Descripción
For 40 years, Fischer’s Mastery of Surgery has provided expert, highly illustrated coverage of the procedures that general surgeons and trainees need to know. The fully revised 8th Edition, under the editorial leadership of Drs. E. Christopher Ellison, Gilbert R. Upchurch Jr., Philip A. Efron, Steven D. Wexner, Nancy D. Perrier, V. Suzanne Klimberg, John H. Stewart IV, Valerie W. Rusch, Jon C. Gould, Susan Galandiuk, Timothy M. Pawlik, William C. Chapman, Benjamin K. Poulose, Peter K. Henke, Alicia M. Mohr, Saleem Islam, Anne M.R. Agur, Carol Scott-Conner, and David Renton, continues the tradition of excellence with two full-color volumes that include the essentials of diagnosis, anatomy, and pre-operative planning while maintaining a focus on clear, step-by-step depictions and descriptions of procedures.
- Brings you up to date with evidence-based approaches for virtually any surgery you’ll be called upon to perform
- Provides extensive coverage (including select procedural videos) of common thoracic, breast, esophageal, endocrine, colorectal, gastric, pancreatic, liver, biliary, vascular, and transplantation procedures across 311 chapters
- Includes new sections on perioperative care and critical care; abdominal core health; trauma, burn, and acute care surgery; and pediatric surgery as well as new Mastery Keys anatomy chapters
- Walks you step by step through each procedure, with tips and cautions from leading surgeons
- Concludes each chapter with expert editorial commentary that puts the chapter material in a broad context and provides helpful critiques of the most recent literature
- Features more than 2,600 illustrations and photographs that offer a surgeon’s-eye-view of the most advanced approaches
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TABLE OF CONTENTS
- Cover
- Title Page
- Copyright
- Foreword
- Preface
- Contents
- Video Contents
- Contributors
VOLUME I
- SECTION I: PERIOPERATIVE CARE OF THE SURGICAL PATIENT
- CHAPTER 1: Metabolic and Inflammatory Responses to Trauma and Infection
- INTRODUCTION
- Acute Phase Response to Injury
- Catabolism in Injury
- Mitochondrial Dysfunction
- Carbohydrate Metabolism
- Hormonal Changes During Injury and Stress
- Glucagon
- Glucocorticoids
- Adrenal Insufficiency
- NEUROENDOCRINE CHANGES DURING TRAUMA AND INFECTION
- ROLE OF THE AUTONOMIC NERVOUS SYSTEM DURING TRAUMA AND INFECTION
- AUTONOMIC DYSFUNCTION
- ADVERSE EFFECTS OF ADRENERGIC STRESS
- OTHER NEUROENDOCRINE ALTERATIONS
- Vasopressin
- Thyroid
- Growth Hormone
- The Gonadal Axis
- IMMUNE RESPONSE TO INJURY
- OUTCOMES
- CHAPTER 2: Perioperative Management: Practical Principles, Risk Determination and Future Directions
- INTRODUCTION
- GENERAL PRINCIPLES
- The Physiologic Changes Due to the Surgical Stress Response and Anesthesia
- Surgical Urgency and Risk Estimation
- PERIOPERATIVE RISK ASSESSMENT
- Surgery-Specific Risk
- Patient-Specific Risk
- Combined Risk Assessment
- History and Physical Examination and Preoperative Laboratory Testing
- A SYSTEM-BASED APPROACH TO PERIOPERATIVE EVALUATION
- Cardiovascular
- Pulmonary
- Renal
- Hepatobiliary
- Rheumatologic
- SPECIAL POPULATIONS
- The Older Patient
- The Pregnant Patient
- The Patient for Whom Transfusion Is Not an Option
- The Patient With a History of Malignancy or Immunocompromise
- The Obese Patient
- MEDICATION REVIEW
- FUTURE DIRECTIONS
- Artificial Intelligence and Surgical Decision Making
- CHAPTER 3: Fluids, Electrolytes, and Renal Replacement Therapy
- INTRODUCTION
- TOTAL BODY WATER AND FLUID COMPOSITION (Fig. 3.1)
- ASSESSMENT OF FLUID STATUS
- INTRAVENOUS FLUIDS
- ELECTROLYTE DISTURBANCES AND MANAGEMENT (FIGS. 3.2 AND 3.3)
- Sodium
- Potassium
- Magnesium (Mg)
- Calcium (Ca)
- Phosphate
- MANAGEMENT OF RENAL FAILURE: RENAL REPLACEMENT THERAPY AND DIALYSIS
- DIAGNOSIS OF ACUTE RENAL FAILURE
- PREVENTION AND MANAGEMENT OF EARLY ACUTE RENAL FAILURE
- INDICATIONS FOR RENAL REPLACEMENT THERAPY
- RENAL REPLACEMENT THERAPY PRINCIPLES
- INTERMITTENT DIALYSIS (IHD) VERSUS CONTINUOUS RENAL REPLACEMENT THERAPY (CRRT)
- CHAPTER 4: Enteral Nutrition Support and Gastrointestinal Issues
- INTRODUCTION
- A History of Artificial Nutrition
- NUTRITION ASSESSMENT
- Anthropometric and Body Composition Assessment
- BIOCHEMICAL ASSESSMENT
- Serum Creatinine and Nitrogen Balance Studies
- Serum Visceral Protein
- Nutrition Assessment Tools
- Summary: Nutritional Assessment of the Surgical Patient
- METABOLIC RESPONSE TO STARVATION AND TO INJURY
- Starvation
- Surgical and Traumatic Injury
- CALORIE AND PROTEIN REQUIREMENTS
- Estimating Energy Expenditure
- Protein Requirements
- MACRONUTRIENTS: ABSORPTION AND UTILIZATION
- Carbohydrates
- Protein
- Lipids
- Vitamins and Minerals
- ENTERAL NUTRITION
- Overview of Nutritional Support Strategies
- Advantages of Enteral Nutrition
- Contraindications
- Timing of Initiation
- Dosing and Permissive Underfeeding Strategies
- Alternatives to Continuous Feeding Strategies
- Monitoring Tolerance
- Enteral Formulations
- DISEASE-SPECIFIC FORMULATIONS AND ADDITIVES
- Pulmonary Formulas
- Diabetic Formulas
- Malabsorptive Formulas
- Renal Formulations
- Hepatic Formulations
- Immune and Metabolic Modulation With Nutrition (Immunonutrition)
- Antioxidant Additives/Supplementation
- Probiotics and Prebiotics
- SPECIAL CONSIDERATIONS IN THE ELECTIVE PERIOPERATIVE SETTING
- Early Initiation of Enteral Support
- Preoperative Carbohydrate Loading
