mesenteric Vein Cholecystectomy Dissection of the Porta Hepatis Antrectomy Dissection and Division of Proximal Jejunum Division of Pancreas Dissection of Uncinate Process Reconstruction Techniques Hepaticojejunal Anastomosis Pancreaticojejunal Anastomosis Pancreaticojejunal Anastomosis by Invagination Insertion of Drains Gastrojejunostomy Pylorus Preservation Operative Technique Closure Postoperative Care Complications Further Reading 97: Total Pancreatoduodenectomy Indications Benign Conditions Premalignant Conditions Malignant Conditions Contraindications Preoperative Preparation Operative Strategy Operative Technique Laparoscopic Exploration Incision Mobilization of Pancreatic Head, Determination of Resectability Cholecystectomy and Hilar Dissection Splenectomy Mobilizing the Distal Pancreas Antrectomy/Pylorus-Preserving Procedure Mobilizing the Duodenojejunal Junction Freeing the Uncinate Process Reconstruction Postoperative Care Complications Further Reading 98: Distal (Left) Pancreatectomy Indications Operative Strategy Operative Technique Laparoscopic Distal Pancreatectomy Open Distal Pancreatectomy Borderline Resectable Neoplasms Radical Antegrade Pantreatico-Splenectomy Distal Pancreatectomy with Celiac Axis Resection (DP-CAR, Appleby) Robotic Distal Pancreatectomy Postoperative Care Complications Further Reading 99: Operations for Pancreatic Pseudocyst Operative Strategy Background/Natural History Operative Indications Preoperative Preparation and Perioperative Considerations Operative Strategy and Technique Cyst-Enterostomy Cystogastrostomy Roux-en-Y Cystojejunostomy Resection Pancreatic Head Resection External Drainage Postoperative Care Follow-Up Pearls Further Reading 100: Pancreaticojejunostomy for Chronic Pancreatitis Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Operative Technique Exposure Incising the Pancreatic Duct Pancreatic Head Resection V-Shape Resection of the Body and Tail Roux-en-Y Reconstruction Postoperative Care Complications Further Reading Part IX: Spleen 101: Concepts in Splenic Surgery Splenectomy for Disease Perioperative Evaluation Autoimmune Thrombocytopenic Purpura Recurrent Symptoms After Splenectomy for Hematologic Disease Choice of Surgical Approach: Open Versus Laparoscopic Procedure Technical Considerations for Safe Laparoscopic Splenectomy Laparoscopic Management of Splenic Cysts Splenic Trauma Nonoperative Splenic Salvage Nonoperative Management of Splenic Trauma Prognostic Indicators of Failure of Nonoperative Management Follow-Up Imaging Laparoscopy for the Management of Splenic Trauma References 102: Open Splenectomy for Disease Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Choice of Approach: Open or Laparoscopic? Avoiding Intraoperative Hemorrhage Preventing Postoperative Hemorrhage Avoiding Pancreatic Injury Avoiding Trauma to the Stomach Preventing Postoperative Sepsis Accessory Spleen Operative Technique Incision Ligating the Splenic Artery Exposing the Spleen Mobilizing the Spleen Ligating the Splenic Vessels Achieving Hemostasis and Searching for Accessory Spleens Imbricating the Greater Curvature of Stomach Abdominal Closure Postoperative Care Complications Further Reading 103: Operations for Splenic Trauma Indications Preparation Pitfalls Operative Strategy Decision for Splenectomy or Repair of Spleen Operative Technique Exposure for Splenectomy Mobilization of the Spleen Temporary Control of Hemorrhage Identification of the Splenic Injury Removal of the Spleen Techniques for Splenic Preservation Iatrogenic Injuries Abdominal Closure Postoperative Care Further Reading 104: Laparoscopic Splenectomy Indications Preoperative Evaluation and Preparation Pitfalls and Danger Points Operative Strategy Operative Technique Special Consideration: Splenomegaly (>11 cm) Laparoscopic Management of Splenic Cysts Postoperative Care Complications Further Reading Part X: Hernia Repairs, Operations for Necrotizing Faciitis, Drainage of Subphrenic Abscess 105: Concepts in Hernia Repair, Surgery for Necrotizing Fasciitis, and