Terminology General Anastamosis = new connection (end-to-end, end-to-side, side-to-side) Roux-en-Y = loop of jejunum for drainage Interposition.

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Presentation transcript:

Terminology General Anastamosis = new connection (end-to-end, end-to-side, side-to-side) Roux-en-Y = loop of jejunum for drainage Interposition = “tube” substitution “Neo-” = new (or replacement) Orthotopic = normal or usual location (Ectopic = abnormal or unusual location)

Common GU Surgeries Urinary Diversion +/- Cystectomy Incontinent (stoma + bag) vs. continent (stoma + no bag) vs. orthotopic or non-orthotopic neobladder (no stoma + no bag) Continent diversions and neobladders - Mainz pouch 3, Indiana pouch 5, UCLA pouch 4, Koch pouch 6, and Studer ileal neobladder 9

Urinary Reservoirs & Neobladders

Common GI Surgeries Esophagus Stomach/duodenum Pancreaticobiliary Small bowel Colon

Common GI Surgeries Esophagus Antireflux – Fundoplication (Nissen, Toupet) Collis gastroplasty Esophagectomy Interposition (usually colonic) Heller myotomy (Achalasia) Stents

Fundoplication Toupet = 270 degrees Nissen = 360 degrees Less dysphagia Nissen = 360 degrees Best results

Collis Gastroplasty Lengthens short esophagus for fundoplication

Esophagectomy and Gastric Pull-up

Common GI Surgeries Stomach Roux-en-Y gastric bypass, adjustable gastric banding (LapBand), vertical banded gastroplasty Gastrojejunostomy Billroth I (partial gastrectomy with gastroduodenostomy) Billroth II (partial gastrectomy with gastrojejunostomy) Gastrectomy with esophagojejunostomy

Obesity Operations

Roux-en-Y Gastric Bypass (RYGB)

Adjustable Gastric Banding (LapBand)

Vertical Banded Gastroplasty

Billroth I

Billroth II

Pancreaticobiliary Surgery Choledochoduodenostomy Choledochojejunostomy Lateral pancreaticojejunostomy (Puestow) Whipple (classic and pyloric sparring)

Whipple Procedure Classic: Cholecystectomy, partial gastrectomy, duodenectomy, partial pancreatectomy, gastrojejunostomy, choledochojejunostomy and pancreaticodochojejunostomy Pyloric sparring: No partial gastrectomy

Whipple Procedure Classic Pyloric sparring

Puestow

Small Bowel Surgeries Resection Ileostomy

Colon Surgeries Resection (any or all) Colostomy (loop; end) Hartman’s procedure (colostomy with closed rectal pouch) J-pouch (proctocolectomy with orthotopic ileal neorectum with ieloanal anasatmosis)

J-Pouch