- SUMMARY
- CHAPTER 5: Respiratory Care and Ventilation in the Surgical ICU
- INTRODUCTION
- NORMAL PULMONARY PHYSIOLOGY
- IMPACT OF SURGICAL CARE ON PULMONARY FUNCTION
- RISK FACTORS FOR ACUTE RESPIRATORY DISTRESS OR ACUTE RESPIRATORY FAILURE
- PREOPERATIVE ASSESSMENT FOR POSTOPERATIVE PULMONARY COMPLICATIONS
- PULMONARY PREHABILITATION FOR THE ELECTIVE SURGICAL PATIENT
- INTRAOPERATIVE MECHANICAL VENTILATION
- COMMON APPROACHES TO NONINVASIVE VENTILATION
- RESPIRATORY PHYSIOLOGY DURING POSITIVE PRESSURE VENTILATION
- VENTILATOR PRESCRIPTION ELEMENTS
- Directly Set Elements
- Measured Pressures
- Derived Pressures
- Essential Waveforms
- Airway Pressure Release Ventilation (APRV) and Bilevel Ventilation (Figs. 5.11 and 5.12)
- Pressure Support Ventilation
- Non–ventilator-Based Assessment Tools
- Postoperative Management
- Adjuncts for Respiratory Care
- CONCLUSIONS
- CHAPTER 6: Cardiovascular Monitoring and Support
- INTRODUCTION
- CARDIOVASCULAR MONITORING
- Physical Findings
- Electrocardiography
- Arterial Blood Pressure Monitoring
- Central Venous Pressure Monitoring
- Pulmonary Artery Catheter Monitoring
- Noninvasive Cardiovascular Monitoring
- CARDIOVASCULAR SUPPORT
- Resuscitation
- Inotropic Support
- Vasoactive Modulation
- MECHANICAL VENTRICULAR ASSISTANCE
- CHAPTER 7: Best Practices in Endocrine Care in the Perioperative Period
- INTRODUCTION
- PINEAL GLAND
- HYPOTHALAMUS/PITUITARY
- PARATHYROID
- THYROID GLAND
- ENDOCRINE PANCREAS
- Insulin
- Glucagon
- Somatostatin
- Amylin, Ghrelin, Pancreatic Polypeptide, Motilin, Obestatin, Substance P, and Serotonin
- Vasoactive Intestinal Peptide (VIP)
- THE ADRENAL GLAND
- CARCINOID SYNDROME AND OTHER FUNCTIONAL NEUROENDOCRINE TISSUE
- TESTIS AND OVARY
- THYMUS AND ADIPOSE TISSUE
- CHAPTER 8: Hemorrhagic Risk, Blood Components, and Anticoagulation/DVT Prophylaxis
- INTRODUCTION
- ACQUIRED COAGULOPATHY
- Trauma-Induced Coagulopathy
- Coagulopathy of Liver Disease
- Disseminated Intravascular Coagulation
- Inherited Coagulopathies
- MEDICATION-INDUCED COAGULOPATHY
- Anticoagulants and Respective Reversal Agents
- Antiplatelet Agents
- Oral Anticoagulants
- Warfarin Reversal
- Direct Oral Anticoagulants (DOACs)
- Emergency Reversal of DOACs
- Viscoelastic Testing (VET)
- WHOLE BLOOD TRANSFUSION
- PACKED RED BLOOD CELLS (PRBC)
- PLASMA
- CRYOPRECIPITATE
- PLATELETS
- TRANEXAMIC ACID
- TRANSFUSION-RELATED IMMUNOSUPPRESSION (TRIM)
- TRANSFUSION-RELATED ACUTE LUNG INJURY (TRALI)
- TRANSFUSION-ASSOCIATED CARDIAC OVERLOAD (TACO)
- CHAPTER 9: Perioperative Antimicrobial Prophylaxis, Treatment of Surgical Infection and Sepsis
- INTRODUCTION
- PREVENTION OF SURGICAL SITE INFECTION
- Epidemiology and Classification of SSI
- Risk Factors for Developing SSI
- Microbiology
- General Measures to Prevent SSI
- Perioperative Antimicrobial Prophylaxis
- MANAGEMENT OF SEPSIS
- MANAGEMENT OF SURGICAL INFECTIONS
- COMPLICATED INTRA-ABDOMINAL SEPSIS
- Diagnostic Workup
- Empiric Antimicrobial Management
- Microbiology in Patients With Community-Associated Infections
- Microbiology in Patients With Health care-Associated Infections
- Broad-Spectrum Antimicrobial Therapy for Severe Community-Associated Infection
- Antimicrobials in Patients With Health care-Associated Intra-Abdominal Infections
- Pharmacokinetic and Pharmacodynamic Considerations in Intra-Abdominal Sepsis
- De-Escalation Approach for Polymicrobial Infections
- Newer Antimicrobial Agents
- Surgical Interventions and Nonoperative Procedures
- Timing of Source Control
- Adequacy of Source Control
- Prognosis and Clinical Outcome
- SKIN AND SOFT TISSUE INFECTIONS
- Skin and Soft Tissue Infections Definitions
- Microbiology of Uncomplicated SSTI
- Microbiology of cSSTI
- Antimicrobial Therapy
- Principles of Surgical Intervention
- Necrotizing Soft Tissue Infection
- ANTIMICROBIAL STEWARDSHIP
- CONCLUSION
- CHAPTER 10: Sedation and Delirium in the Surgical Intensive Care Unit
- INTRODUCTION
- ICU SEDATION AND AGITATION
- Historical Perspective
- Assessment of Sedation and Agitation
- Sedative Agents in the ICU
- Treatment of Agitation
- Specific Populations
- DELIRIUM
- Pathophysiology of Delirium and Its Risk Factors
- Recognition and Diagnosis
- Prevention and Treatment
- SUMMARY
- CHAPTER 11: Acute Postoperative Pain Management
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- PREOPERATIVE PLANNING
- THERAPY OPTIONS
- Acetaminophen
- Alpha-2 Adrenergic Agonists
- Gabapentinoids
- Ketamine
- Lidocaine Intravenous Infusion
- Muscle Relaxants
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
- Opioids
- Regional Analgesics
- Tramadol
- Multimodal THERAPY
- DISCHARGE
- SPECIAL POPULATIONS
- Geriatric Patients
- Chronic Pain Patients
- CONCLUSION
- CHAPTER 12: Surgeons and the Opioid Epidemic
- INTRODUCTION
- BRIEF HISTORY OF OPIOIDS
- A REVOLUTION IN PHARMACEUTICAL ADVERTISING
- MISCONSTRUED SCIENCE
- PARADIGM CHANGE
- A RAPID INCREASE IN PRESCRIPTION OPIOIDS
- A MIDDLE-AMERICA PROBLEM
- OPIOIDS AND THE SURGEON
- Preoperative Chronic Opioid Use
- Surgeons Are Overprescribing Opioids for Postoperative Pain
- APPROACHES TO PREVENTION
- Primary Prevention
- Secondary Prevention
- APPROACHES TO ADDICTION TREATMENT
- Methadone
- Buprenorphine
- Naltrexone
- HARM REDUCTIONS STRATEGIES
- Needle Exchange Programs
- Supervised Injection Facilities
- MULTIMODALITY ADDICTION STRATEGIES
- MAINTAINING ABSTINENCE
- FINAL DISCUSSION
- CONCLUSION