Drainage of Subphrenic Abscess Patient Selection Selection of Anesthesia Perioperative Antibiotics Groin Hernia Repair Primary Repair Prosthetic Mesh Repair Laparoscopic Technique Repair of Femoral Hernia Repair of Recurrent Inguinal Hernia Repair of Large Ventral Hernias Necrotizing Fasciitis Subphrenic Abscess References 106: Shouldice Repair of Inguinal Hernia Indications Preoperative Preparation Pitfalls and Danger Points Documentation Operative Strategy Anesthesia Dissection Reconstruction Operative Technique Local Anesthesia and Incision Dissection Inguinal Repair The First Line of the Repair The Second Line of the Repair The Third and Fourth Lines of Repair Complete Groin Repair Technique for Femoral Hernia Closure of Superficial Layers Postoperative Care Avoiding Postoperative Complications Infection Hemorrhage Testicular Atrophy and Hydrocele Injury to Bladder and Bowel Chronic Postoperative Pain Ejaculatory Dysfunction (Dysejaculation) Urinary Retention Hernia Recurrence Further Reading 107: Cooper’s Ligament (McVay) Repair of Inguinal Hernia Indications Operative Strategy Documentation Basics Operative Technique Incision and Exposure Making the Relaxing Incision Inserting Cooper’s Ligament Sutures Closing the External Oblique Aponeurosis Postoperative Care Complications Further Reading 108: Mesh Repair of Inguinal Hernia Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Documentation Basics Operative Technique Incision Dissection and Identification of Direct and Indirect Sacs Placement of Patch Closure Postoperative Care Complications Further Reading 109: Laparoscopic Inguinal Hernia Repair: Transabdominal Preperitoneal (TAPP) and Totally Extraperitoneal (TEP) Repairs Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Operative Technique Patient Position and Room Setup: TAPP or TEP TAPP Approach Placement of Mesh Peritoneal Closure Bilateral Hernias TEP Approach Complications Vascular Injuries Urinary Retention, Urinary Infection, Hematuria Bladder Injury Nerve Injury Vas Deferens and Testicular Complications Complications Related to the Mesh Recurrence of the Hernia Osteitis Wound Infection Further Reading 110: Operations for Recurrent Inguinal Hernia Indications Preoperative Preparation Pitfalls and Danger Points Documentation Operative (Management) Strategy Internal Ring Left Too Wide Inadequate Reconstruction of the Inguinal Floor Defect at Pubic Tubercle Failure to Suture Transversalis Fascia or Transversus Arch Failure to Excise Sac Use of Absorbable Sutures Subcutaneous Transplantation of Cord Femoral Recurrence Following Inguinal Hernia Repair Infection Recurrent Indirect and Direct Inguinal Hernia Choice of Approach Anesthesia Selecting the Optimal Technique for Repair of Recurrent Inguinal Hernia Technique of Dissection Avoiding Testicular Complications Operative Technique Inguinal Approach Incision and Exposure Repairing Recurrent Hernia Following Previous Halsted Operation Without Opening the Inguinal Canal Dissecting the Inguinal Canal Repairing a Localized Defect in the Inguinal Floor Prosthetic Mesh Repair Abandoning the Anterior Approach Preperitoneal Approach Using Mesh Prosthesis (Surgical Legacy Technique) Incision and Exposure Suturing the Mesh Closing the Abdominal Incision Postoperative Care Complications References Further Reading 111: Femoral Hernia Repair Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Inguinal Approach Low Groin Approach Preperitoneal Approach Documentation Basics Operative Technique Low Groin Approach for Left Femoral Hernia Low Groin Approach Using Prosthetic Mesh “Plug” Preperitoneal Approach for Right Femoral Hernia (Nyhus) Anesthesia Incision Mobilizing the Hernial Sac Suturing the Hernial Ring Postoperative Care Complications Further Reading 112: Operations for Large Ventral Hernia Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Avoiding Postoperative Complications Infection Occult Wound Dehiscence Large Drain Exit Site at the Fascia Failure to Close Laparoscopic Trocar Sites Adequately Transverse Versus Vertical