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…
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…
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…
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…
Method IP or OP treatment Dressing changes required Weeks to healing (average) Recurrence (%) Abscess drainage/Shaving OP Yes 3–4 25–40 Excision OP No 3 16 Fistulotomy OP Yes 4–6 1–19…
Figure 39.1 Entering the lesser sac Figure 39.2 Taking down the short gastric vessels Figure 39.3 Exposing the anterior pancreas Figure 39.4 The pancreas in situ Figure 39.5 Mobilizing the…
Figure 24.1 A window is made behind the IMA and IMV to isolate these structures prior to transection. The hypogastric nerves are identified and swept posteriorly to avoid injury A…
Figure 23.1 Mobilization of the sigmoid colon can be performed in a lateral to medial fashion by incising the white line of Toldt and separating the sigmoid mesentery from the…
Figure 38.1 Initial dissection for pancreaticoduodenectomy. A curvilinear, subcostal incision is first carried out over the right upper quadrant and is subsequently extended across the midline as far as is…
Figure 22.1 The right colon is retracted medial while dividing the lateral peritoneal attachments, taking care to identify and preserve the right ureter. As the dissection is carried superiorly, the…