- ACKNOWLEDGMENTS
- CHAPTER 13: Surgery and Perioperative Care during the COVID-19 Pandemic
- INTRODUCTION
- PREADMISSION AND ADMISSION CONSIDERATIONS IN COVID-19 PANDEMIC
- PREOPERATIVE PLANNING
- INTRAOPERATIVE CONSIDERATIONS
- POSTOPERATIVE CARE
- COST OF DELAY
- CHAPTER 14: Core Procedures in the Surgical Intensive Care Unit
- INTRODUCTION
- INDICATIONS AND CONTRAINDICATIONS
- PREPROCEDURAL PLANNING AND EQUIPMENT
- TECHNIQUE
- COMPLICATIONS
- INDICATIONS AND CONTRAINDICATIONS
- PREPROCEDURAL PLANNING AND EQUIPMENT
- TECHNIQUE
- COMPLICATIONS
- INDICATIONS AND CONTRAINDICATIONS
- PREPROCEDURAL PLANNING AND EQUIPMENT
- TECHNIQUE
- COMPLICATIONS
- INDICATIONS AND CONTRAINDICATIONS
- PREPROCEDURAL PLANNING AND EQUIPMENT
- TECHNIQUE
- COMPLICATIONS
- CHAPTER 15: Mastery Keys: Anatomy of Venous Access, Subclavian and Internal Jugular Veins
- OVERVIEW OF VENOUS DRAINAGE OF NECK
- SUBCLAVIAN VEIN
- INTERNAL JUGULAR VEIN
- SECTION II: Basic Surgical Skills and Emerging Technology
- CHAPTER 16: Laparoscopic Suturing and Stapling
- BACKGROUND
- LAPAROSCOPIC SUTURING INSTRUMENTS
- LAPAROSCOPIC SUTURING TECHNIQUES
- Intracorporeal Suturing/Knot Tying
- Extracorporeal Suturing/Knot Tying
- Loop Ligature
- Additional Laparoscopic Suturing and Ligature Techniques
- LAPAROSCOPIC STAPLING
- Laparoscopic Linear Staplers
- Circular Staplers in Laparoscopy
- Surgical Stapler Buttress Materials
- Evidence for Surgical Stapling
- LAPAROSCOPIC SIMULATION AND TRAINING
- CONCLUSIONS
- CHAPTER 17: Ultrasonography by Surgeons
- INTRODUCTION
- INDICATIONS FOR INTRAOPERATIVE ULTRASOUND
- BASIC PHYSICS: THE PIEZOELECTRIC EFFECT
- INSTRUMENTATION
- Transducers (Probes)
- Open US Probes
- Laparoscopic US Probes
- Robotic US Probes
- Knobology
- Ultrasound Terminology
- SCANNING TECHNIQUES
- General Considerations
- Coupling
- Probe Placement
- Probe Movement/Manipulation
- OPEN ULTRASOUND
- Liver Scanning Method
- Biliary Scanning Method
- Pancreas Scanning Method
- LAPAROSCOPIC ULTRASOUND
- Liver Scanning Method
- Biliary Scanning Method
- Pancreas Scanning Method
- ROBOTIC ULTRASOUND
- ULTRASOUND-GUIDED PROCEDURES
- Targeting
- Ultrasound-Guided Procedure Planning
- Ultrasound-Guided Tissue Dissection
- TRAINING IN SURGICAL ULTRASOUND
- CONCLUSIONS
- CHAPTER 18: Tumor Ablation: Technologies and Clinical Applications
- INTRODUCTION
- POTENTIAL BENEFITS OF TUMOR ABLATION
- Combination Therapy
- Immunologic Benefit
- TECHNOLOGIES USED FOR TUMOR ABLATION
- Chemical Ablation (Nonenergy)
- Energy-Based Ablation
- Irreversible Electrocorporation
- Cryoablation
- TUMOR ABLATION IN CLINICAL PRACTICE
- Liver
- Prostate
- Kidney
- Breast
- Other Uses
- CONCLUSIONS
- CHAPTER 19: Upper and Lower Gastrointestinal Endoscopy
- INTRODUCTION
- INDICATIONS/CONTRAINDICATIONS
- SURGICAL TECHNIQUE
- Instrumentation
- Advanced Imaging in Endoscopy
- Technique of Esophagogastroduodenoscopy
- Therapeutic Interventions During Upper Endoscopy
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Technique of Colonoscopy and Basic Colonoscopic Design
- Snares
- Advanced Techniques
- Submucosal Injection
- Endoscopic Mucosal Resection
- Endoscopic Submucosal Dissection
- Precut EMR and Hybrid ESD
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES AND LONG-TERM FOLLOW-UP
- NOVEL ENDOLUMINAL PLATFORMS AND ENDOROBOTICS
- CONCLUSION
- Disclosures
- CHAPTER 20: Mastery Keys: Endoscopic Anatomy of Upper and Lower Gastrointestinal Tract
- ENDOSCOPIC ANATOMY OF UPPER GASTROINTESTINAL TRACT
- Pharynx
- Esophagus
- Stomach
- Duodenum
- ENDOSCOPIC ANATOMY OF LOWER GASTROINTESTINAL TRACT
- Rectum and Anal Canal (Fig. 20.2A,B)
- Sigmoid Colon (Fig. 20.2C,D)
- Descending Colon
- Transverse Colon (Fig. 20.2E,F)
- Ascending Colon and Cecum (Fig. 20.2G–I)
- CHAPTER 21: Robotic Surgery
- INTRODUCTION
- HISTORY OF MINIMAL INVASIVE SURGERY
- MIS AND ROBOTICS
- ROBOTIC PLATFORMS AND EVOLUTION
- THE DA VINCI SURGICAL SYSTEM
- EQUIPMENT FUNDAMENTALS
- EDUCATION AND SKILL ACQUISITION
- LIMITATIONS
- FUTURE DIRECTIONS
- Flexible Robotics
- Fluorescent Surgery
- Artificial Intelligence and Machine Learning
- CONCLUSION
- CHAPTER 22: Surgical Energy
- INTRODUCTION
- TYPES OF ENERGY IN THE OPERATING ROOM
- Monopolar Radiofrequency Energy
- Bipolar Radiofrequency Energy
- Ultrasonic Energy
- Plasma Energy
- Lasers
- Microwave and Radiofrequency Energy Ablation
- THE EIGHT REPRODUCIBLE PATTERNS OF ELECTROSURGICAL INJURY
- Fires
- Antenna Coupling
- Insulation Failure
- Residual Heat
- Direct Application
- Interaction With Electronic Devices
- Direct Coupling
- Capacitive Coupling
- SPECIAL CONSIDERATIONS
- Endoscopy
- Pregnancy and Pediatric Surgery
- Surgical Smoke and Infectious Risk
- CONCLUSION
- CHAPTER 23: Telemedicine for Surgeons
- INTRODUCTION
- DEFINITION OF TELEMEDICINE
- DIFFERENT TYPES OF TELEMEDICINE
- ORIGINS OF TELEMEDICINE
- COVID-19 PANDEMIC AND ITS IMPACT ON TELEMEDICINE
- TECHNOLOGY BEHIND TELEMEDICINE
- THE VIRTUAL EXAMINATION
- CLINICAL LOGIC BEHIND SURGICAL TELEHEALTH
- USING TELEMEDICINE IN THE SURGICAL CARE CONTINUUM
- FINANCIAL IMPLICATIONS OF TELEMEDICINE
- OPERATIONAL MODEL FOR SURGICAL TELEMEDICINE
- SURGICAL TELEMEDICINE IN A SERVICE LINE
- COLLABORATIVE TELEMEDICINE OPPORTUNITIES AMONG SURGEONS AND OTHER SPECIALTIES
- CRAFTING OUR SURGICAL TELEMEDICINE FUTURE
- CONCLUSION
- CHAPTER 24: Artificial Intelligence and Virtual Reality
- ARTIFICIAL INTELLIGENCE
- What Is Artificial Intelligence?