Incision Suturing Technique Type of Suture Material Size of Tissue Bites Suture Tension Intercurrent Disease Tissue Integrity Tension During Repair Role of Prosthetic Mesh Types of Synthetic Prosthetic Material Biologic Mesh (Biomesh) Myocutaneous Flap Separation of Components Use of Drains Operative Technique Elective Ventral Hernia Repair Dissecting the Hernial Sac Resecting the Hernial Sac Mesh Repair of Ventral Hernia Sandwich Repair Onlay Patch Mesh Repair Postoperative Care Complications Further Reading 113: Laparoscopic Ventral Hernia Repair Indications Preoperative Preparation Pitfalls and Danger Points Operative Technique Patient Positioning and Preparation of the Defect Sizing the Mesh Management of the Fascial Defect Postoperative Care Complications References Further Reading 114: Operations for Infected Abdominal Wound Dehiscence, Necrotizing Fasciitis, and Intraabdominal Abscesses Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy: Infected Abdominal Wall and Dehiscence Local Exploration Wide Debridement Managing the Abdominal Wall Defect Repeat Laparotomy for Recurrence of Abdominal Sepsis Management of Intestinal Stomas and Fistulas Marsupialization and Open Abdomen Management Intraabdominal Abscesses Approaches to Abscess Drainage Percutaneous Drainage Lateral and Subcostal Extraperitoneal Approach Laparoscopy Laparotomy Extraserous Approach Operative Technique Extraserous Subcostal Drainage of Right Subphrenic Abscess (Surgical Legacy Technique) Incision and Exposure Drainage and Closure Laparotomy for Subphrenic and Abdominal Abscesses Incision and Exposure Drainage and Closure Postoperative Care Postoperative Care After Abscess Drainage Further Reading Part XI: Breast and Melanoma 115: Concepts in Breast Surgery Introduction Breast Cancer Epidemiology Breast Cancer Risk Breast Cancer Screening Imaging Modalities Breast Biopsy: Obtaining a Tissue Diagnosis Management of Common Benign Breast Lesions Nipple Discharge Breast Abscess Benign Breast Mass or Cyst Breast Lesions on CNB That May Require Excision Breast Malignant Diseases Ductal Carcinoma In Situ (DCIS) Paget’s Disease of the Breast Invasive Breast Cancer Inflammatory Breast Cancer Surgical Treatment of Breast Cancer Considerations Prior to Surgery Is the Patient a Surgical Candidate? Is the Patient a Candidate for Breast Conservation? Surgery First or Neoadjuvant Treatment Followed by Surgery? Is the Patient a Candidate for Omitting SLN Biopsy? Will the Patient Require Postmastectomy Radiation? Are There Indications for Genetic Counseling? The Role of Shared Decision-Making Surgical Treatment of the Breast Breast Conservation Therapy (BCT) Mastectomy Lymph Node Surgery Adjuvant Systemic Therapy Treatment of Local Recurrence Metastatic Disease Breast Problems in Men References 116: Excision of Benign Palpable Breast Mass Indications Preoperative Preparation Operative Strategy Operative Technique Choice of Incision Local Anesthesia Dissection Repair Postoperative Care Complications Further Reading 117: Excision of Ducts, Operations for Breast Abscess Excision of Ducts Indications Preoperative Preparation Physical Examination Ductography Ductal Endoscopy Operations for Breast Abscess Indications Preoperative Preparation Documentation Operative Strategy Single Duct Excision Versus Total Duct Excision Strategic Approach to Breast Abscesses Avoiding Postoperative Complications Prevention of Skin Necrosis with Ductal Excision Operative Technique Single Duct Excision Incision Identification and Excision Closure Total Duct Excision Incision Excising the Ductal System Reconstruction Simple Breast Abscess Recurring Subareolar Abscess/Lactiferous Duct Fistula Postoperative Care Complications Further Reading 118: Lumpectomy for Breast Cancer Indications Preoperative Preparation Pitfalls and Danger Points Documentation Operative Strategy Localization Incision Extent of Excision, Orienting the Specimen and Additional Margins Closure Special Techniques Intraoperative Radiation Therapy Oncoplastic Lumpectomy Avoiding