Surgical Procedures

Gastric Surgery Vagotomy – surgical ligation of the vagus nerve to decrease the secretion of gastric acid Pyloroplasty – surgical dilatation of the pyloric sphincter to increase the rate of gastric emptying

Gastroduodenostomy (Billroth I) – surgical removal of the lower portion of the stomach with anastomosis of the remaining portion of the stomach to the duodenum Gastrojejunostomy (Billroth II) – surgical removal of the antrum and distal portion of the stomach and duodenum with anastomosis of the stomach to the jejunum

Gastrostomy The creation of an artificial external opening into the stomach for nutritional support or gastrointestinal compression

Gastrectomy The removal of part or all of the stomach. There are three main types of gastrectomy: partial gastrectomy, removal of the lower half of the stomach full gastrectomy, removal of the entire stomach sleeve gastrectomy, removal of the left side of the stomach

Gastrointestinal bypass surgical procedure that creates a very small stomach; the rest of the stomach is removed.

GB and Pancreatic Surgeries Cholecystostomy – surgical incision into the gallbladder to drain bile Choledochotomy – surgical incision into the common bile duct to remove stones Choledochostomy – surgical opening of the common bile duct to insert a T-tube or catheter for drainage

Cholecystectomy – surgical removal of the gallbladder Laparoscopic Cholecystectomy – removal of the gallbladder through a small incision in the abdomen and the use of a fiber-optic endoscope Pancreatectomy – surgical removal of part or the entire pancreas

Bowel Surgery Abdominoperineal resection – removal of the distal sigmoid colon, rectum and anus with the creation of a permanent colostomy Colectomy- a surgical procedure to remove all or part of your colon.

Total colectomy involves removing the entire colon. Partial colectomy involves removing part of the colon and may also be called subtotal colectomy. Hemicolectomy involves removing the right or left portion of the colon. Proctocolectomy involves removing both the colon and rectum.

Ileostomy – surgical opening of the ileum to the abdominal surface to form a stoma Bowel resection- surgical excision of a portion of the bowel Colostomy - is a surgical procedure that brings a portion of the large intestine through the abdominal wall to carry feces out of the body.

Hemorrhoidectomy Surgical removal of the hemorrhoids Incisions are made in the tissue around the hemorrhoid. The swollen vein inside the hemorrhoid is tied off to prevent bleeding, and the hemorrhoid is removed

Preoperative Nursing Responsibilities * Complete patient and family teaching * Complete the pre-operative checklist and obtain a signed informed consent * Administer preoperative medications as prescribed * Document’s the patient history and physical assessment data * Administer bowel preparation as prescribed

Postoperative Nursing Responsibilities * Assess respiratory, cardiac status and fluid balance * Administer IV fluids, NG tube feedings and transfusion as prescribed * Provide wound care and dressing changes * Assess for the return of peristalsis * Monitor and maintain the position and patency of drainage tubes, NG, IFC, wound drainage * Assess pain and administer analgesics as prescribed