- Types of Artificial Intelligence
- Types of Learning
- Subfields of Artificial Intelligence
- Artificial Intelligence in Surgery
- Limitations of AI
- Ethical Considerations
- VIRTUAL REALITY
- What Is the Reality–Virtuality Continuum?
- Role of VR/AR in Training and Planning
- Role of VR/AR During Surgery
- FUTURE DIRECTIONS
- CHAPTER 25: Telepresence Surgery
- INTRODUCTION
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING OF THE WORLD’S FIRST TELESURGERY
- Technical Challenges
- Ethical and Medicolegal Aspects
- Preclinical Proof-of-Concept for Safe Clinical Use
- THE SURGICAL TECHNIQUE OF OPERATION LINDBERGH
- POSTOPERATIVE CARE/COMPLICATIONS/MANAGEMENT
- POST-LINDBERGH DEVELOPMENT OF TELESURGERY
- New Technology for Democratized Telesurgery
- TELESURGERY BEYOND EARTH
- OUTLOOK
- ACKNOWLEDGEMENTS
- CHAPTER 26: An Effective Approach to Mastering Communication in Surgery
- KEY PRINCIPLES IN EFFECTIVE COMMUNICATION
- COMMUNICATION ACROSS THE SURGICAL PATHWAY
- Effective Communication Critical to Patient Safety
- Structured Communication Tools
- TEAM COMMUNICATION
- CASE SCENARIOS
- Case #1
- Case #2
- Case #3
- TECHNIQUES ACROSS DIFFERENT COMMUNICATION PLATFORMS
- Parting Thoughts
- CHAPTER 27: Fluorescence Imaging
- INTRODUCTION
- EQUIPMENT
- SPECIFIC APPLICATIONS OF FLUORESCENCE TECHNOLOGY
- Gastrointestinal Surgery
- Hepatobiliary Surgery
- Foregut Surgery
- Bariatric Surgery
- Colorectal Surgery
- Abdominal Wall Reconstruction/Plastic Surgery
- ENDOCRINE SURGERY
- Parathyroid Glands
- Adrenal
- Pancreas
- SENTINEL LYMPH NODE IDENTIFICATION
- LYMPHATIC SURGERY
- FINANCIAL IMPLICATIONS
- FUTURE DIRECTIONS
- CONCLUSIONS
- CHAPTER 28: Video-Based Education
- THE TRIPLE PARADIGM SHIFT
- BASIC CONCEPTS, MODALITIES, AND SOURCES FOR LEARNING
- Video-Based Learning (VBL)
- Online Platforms: Virtual Repositories and Video Libraries
- Live Surgery
- Apps for Mobile Devices
- Video-Based Review (VBR) and Assessment (VBA)
- Video-Based Coaching (VBC)
- Telementoring
- Video Games
- TECHNICAL REQUIREMENTS, TOOLS AND REGULATION
- Telestration (Video 28.1)
- Recommendations for Online Audiovisual Resources
- EVALUATION METHODS SPECIFIC TO VBE
- Objective Scales
- Self-Assessment
- Limitations and New Directions in Objective Assessment
- RESULTS TO DATE
- DIFFICULTIES FOR ITS INCLUSION IN TRAINING PROGRAMS
- LIABILITY AND OTHER MEDICO-LEGAL ASPECTS
- FUTURE TRENDS IN NON–FACE-TO-FACE SURGICAL EDUCATION
- CHAPTER 29: Deferred Live Surgery
- INTRODUCTION
- HISTORY
- LIVE SURGERY
- Preoperative Concerns
- Intraoperative Concerns
- Postoperative Concerns
- Policies on Live Surgical Broadcasting
- Synchronized Deferred Live (dLIVE) Surgery
- CHAPTER 30: Integrated Operating Room
- INTRODUCTION
- REVOLUTION OF MIS SURGERY—EMERGENCY OF “ENDOLAPAROSCOPIC” CONCEPT
- DEVELOPMENT OF MINIMALLY INVASIVE SUITE
- Patient Care
- The Surgeon
- OT Staff
- FUTURE TRENDS OF MIS SUITE
- Robotic Surgery
- Navigational Surgery With Different Imaging Modalities
- Voice Recognition or System
- CHAPTER 31: Regenerative Medicine in Surgery
- INTRODUCTION
- COLORECTAL SURGERY
- SOLID ABDOMINAL ORGAN TRANSPLANTATION
- INFLAMMATION-DRIVEN PATHOLOGY OF UNKNOWN ETIOLOGY
- ORTHOPEDIC SURGERY
- PLASTIC SURGERY
- LIMITATIONS OF CELL THERAPY
- CONCLUSION
- CHAPTER 32: Social Media as a Surgical Tool
- INTRODUCTION TO SOCIAL MEDIA FOR SURGERY
- THE SOCIOLOGIC BASIS OF SOCIAL MEDIA
- HOW TO DETERMINE THE BEST PLATFORM FOR YOUR NEEDS
- YouTube
- TikTok
- Surgical Education Platforms
- Other Platforms
- CONNECTING AND ENGAGING WITH SURGEONS ON SOCIAL MEDIA
- MEASURING SOCIAL MEDIA IMPACT
- BENEFITS, RISKS, AND LIMITATIONS OF SOCIAL MEDIA
- SOCIAL MEDIA AS A TOOL FOR SURGICAL EDUCATION AND TRAINING
- SOCIAL MEDIA FOR SURGICAL RESEARCH
- CONCLUSION
- CHAPTER 33: Hyperthermic Intraperitoneal Chemotherapy and Pressurized Intraperitoneal Aerosol Chemotherapy
- INTRODUCTION
- PATHOPHYSIOLOGY
- CLINICAL PRESENTATION AND DIAGNOSIS
- MULTIMODAL THERAPY, INDICATIONS, AND CONTRAINDICATIONS
- Contraindications for HIPEC
- Contraindications for PIPAC
- Relative Contraindications
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Cytoreductive Surgery
- HIPEC
- PIPAC
- POSTOPERATIVE CARE
- COMPLICATIONS AND MANAGEMENT
- OUTCOMES
- Malignant Peritoneal Mesothelioma
- Appendiceal Pseudomyxoma Peritonei
- Colorectal
- Ovarian, Fallopian Tube, and Primary Peritoneal Cancer
- Gastric Cancer
- CONCLUSIONS
- SECTION III: Endocrine Surgery
- Part A: Thyroid
- CHAPTER 34: Indications for Surgical Management of Thyroid Disease
- INTRODUCTION
- DIAGNOSIS/CLINICAL PRESENTATION
- Hyperfunctional Diseases
- Toxic Multinodular Goiter/Toxic Adenoma
- TREATMENT AND PROGNOSIS
- Graves Disease
- Toxic Multinodular Goiter/Toxic Adenoma
- Hashimoto Thyroiditis
- Benign Multinodular Goiter
- SPECIAL CONSIDERATIONS FOR SUBSTERNAL DISEASE
- INTRODUCTION
- Well-Differentiated Thyroid Carcinoma (Papillary Thyroid Carcinoma, Follicular Thyroid Carcinoma, and Hurthle Cell Thyroid Carcinoma)
- Medullary Thyroid Carcinoma
- Anaplastic Thyroid Carcinoma
- DIAGNOSIS/CLINICAL PRESENTATION
- Well-Differentiated Thyroid Carcinoma (Papillary Thyroid Carcinoma, Follicular Thyroid Carcinoma, and Hurthle Cell Thyroid Carcinoma)
- Medullary Thyroid Carcinoma
- Anaplastic Thyroid Carcinoma
- SURGICAL MANAGMENT
- Well-Differentiated Thyroid Carcinoma (Papillary Thyroid Carcinoma, Follicular Thyroid Carcinoma, and Hurthle Cell Thyroid Carcinoma)
