General Management in the Elderly: Preoperative and ICU
Frailty criteria Measurement Shrinkage Loss of 10 or more pounds in the last year Weakness Decreased grip strength (<20 % by gender and BMI) Exhaustion Self reported “exhaustion,” poor energy…
Uncategorized
Pathophysiology of Polytrauma
Fig. 5.1 Danger sensing mechanisms at trauma. DAMPs danger associated molecular patterns, PAMPs pathogen associated molecular patterns Cytokines are polypeptides that are produced from a variety of cells such as…
Head Injuries: Neurosurgical and Orthopedic Strategies
Fig. 6.1 Schematic of priorities in the management of associated orthopedic injuries in patients with severe head injuries, based on the understanding of the underlying immunological pathophysiology In TBI patients…
Minimally Invasive Liver and Biliary Procedures
Figure 37.1 (a) Port placement for laparoscopic cholecystectomy. (b) Port placement for multiport, robotic-assisted cholecystectomy. An optional 5 mm assist port is used in the right lower quadrant if needed…
Open Hepatic and Biliary Procedures
Figure 36.1 Subcostal incision (dotted line) and vertical upper midline incision (solid line) For oncological resections, careful inspection and palpation of the liver and peritoneal surfaces is performed to identify…
Bariatric Surgery
Category BMI (kg/m2) Underweight <18.5 Normal weight 18.5–24.9 Overweight 25–29.9 Obesity class 1 30–34.9 Obesity class 2 35–39.9 Extreme (severe) obesity class 3 ≥40 Obesity is a multifactorial disease with…
Laparoscopic Surgery for Para-esophageal Hernias
Figure 13.1 Types of hiatal hernia (Illustration by Clinton T. Morgan, M.D.) Preoperative Preparation Pre-operative management varies according to patient presentation. For the symptomatic patient seeking surgical intervention, a thorough…
Gastric and Duodenal Surgery
Figure 17.1 Laparoscopic pyloroplasty with longitudinal incision across pylorus (A duodenum, B pylorotomy, C stomach) Figure 17.2 Closure of enterotomy proceeds transversely; retraction with atraumatic grasper replaces preplaced stay sutures…
Esophagectomy
Figure 16.1 Division of the gastrohepatic ligament (A caudate lobe, B right crus, C divided gastrohepatic ligament, D esophageal hiatus) Figure 16.2 Esophageal mobilization from the abdomen. The upper picture…
Laparoscopic Antireflux Surgery
Hasson 12 mm trocar (1) 5 mm blunt trocar (3) 11 mm blunt trocar (1) 10 mm – 30° scope Atraumatic laparoscopic graspers Laparoscopic needle holder Babcock clamp L-shaped hook…