Postoperative Complications Operative Technique Basic Lumpectomy Techniques for Localization Palpation-Guided Lumpectomy Wire-Localized Lumpectomy Ultrasound-Guided Lumpectomy Lumpectomy Using Implanted Localization Marker Postoperative Care Complications Further Reading 119: Mastectomy: Simple (Total), Modified, and Classical Radical Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Sequencing the Operation Simple Versus Modified Radical Mastectomy Modified Radical Mastectomy Radical Mastectomy Incision and Skin Flaps Thickness of Skin Flap Alternative Incisions for Mastectomy Avoiding Dog Ears Axillary Lymph Node Anatomy for Breast Surgeons Documentation Basics Operative Technique Clearing the Pectoral Fascia Axillary Dissection: Unroofing the Axillary Vein Axillary Vein Dissection Radical Mastectomy Irrigation and Closure Postoperative Care Postoperative Complications Ischemia of Skin Flap Wound Infection Seromas Lymphedema Further Reading 120: Skin and Nipple Sparing Mastectomy Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Skin Sparing Versus Nipple Sparing Mastectomy Axillary Lymph Nodes Extent of Mastectomy Incision and Skin Flaps Skin Flap Techniques Visualization Incisions Documentation Basics Operative Technique Develop the Skin Flaps (Anterior) Skin Sparing Mastectomy Nipple Sparing Mastectomy Release the Breast from the Chest Wall (Posterior) Finishing the Mastectomy Postoperative Care Postoperative Complications Ischemia of Skin Flap Ischemia of Nipple Wound Infection Further Reading 121: Sentinel Lymph Node Biopsy and Axillary Staging for Breast Cancer Indications Contraindications Preoperative Preparation Operative Strategy Sentinel Lymph Node Biopsy Axillary Node Dissection Targeted Axillary Dissection Axillary Reverse Mapping Pitfalls and Danger Points Documentation Basics Operative Technique Sentinel Lymph Node Biopsy Axillary Node Dissection Postoperative Care Complications Further Reading 122: Concepts in Melanoma Introduction Diagnosis Risk Factors Biopsy Staging Primary Lesion: Wide Local Excision (WLE) Management of the Regional Lymph Nodes Sentinel Lymph Node Biopsy Adjuvant Therapy In-Transit Melanoma Metastatic Disease References 123: Wide Local Excision and Sentinel Lymph Node Biopsy for Melanoma Indications Wide Local Excision Sentinel Lymph Node Biopsy Contraindications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Biopsy Wide Local Excision Sentinel Lymph Node Biopsy Documentation Basics Operative Technique Wide Local Excision Sentinel Lymph Node Biopsy Postoperative Care Complications Further Reading 124: Axillary Lymphadenectomy for Melanoma Indications Preoperative Preparation Pitfalls and Danger Points Documentation Operative Strategy Operative Technique Incision Exposing the Axillary Contents Clearing the Axillary Vein Dissecting the Chest Wall Subscapular Space Drainage and Closure Postoperative Care Complications Further Reading 125: Superficial and Deep Groin (Femoroinguinal and Pelvic) Dissection Indications Preoperative Evaluation Pitfalls and Danger Points Documentation Operative Strategy Preventing Wound Infection and Wound Dehiscence Reducing Incidence of Lymphedema Indications for Deep Groin Dissection and Exposure Adequacy of Nodal Dissection Operative Technique Incision and Exposure Dissection in the Femoral Triangle Supra Inguinal Ligament Dissection Deep Groin (Pelvic) Dissection Sartorius Muscular Flap Skin Closure and Drainage Postoperative Care Complications Further Reading Part XII: Thyroid, Parathyroid, and Adrenal, Parotidectomy, and Tracheal Procedures 126: Concepts in Thyroid, Parathyroid, and Adrenal Surgery Thyroid Benign Thyroid Disease Hyperthyroidism Multinodular Goiter Thyroid Carcinoma Ultrasound, Fine-Needle Aspiration, and Molecular Testing Surgical Treatment of Thyroid Cancer Well-Differentiated Thyroid Cancer Medullary Thyroid Cancer Parathyroid Primary Hyperparathyroidism Secondary and Tertiary Hyperparathyroidism Parathyroidectomy Adrenal Adrenal Incidentalomas Primary Aldosteronism Cushing’s