- Medullary Thyroid Carcinoma
- Anaplastic Thyroid Carcinoma
- POSTOPERATIVE CARE
- Postoperative Hematoma
- Hypoparathyroidism
- Postoperative Hoarseness
- CHAPTER 35: Mastery Keys: Surgical Anatomy of Thyroid Gland and Midline Neck Structures
- EXPOSURE
- THYROID GLAND
- VENOUS DRAINAGE
- ARTERIAL SUPPLY
- INNERVATION
- Lymph Nodes
- CHAPTER 36: Open Thyroidectomy
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- CLINICAL PRESENTATION
- PLANNING, POSITIONING, AND TOOLS
- SURGICAL TECHNIQUE
- Incision, Exposure of Thyroid, Including Separation of Strap Muscles and Thyroid and Medialization of the Thyroid Gland
- Exposure of the Pyramidal Lobe
- Exposure of Superior and Ligation of Superior Pole Vessels
- Medialization of the Thyroid, Identification of Parathyroid Glands, and Exposure of Recurrent Laryngeal Nerve
- Ligation of the Inferior Thyroid Vessels
- Fine Dissection Along the Laryngeal Nerve
- Ligation of the Ligament of Berry
- Completion and Division of the Isthmus
- Hemostasis and Autotransplantation of Parathyroid Glands If Necessary
- Closure
- Special Cases
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 37: Neck Dissection for Thyroid Cancer
- INTRODUCTION
- SURGICAL TECHNIQUE
- Lateral Neck Dissection
- Central Neck Dissection
- CONCLUSIONS
- CHAPTER 38: Mastery Keys: Surgical Anatomy of Neck Dissection
- LYMPHATIC DRAINAGE OF NECK
- ANATOMY OF NECK
- Superficial Fascia of Neck (Figs. 38.1, 38.2, and 38.3)
- Deep Fascia of Neck (Fig. 38.2A)
- Triangles of Neck (Fig. 38.2B)
- Part B: Parathyroid
- CHAPTER 39: Primary Hyperparathyroidism
- INTRODUCTION
- PATHOPHYSIOLOGY
- Resorption of Bone
- Reabsorption in the Kidney
- Absorption in the Intestine
- CLINICAL MANIFESTATIONS
- DIAGNOSIS
- RESPONSE TO SURGERY
- INDICATIONS FOR SURGERY
- IMAGING
- Thyroid and Parathyroid Ultrasonography
- Parathyroid Scintigraphy
- 4D-CT
- MRI, PET, and Invasive Tests
- SURGICAL STRATEGY AND PRINCIPLES
- Adjuncts
- FAILURE AND OTHER SURGICAL RISKS
- Cure and Failure
- Hypoparathyroidism
- Hoarseness/Nerve Injury
- Hematoma
- Rare Complications
- SPECIAL CONSIDERATIONS
- Familial Hypocalciuric Hypercalcemia
- Familial PHPT
- Reoperative Parathyroid Surgery
- CHAPTER 40: Mastery Keys: Surgical Anatomy of Parathyroid Glands
- SUPERIOR PARATHYROID GLANDS
- INFERIOR PARATHYROID GLANDS
- CHAPTER 41: Minimally Invasive Parathyroidectomy
- INTRODUCTION
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE AND ADJUNCTS
- Anesthesia and Patient Positioning
- Surgical Approaches
- Intraoperative Adjuncts to Identify Parathyroid Tissue
- Confirmation of Excision of Hyperfunctional Parathyroid Tissue
- CHALLENGING SITUATIONS
- Intraoperative Troubleshooting
- Failure of Adequate 10-Minute Intraoperative PTH Drop
- Conversion to Unilateral or Bilateral Cervical Exploration
- Concomitant Thyroid Disease
- Reoperative Parathyroidectomy
- POSTOPERATIVE CARE
- OUTCOMES
- CHAPTER 42: Standard Cervical Exploration for Primary Hyperparathyroidism
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Intraoperative Nerve Monitoring
- Intraoperative PTH Monitoring
- Parathyroid Identification
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 43: Secondary and Tertiary Hyperparathyroidism as a Consequence of End-Stage Renal Disease
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS AND CLINICAL PRESENTATION
- MULTIMODAL THERAPY/MEDICAL MANAGEMENT
- Phosphate Binders
- Vitamin D Receptor Activators (VDRAs)
- Calcimimetics
- INDICATIONS FOR PARATHYROIDECTOMY
- Preoperative Planning
- SURGICAL TECHNIQUE/EXTENT OF SURGERY
- SPECIAL CONSIDERATIONS FOR THE TECHNIQUE OF PARATHYROIDECTOMY IN PATIENTS WITH SHPT AND THPT
- POSTOPERATIVE CARE
- Complications/Management
- Outcomes
- CHAPTER 44: Parathyroid Carcinoma
- INTRODUCTION
- EPIDEMIOLOGY
- ETIOLOGY AND PATHOPHYSIOLOGY
- Molecular Pathogenesis
- Germline Predisposition
- DIAGNOSIS/CLINICAL PRESENTATION
- Preoperative Suspicion of PC and Clinical Manifestations
- Histologic Features and Immunohistochemical Panel
- Atypical Presentations
- MULTIMODAL THERAPY
- Control of Hypercalcemic Crisis
- Role of Adjuvant Radiotherapy
- Medical Management of Metastatic PC
- Role of Immunotherapy and Target Therapy
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- Imaging Assessment
- Imaging
- Staging (American Joint Committee on Cancer/Union for International Cancer Control)
- Other Considerations for Preoperative Preparation
- SURGICAL TECHNIQUE
- Primary PC Tumor Resection
- Lymph Node Dissection: Central and Radical
- SPECIAL SURGICAL CONSIDERATIONS
- Margins
- Intraoperative Parathyroid Hormone Monitoring in PC
- Parathyroid Tissue Confirmation
- Recurrences and Metastatic Disease
- POSTOPERATIVE CARE
- Short-Term Follow-Up
- Long-Term Follow-Up
- OUTCOMES
- Prognostics Factors
- CONCLUSIONS
- Part C: Adrenal
- CHAPTER 45: Work Up of Adrenal Masses and Preoperative Management of Functional Adrenal Tumors
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/PRESENTATION
- ADRENOCORTICAL CARCINOMA
- BIOCHEMICAL EVALUATION
- MULTIMODAL THERAPY
- IMAGING
- TUMOR SIZE
- SPECIFIC ADRENAL TUMORS
- Aldosteronoma
- Cortisol-Producing Adenoma
- Pheochromocytoma
- Indications and Contraindications
- GENETIC COUNSELING
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 46: Minimally Invasive Adrenalectomy (Laparoscopic and Retroperitoneoscopic)
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- General Preparation and Positioning for TLA
