By Thomas H. Gouge (auth.), Carol E. H. Scott-Conner MD, PhD, MA (eds.)
Chassin’s Operative recommendations in Esophageal surgical procedure bargains the reader a succinct assessment of surgical thoughts for problems of the esophagus. Spanning from well-established legacy methods to the main up to date minimally invasive methods for GERD, this brilliantly illustrated atlas completely provides the theoretical foundation of the operations in addition to the innovations required to lead away from universal pitfalls. Educed from Chassin’s Operative concepts regularly surgical procedure, this quantity contains step by step descriptions of 13 (13) operative approaches in esophageal surgery.
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Extra info for Chassin’s Operative Strategy in Esophageal Surgery
Pyloromyotomy Although in 80% of patients satisfactory results may be obtained without it, pyloromyotomy is generally performed at this point to prevent secondary operations for excessive gastric stasis due to vagotomy. 22 Esophagectomy: Right Thoracotomy and Laparotomy ’ Fig. 0-cm incision across the anterior surface of the pyloric sphincter muscle (Figs. 2–17, 2–18, 2–19). This maneuver is more difﬁcult in an adult (who has only the normal thickness of muscle) than in an infant who suffers hypertrophic pyloric stenosis.
Operative Technique 21 Fig. 2–15 the pancreas. Again, pinch the tissue between ﬁngertip and thumb, which leaves vascular and fatty tissue behind, allowing this ligamentous structure to be divided. Incise it with Metzenbaum scissors (Fig. 2–15). Repeat this maneuver, going around the second and third portions of duodenum (behind the hepatic ﬂexure); this leads to the point at which the superior mesenteric vein crosses over the duodenum. Be careful, as excessive traction with the index ﬁnger may tear this vessel.
With the patient’s head turned slightly to the left, make an oblique incision along the anterior border of the right sternomastoid muscle (Fig. 2–27). Carry the incision through the platysma. Identify (Fig. 2– 28) and transect the omohyoid muscle. Retract the sternomastoid muscle and carotid sheath laterally and retract the prethyroid muscles medially,exposing the thyroid gland (Fig. 2–29). The middle thyroid vein, when present, should be doubly ligated and divided. Put traction on the areolar tissue between the gland and the carotid sheath by upward and medial displacement of the thyroid.
Chassin’s Operative Strategy in Esophageal Surgery by Thomas H. Gouge (auth.), Carol E. H. Scott-Conner MD, PhD, MA (eds.)