2. (1)

3. A gastrectomy is a medical procedure that involves surgically removing the stomach There are many types of gastrectomy including: Partial gastrectomy, where part of the stomach is removed Total gastrectomy, where the whole stomach is removed Sleeve gastrectomy, where the left side of the stomach is removed stomach cancer, also known as gastric cancer. stomach cancer stomach ulcers (open sores develop inside lining of the stomach) stomach ulcers non-cancerous tumours life-threatening obesityobesity

4. Possible complications of a gastrectomy include: wound infection leaking from where the stomach has been closed or reattached to the small intestine stricture, where stomach acid leaks up into your oesophagus and over time causes scarring, leading to the oesophagus becoming narrow and constricted chest infection internal bleeding blockage of the small intestine (small bowel )

5. (2)

6. Nephrectomy (nephro = kidney, ectomy = removal) is the surgical removal of a kidney. There are two types of nephrectomy for a diseased kidney : Partial nephrectomy: only the diseased or injured portion of the kidney is removed. Radical nephrectomy : involves removing the entire kidney, along with a section of the tube leading to the bladder (ureter), the gland that sits atop the kidney (adrenal gland), and the fatty tissue surrounding the kidney. Bilateral nephrectomy : When both kidneys are removed at the same time,

7. All surgery has certain risks and complications. Possible complications of nephrectomy surgery include: Infection Bleeding (hemorrhage) requiring blood transfusion Post-operative pneumonia Rare allergic reactions to anesthesia Death There is also the small risk of kidney failure in a patient with lowered function or disease in the remaining kidney. kidney cancer as well as other kidney diseases and injuries. Nephrectomy is also done to remove a healthy kidney from a donor for transplantation.

8. (3)

9. A colostomy is formed during surgery to divert a section of the large intestine (colon) through an opening in the abdomen (tummy). The opening is known as a stoma. A pouch is placed over the stoma to collect waste products that would usually pass through the colon and out of the body through the rectum and anus. A colostomy can be permanent or temporary. There are two main ways a colostomy can be formed. a loop colostomy – where a loop of colon is pulled out through a hole in your abdomen, before being opened up and stitched to the skin an end colostomy – where one end of the colon is pulled out through a hole in your abdomen and stitched to the skin

10. 1.Rectal discharge People who have a colostomy but have an intact rectum and anus often experience a discharge of mucus from their rectum. Mucus is a liquid produced by the lining of the bowel that acts as a lubricant, helping the passage of stools. The lining of the bowel continues to produce mucus even though it no longer serves any purpose. The longer the length of the remaining section of your bowel, the more likely you are to experience rectal discharge A colostomy usually needs to be formed when there is a problem with an area of the colon. bowel cancer Crohn's disease – a condition that causes inflammation of the digestive system Crohn's disease diverticulitis – a condition that causes small pouches to develop in the wall of the colon, called diverticula, which become infected and inflamed diverticulitis

11. 2. Parastomal hernia A hernia occurs when an internal part of the body, such as an organ, pushes through a weakness in the muscle or surrounding tissue wall. In cases of parastomal hernia, the intestines push through the muscles around the stoma resulting in a noticeable bulge under the skin. People with colostomies have an increased risk of developing parastomal hernias because the muscles in their abdomen have been weakened during surgery. 3. Stoma blockage Some people develop a blockage in their stoma due to a build-up of food. Signs of a blockage can include: reduced stool production, or passing watery stools bloating and swelling in the abdomen (tummy) tummy cramps a swollen stoma nausea and/or vomiting

12. skin problems –the skin around the stoma becomes irritated and sore stomal fistula –a small channel develops in the skin alongside the stoma stoma retraction – where the stoma sinks below the level of the skin after the initial swelling goes down, stoma prolapse –the stoma comes out too far above the level of the skin stomal stricture (stenosis) –the stoma becomes scarred and narrowed leakage – where digestive waste leaks from the colon onto the surrounding skin or within the abdomen stomal ischaemia –the blood supply to the stoma is reduced after surgery

13. (4)

14. A hysterectomy is a surgical procedure to remove the womb (uterus). Patient become no longer be able to get pregnant after the operation total hysterectomy – the womb and cervix (neck of the womb) are removed; this is the most commonly performed operation subtotal hysterectomy – the main body of the womb is removed, leaving the cervix in place total hysterectomy with bilateral salpingo-oophorectomy – the womb, cervix, fallopian tubes (salpingectomy) and the ovaries (oophorectomy) are removed radical hysterectomy – the womb and surrounding tissues are removed, including the fallopian tubes, part of the vagina, ovaries, lymph glands and fatty tissue

15. Hysterectomies are carried out to treat conditions that affect the female reproductive system, including: heavy periods (menorrhagia) heavy periods long-term pelvic painpelvic pain non-cancerous tumours (fibroids)fibroids ovarian cancer, uterine cancer, cervical cancer or cancer of the fallopian tubes ovarian canceruterine cancercervical cancer Bleeding Ureter damage Bladder or bowel damage Infection Thrombosis Vaginal problems Ovary failure Early menopause

16. (5)

17. This refers to the opening of the abdominal cavity for direct examination of its contents To locate a source of bleeding or trauma. It may or may not be followed by repair or removal of the primary problem A common reason for a laparotomy is to investigate abdominal pain, but the procedure may be required for a broad range of indications. The abdominal organs include the digestive tract (such as the stomach, liver and intestines) and the organs of excretion (such as the kidneys and bladder

18. LAPAROTOMY INCISION

19. LAPAROTOMY PROCEDURE A laparotomy is performed under general anesthesia. The surgeon makes a single cut through the skin and muscle of the abdomen, so that the underlying organs can be clearly viewed. The exposed organs are then carefully examined. Once diagnosed, the problem may be fixed on the spot (for example, a perforated bowel may be repaired). In other cases, a second operation may be needed. Once the laparotomy is complete, the muscle of the abdominal wall and the overlying skin are sutured (sewn) closed.

20. LAPROTOMY PROCEDURE

21. COMPLICATIONS FOLLOWING LAPAROTOMY Haemorrhage Infection Damage to internal organs Formation of internal scar tissue (adhesions) Bowel blockages or abdominal pain, which may be caused by adhesions