- SURGICAL TECHNIQUE
- Technique for Transabdominal Laparoscopic Adrenalectomy
- Additional Technical Considerations During TLA
- Surgical Technique for Posterior Retroperitoneal Adrenalectomy
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 47: Mastery Keys: Anatomy of Adrenal Glands
- LEFT ADRENAL GLAND (FIGS. 47.4 TO 47.6)
- Blood Supply
- RIGHT ADRENAL GLAND (FIGS. 47.4 TO 47.6)
- Blood Supply
- LYMPHATIC DRAINAGE OF LEFT AND RIGHT ADRENAL GLANDS
- CHAPTER 48: Robotic Adrenalectomy
- INTRODUCTION
- SURGICAL TECHNIQUE
- Patient Positioning and Set-Up
- Right Transabdominal Adrenalectomy
- Left Transabdominal Adrenalectomy
- SURGICAL TECHNIQUE
- Right versus Left Robotic Retroperitoneal Adrenalectomy
- COMPARATIVE OUTCOMES BETWEEN ROBOTIC AND LAPAROSCOPIC ADRENALECTOMY
- CHAPTER 49: Open Adrenalectomy
- INTRODUCTION
- DIAGNOSIS/CLINICAL PRESENTATION
- Disease-Specific Decision Making
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Open Surgical Approaches to the Adrenal Gland
- Open Anterior Transabdominal
- Open Flank—Transabdominal and Retroperitoneal
- Open Posterior (Lumbotomy)
- Thoracoabdominal Approach
- Disease-Specific Considerations and Decision for Extent of Adrenalectomy
- Bilateral Adrenalectomy
- Partial Adrenalectomy
- Disease-Specific Intraoperative Considerations
- POSTOPERATIVE CARE
- Pheochromocytoma
- Primary Aldosteronism
- Hypercortisolism
- Adrenocortical Carcinoma
- Bilateral Adrenalectomy
- Nelson Syndrome
- COMPLICATIONS/MANAGEMENT
- Complications Associated With Operative Approach
- Intraoperative Complications
- Postoperative Complications
- ADDITIONAL CONSIDERATIONS
- Adrenalectomy in Pregnancy
- Adrenalectomy in the Pediatric Population
- OUTCOMES
- Long-Term Follow-Up
- SECTION IV: Breast
- CHAPTER 50: Mastery of Benign Disease and Breast Pain
- INTRODUCTION
- PERCUTANEOUS CORE NEEDLE BIOPSY AND CONCORDANCE
- BENIGN BREAST LESIONS—HISTOPATHOLOGY, MANAGEMENT AFTER CORE NEEDLE BIOPSY, AND LONG-TERM RISKS FOR BREAST CANCER DEVELOPMENT
- Nonproliferative Disease
- FAT NECROSIS
- SUMMARY RECOMMENDATIONS FOR NONPROLIFERATIVE LESIONS (Table 50.1)
- Proliferative Disease Without Atypia
- SUMMARY RECOMMENDATIONS FOR PROLIFERATIVE LESIONS WITHOUT ATYPIA (Table 50.1)
- Atypical Lesions (Papillomas, Hyperplasias, Classic Lobular Carcinoma in Situ)
- SUMMARY RECOMMENDATIONS FOR ATYPICAL LESIONS (Table 50.1)
- Risk Reduction Strategies
- Summary of Benign Breast Disease
- Breast Pain
- CHAPTER 51: Mastery Keys: Surgical Anatomy of Breast
- LYMPHATIC DRAINAGE OF BREAST (Fig. 51.2A,B)
- BLOOD SUPPLY OF BREAST (Fig. 51.2C)
- Arterial Supply
- Venous Drainage
- NIPPLE–AREOLAR COMPLEX (Fig. 51.1)
- INNERVATION
- BLOOD SUPPLY OF NIPPLE AREOLAR COMPLEX (Fig. 51.2C)
- MALE BREAST
- CHAPTER 52: Diagnostic Approach to Breast Abnormalities
- INTRODUCTION
- INDICATIONS/CONTRAINDICATIONS
- PATHOPHYSIOLOGY SCREENING
- MULTIMODALITY IMAGING
- Mammography
- Digital Breast Tomosynthesis (DBT)
- Contrast-Enhanced Spectral Mammography (CESM)
- Breast Ultrasound
- Breast MRI
- SURGICAL TECHNIQUE
- Image-Guided Breast Procedures
- POSTOPERATIVE BIOPSY CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 53: Breast-Conserving Therapy
- INTRODUCTION
- Margins
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Incision Placement
- Surgical Dissection
- Closure
- Breast-Conserving Surgery Following Neoadjuvant Therapy
- Oncoplastic Surgery
- POSTOPERATIVE CARE
- Indications for Re-Excision
- Surveillance
- COMPLICATIONS
- OUTCOMES
- Management of Local Recurrence After BCT
- SUMMARY
- CHAPTER 54: Postoperative Radiation Treatment for Management of Breast Cancer
- INTRODUCTION
- INDICATIONS
- RADIATION PLANNING
- RADIATION TECHNIQUES
- Whole Breast Irradiation
- Indications and Recommendations
- PARTIAL BREAST IRRADIATION
- Rationale and Background
- Accelerated Partial Breast Irradiation
- Multicatheter Brachytherapy APBI
- Single Entry Device Brachytherapy ABPI
- 3DCRT and IMRT APBI
- Indications and Recommendations
- Intraoperative Partial Breast Irradiation
- Electron IORT
- kV IORT
- Indications and Recommendations
- Complications
- CONCLUSIONS
- ACKNOWLEDGMENT
- CHAPTER 55: Ablative Techniques for Benign and Malignant Breast Tumors
- INTRODUCTION
- INDICATIONS/CONTRAINDICATIONS
- PREABLATION PLANNING
- ABLATIVE TECHNIQUES AND OUTCOMES
- RADIOFREQUENCY ABLATION
- OUTCOMES
- CRYOABLATION
- OUTCOMES
- INTERSTITIAL LASER THERAPY
- OUTCOMES
- MICROWAVE ABLATION
- OUTCOMES
- HIGH-INTENSITY FOCUSED ULTRASOUND ABLATION
- OUTCOMES
- IRREVERSIBLE ELECTROPORATION
- OUTCOMES
- SUMMARY
- CHAPTER 56: Treatment of the Axilla
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS AND CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- Evaluation
- SURGICAL TECHNIQUE
- Positioning
- Incision Planning
- Sentinel Lymph Node Biopsy
- Axillary Lymph Node Dissection
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- Long-Term Follow-Up
- Novel Techniques and Future Directions
- Axillary Reverse Mapping
- Immediate Lymphatic Reconstruction
- De-escalation of Surgery
- CHAPTER 57: Mastery Keys: Surgical Anatomy of Axilla and Pectoral Region
- AXILLA
- REGIONAL FASCIA
- Pectoral Fascia (Fig. 57.2A)
- Clavipectoral Fascia (Fig. 57.2B)
- MUSCLES
- Pectoralis Major Muscle (Fig. 57.2A)
- Pectoralis Minor Muscle (Figs. 57.1A and 57.3)
- Latissimus Dorsi (Figs. 57.1A and 57.4)
- Serratus Anterior (Figs. 57.1A, 57.2A, and 57.4)
- NERVES