Syndrome Pheochromocytoma/Paraganglioma Surgical Approaches to the Adrenal Gland Further Reading 127: Thyroidectomy Indications Preoperative Preparation Pitfalls and Danger Points Documentation Operative Strategy Preserving the Superior Laryngeal Nerve Identification and Preservation of Recurrent Laryngeal Nerve Preserving Parathyroid Glands Operative Technique Intraoperative Preparation Incision and Exposure Identification and Ligation of the Isthmus and Middle Thyroid Vein Dissecting the Superior Pole and Superior Parathyroid Gland Identification of Inferior Pole Vessels Identification of the Recurrent Laryngeal Nerve and Inferior Parathyroid Gland Reimplantation of Parathyroid Glands Subtotal Thyroid Lobectomy Total Thyroid Lobectomy Partial Thyroid Lobectomy Closure Postoperative Care Complications Minimally Invasive Thyroidectomy Further Reading 128: Neck Dissection for Thyroid Cancer Indications Preoperative Preparation Pitfalls and Danger Points Scarring Due to Prior Surgery Nerve Injuries Injury to the Thoracic Duct Seroma Documentation Operative Strategy Operative Technique Central Compartment Neck Dissection Lateral Compartment Neck Dissection Avoiding Postoperative Complications Postoperative Care Complications Further Reading 129: Parathyroidectomy Indications Preoperative Preparation Pitfalls and Danger Points Operative Strategy Curing the Disease Preserving the Recurrent Laryngeal Nerve Preserving the Superior Laryngeal Nerve Preserving Normal Parathyroid Tissue Operative Technique Incision and Exposure Identify Crossing of the Inferior Thyroid Artery and the Recurrent Laryngeal Nerve Identifying Inferior and Superior Parathyroids Resecting the Adenoma Biopsying Normal Parathyroid Subtotal Parathyroidectomy Total Parathyroidectomy with Autotransplantation Sequence for an Unfound Parathyroid Gland Closure Reoperation Posterior Approach Postoperative Care Complications References 130: Minimally Invasive Parathyroidectomy Indications and Preoperative Preparation Pitfalls and Danger Points Documentation Operative Strategy Intraoperative PTH Monitoring (IOPTH) Avoiding Postoperative Complications Preserving the Recurrent Laryngeal Nerve Operative Technique Incision and Exposure Postoperative Care Complications References 131: Open Adrenalectomy Indications Preoperative Preparation Pitfalls and Danger Points Documentation Operative Strategy Operative Technique: Right Adrenalectomy Left Adrenalectomy Postoperative Care Complications Further Reading 132: Laparoscopic Adrenalectomy Indications Relative Contraindications Preoperative Preparation Special Considerations Pitfalls and Danger Points Preoperative Intraoperative Postoperative Documentation Operative Strategy Avoiding Postoperative Complications Operative Technique Transabdominal Approach Retroperitoneoscopic Approach Special Circumstances Postoperative Care Complications Further Reading 133: Parotidectomy Indications Pitfalls and Danger Points Operative Strategy Extent of Resection Locating and Preserving the Facial Nerve Documentation Basics Operative Technique Incision and Exposure Exposing the Posterior Margin of the Parotid Gland Locating the Facial Nerve Dissecting Facial Nerve Branches Removing Deep Lobe of Parotid Gland (When Indicated) Drainage and Closure Postoperative Care Complications Further Reading 134: Cricothyroidotomy Indication Preoperative Preparation Pitfalls and Danger Points Operative Strategy Documentation Basics Operative Technique Postoperative Care Complications References Further Reading 135: Tracheostomy Indications Preoperative Preparation Pitfalls and Danger Points Introduction Operative Strategy Documentation Basics Operative Technique: Formal Tracheostomy Endotracheal Tube Incision and Exposure Identifying the Tracheal Rings Checking the Tracheostomy Equipment Opening the Trachea Inserting the Tracheostomy Tube Closure Percutaneous Tracheostomy Positioning and Setup Procedure Postoperative Care Complications Further Reading Index
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