- Medial and Lateral Pectoral Nerves (Fig. 57.3)
- Long Thoracic Nerve (Figs. 57.1A, 57.3, and 57.4)
- Thoracodorsal Nerve (Figs. 57.3 and 57.4)
- Intercostobrachial Nerve (Fig. 57.1A)
- ARTERIES AND VEINS
- Axillary Artery (Figs. 57.3 and 57.4)
- Axillary Vein (Figs. 57.1A, 57.3, and 57.5A)
- LYMPH NODES (Fig. 57.5)
- Groups of Lymph Nodes
- CHAPTER 58: Lymphedema—Pathophysiology, Prevention, and Treatment
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- Incidence
- RISK FACTORS
- DIAGNOSING LYMPHEDEMA
- STAGING AND EARLY DETECTION
- PREVENTION
- Prediction
- Clinical Trials
- Surgery
- TREATMENT
- Complex Decongestive Therapy
- Exercise
- Surgery
- CHAPTER 59: Simple, Modified, and Radical Mastectomy
- INTRODUCTION
- INDICATIONS
- PREOPERATIVE PLANNING
- Preoperative Workup
- SURGICAL TECHNIQUE: SIMPLE (TOTAL) MASTECTOMY
- Positioning
- Incision
- Boundaries of Mastectomy
- Flap Elevation and Parenchymal Dissection
- SURGICAL TECHNIQUE: MODIFIED RADICAL MASTECTOMY
- Positioning
- Surgical Technique
- Axillary Lymph Node Dissection
- SURGICAL TECHNIQUE: RADICAL MASTECTOMY
- Technique
- MARGINS AFTER MASTECTOMY
- POSTOPERATIVE MANAGEMENT
- Drain Management
- Complications
- CHAPTER 60: Oncoplastic Techniques for Breast Cancer
- INTRODUCTION
- CLASSIFICATION OF TECHNIQUES
- Volume Replacement Techniques
- Volume Replacement Techniques
- INDICATIONS/CONTRAINDICATIONS IN THE SELECTION OF PATIENTS
- Selection of Patients
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Volume Displacement Techniques: Level I
- Volume Displacement Techniques: Level II
- Symmetrization
- POSTOPERATIVE CARE
- Complications/Management
- OUTCOMES
- Oncologic
- Patient Reported Outcomes
- TRAINING IN OPS
- CONCLUSION
- CHAPTER 61: Breast Reconstruction Following Mastectomy
- INTRODUCTION
- INDICATIONS
- PREOPERATIVE PLANNING
- Definition of the Mastectomy Deformity
- PARTIAL MASTECTOMY/LUMPECTOMY
- SURGICAL TECHNIQUES
- TISSUE EXPANSION/IMPLANTS
- RECONSTRUCTION WITH ACELLULAR DERMAL MATRIX
- SURGICAL TECHNIQUE FOR TISSUE EXPANDER/ACELLULAR DERMAL MATRIX
- SURGICAL TECHNIQUE OF MYOCUTANEOUS FLAPS
- SURGICAL TECHNIQUE OF THE LATISSIMUS FLAP
- SURGICAL TECHNIQUE OF THE THORACOEPIGASTRIC FLAP
- SURGICAL TECHNIQUE OF THE TRANSVERSE RECTUS ABDOMINIS MYOCUTANEOUS FLAP
- ONCOPLASTIC SURGERY
- RECONSTRUCTION WITH FAT GRAFTING
- CONTRALATERAL BREAST CONSIDERATIONS
- REDUCTION MAMMAPLASTY AND MASTOPEXY SURGICAL TECHNIQUE
- NIPPLE RECONSTRUCTION TECHNIQUE
- COMPLICATIONS
- Reconstruction Postradiation
- TIMING OF BREAST RECONSTRUCTION
- CONCLUSIONS
- CHAPTER 62: Salvage Surgery for Recurrent/Advanced Carcinoma of the Breast
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- SURGICAL TECHNIQUES
- General Principles
- Ipsilateral Breast Tumor Recurrences
- Chest Wall Recurrences
- Nodal Recurrences
- POSTOPERATIVE CARE
- COMPLICATIONS
- OUTCOMES
- CONCLUSION
- CHAPTER 63: Clinical Trials and Follow-up in Breast Cancer
- INTRODUCTION
- BREAST SURGERY
- NSABP B-04: Radical Mastectomy versus Total Mastectomy
- NSABP B-06: Mastectomy versus Breast-Conserving Surgery (BCS)
- MILAN I: Radical mastectomy versus BCT
- MARGINS
- Margin Guideline Meta-Analysis and Consensus for Invasive and Mixed Cancer Subtypes
- SHAVE trial
- RADIATION TRIALS
- EBCTCG 1081: Meta-Analysis of BCS with and Without RT
- NCIC CTG MA.20: Adding Regional Nodal Irradiation to Whole Breast RT
- CALGB 9343: Omission of Radiation for cT1 N0, ER+, >70 Years Old
- PRIME II: Omission of Radiation for cT1-2 N0 ER +>65 Years Old
- Partial Breast RT: TARGIT-A, ELIOT
- NONINVASIVE (DCIS) BREAST CANCER
- NSABP B-17, B-24, B-35: BCT for Patients with DCIS
- EORTC 10853
- ECOG-ACRIN E5194
- Margin Guideline Meta-Analysis and Consensus for Noninvasive Breast Cancer
- Future Directions (COMET, LORIS, LORD): Active Surveillance for Low-Risk DCIS
- AXILLARY SURGERY
- NSABP B-32: Safety of SLNB
- ACOSOG Z0010: Safety of SLNB and Risk Factors for Regional Nodal Recurrences
- ALMANAC: SLNB versus ALND on Arm Mobility and Quality of Life
- SNAC: SLNB Reduces Arm Morbidity
- IBCSG 23.01: Omission of ALND in Patients with Micrometastasis
- ACOSOG Z0011: Omission of ALND in Patients with 1 to 2 Positive Nodes After SLNB
- EORTC 10981 to 22023 AMAROS: ALND versus RT in Patients with Clinical N0 That are Found to be N+
- SENTINA: Timing of SLNB in Relation to Neoadjuvant Chemotherapy
- ACOSOG Z1071: SLNB Following NAC in cN+ Patients
- Targeted Axillary Dissection (TAD)
- SN FNAC: Using Immunohistochemistry (IHC) Reduces FNR
- A11202: Noninferiority Trial Comparing RT to Surgery in N+ Patients After NAC
- A221702: Axillary Reverse Mapping (ARM) Procedure to Prevent Lymphedema
- SentiNot: Preoperative Injection of Superparamagnetic Iron Oxide Particles for Patients with DCIS Who May Benefit From Delayed Axillary Evaluation
- SYSTEMIC CONSIDERATIONS
- NSABP B-14, NSABP B-21: Introduction of Tamoxifen
- TUMOR GENOMICS
- Oncotype DX
- TAILORx
- RxPONDER
- CONCLUSION
- CHAPTER 64: Management of Breast Cancer in Special Presentations
- INTRODUCTION
- BREAST CANCER IN PREGNANCY AND LACTATION
- BREAST CANCER IN MEN
- AXILLARY LYMPHADENOPATHY WITH UNKNOWN PRIMARY
- INFLAMMATORY BREAST CANCER
- METAPLASTIC BREAST CANCER
- PAGET’S DISEASE
- BILATERAL BREAST CANCER
- BREAST SARCOMA/ANGIOSARCOMA
- PHYLLODES TUMORS
- CHAPTER 65: Quality Measure and Outcomes in Breast Cancer
- INTRODUCTION
- THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY (ASCO)
- AMERICAN COLLEGE OF SURGEONS NATIONAL SURGICAL QUALITY IMPROVEMENT DATABASE PROGRAM
- COMMISSION ON CANCER
- AMERICAN COLLEGE OF SURGEONS AND COMMISSION ON CANCER OPERATIVE STANDARDS AND SYNOPTIC OPERATIVE REPORTING
- CONCLUSION
- CHAPTER 66: Molecular Staging and Its Implication in Treating Breast Cancer
- INTRODUCTION
- STAGING OF BREAST CANCER–DEFINING PROGNOSIS AND TREATMENT
- LIMITATIONS OF ANATOMIC BREAST CANCER STAGING
- BREAST CANCER AS A FAMILY OF SEPARATE CANCER TYPES
- BREAST CANCER SUBTYPES
- INCORPORATION OF MOLECULAR/NONANATOMIC FACTORS IN CANCER STAGING
- PROGNOSTIC STAGING: THE AJCC APPROACH TO TNM STAGING
- OTHER KEY ISSUES WITH PROGNOSTIC STAGING
- CONCLUSION AND FUTURE DIRECTIONS
- SECTION V: Melanoma and Soft Tissue Tumors
- Part A: Cutaneous Lesions
- CHAPTER 67: Workup of Suspicious Cutaneous Lesions to Melanoma and Soft Tissue Tumors
- INTRODUCTION
- DIAGNOSIS/CLINICAL PRESENTATION
- Clinical Presentation/History
- Physical Exam
- Diagnostic Evaluation
- Punch Biopsy
- Shave Biopsy
- Excisional Biopsies
- Incisional Biopsy
- Fine Needle Aspiration Biopsy (FNAB)
- Core Needle Biopsy (CNB)
- Next Steps After Tissue Diagnosis
- CHAPTER 68: Malignant Melanoma
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS AND CLINICAL PRESENTATION
- MULTIMODALITY THERAPY—SURGERY
- MULTIMODALITY THERAPY—ADJUVANT THERAPY FOR STAGE II AND III MELANOMA
- MULTIMODALITY THERAPY—NEOADJUVANT THERAPY FOR STAGE III AND IV MELANOMA
- MULTIMODALITY THERAPY—SYSTEMIC THERAPY FOR STAGE III AND IV MELANOMA
- MULTIMODALITY THERAPY—REGIONAL CHEMOTHERAPY FOR IN-TRANSIT DISEASE
- OUTCOMES AND SPECIAL SITUATIONS
- MELANOMA OF UNKNOWN PRIMARY
- MELANOMA ARISING IN PREGNANCY
- DESMOPLASTIC MELANOMA
- HEAD AND NECK MELANOMA INCLUDING LENTIGO MALIGNA
- HAND AND FOOT MELANOMA
- PEDIATRIC MELANOMA AND ATYPICAL SPITZOID TUMORS
- ANAL MELANOMA
- CHAPTER 69: Merkel Cell Cancer
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- Staging
- MULTIMODAL THERAPY
- ADJUVANT AND NEOADJUVANT OPTIONS
- Adjuvant Radiation
- Immunotherapy
- Adjuvant
- Neoadjuvant
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Wide Local Excision
- Sentinel Lymph Node Biopsy
- Therapeutic Lymph Node Dissection
- POSTOPERATIVE CARE
- OUTCOMES
- CHAPTER 70: Cutaneous Squamous Cell Carcinoma
- INTRODUCTION
- Etiology and Pathophysiology
- DIAGNOSIS/CLINICAL PRESENTATION
- PREOPERATIVE PLANNING
- TREATMENT
- Localized Disease
- LOCAL TUMOR DESTRUCTION
- SURGICAL TECHNIQUE
- Conventional Excision and Management of the Nodal Basin
- Total Margin-Controlled Excision (TMCE)/Mohs Micrographic Surgery (MMS)
- Primary Radiation Therapy (RT)
- ADVANCED DISEASE
- Management of Regional/Systemic Disease
- INDICATIONS/CONTRAINDICATIONS
- Surgery
- Radiation
- Systemic Therapy
- POSTOPERATIVE CARE
- OUTCOMES
- CHAPTER 71: Basal Cell Carcinoma
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS AND CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- OUTCOMES
- Part B: Soft Tissue Sarcomas
- CHAPTER 72: Extremity Sarcomas
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- Confirming the Diagnosis
- Staging
- MULTIMODAL THERAPY
- Radiation Therapy for High-Grade Tumors
- Preoperative versus Postoperative Radiation
- Radiation Therapy for Low-Grade Tumors
- Chemotherapy
- INDICATIONS/CONTRAINDICATIONS
- Surgery
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Surgical Treatment of Locoregional Disease
- Surgery After an Unplanned Excision
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- Local Recurrence
- Metastatic Disease
- CHAPTER 73: Retroperitoneal Sarcoma
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- Genetic Syndromes
- Radiation Exposure
- Histology
- Specific Sarcoma Histologies and Associated Mutations and Translocations
- CLINICAL PRESENTATION/DIAGNOSIS
- Presentation
- Diagnosis
- Staging
- MULTIMODAL THERAPY
- Neoadjuvant Therapy
- Adjuvant Therapy
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- Extent of Resection
- Preoperative Optimization
- Multidisciplinary Surgical Team
- SURGICAL TECHNIQUE
- Margin Status
- Vascular Resection
- POSTOPERATIVE CARE
- Acute Postoperative Care
- COMPLICATIONS/MANAGEMENT
- Complications
- Surveillance
- OUTCOMES
- Survival
- Local Recurrence
- Distant Recurrence
- SUMMARY
- Part C: Plastic and Reconstructive Surgery
- CHAPTER 74: Plastic and Reconstructive Surgery for Melanoma and Soft Tissue Tumors
- INTRODUCTION
- HEALING BY SECONDARY INTENT
- PRIMARY CLOSURE
- SKIN GRAFTS
- Split-Thickness Skin Graft
- Full-Thickness Skin Graft
- SKIN SUBSTITUTES
- FLAPS
- Local Flaps
- Axial Flaps
- Perforator Flaps
- Regional Flaps
- Free Flaps
- PREOPERATIVE PLANNING
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- Part D: Lymph Node Dissections
- CHAPTER 75: Management of the Inguinal Lymph Node Basin for Melanoma
- INTRODUCTION
- SENTINEL LYMPH NODE BIOPSY
- COMPLETION INGUINAL LYMPH NODE DISSECTION
- THERAPEUTIC LYMPH NODE DISSECTION
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- LONG-TERM FOLLOW-UP
- CHAPTER 76: Mastery Keys: Anatomy of Inguinal Lymph Node Dissection
- SUPERFICIAL INGUINAL NODES (Fig. 76.1)
- DEEP INGUINAL NODES (FIGS. 76.1 AND 76.2B)
- Relationships of Lymph Nodes to Surrounding Structures
- SECTION VI: CHEST WALL, ESOPHAGEAL CANCER, LUNG, AND MEDIASTINUM
- CHAPTER 77: Airway Procedures
- INTRODUCTION
- BASIC PRINCIPLES
- THE SCOPES
- Rigid Bronchoscope
- Flexible Bronchoscope
- Linear Endobronchial Ultrasound (CP-EBUS)
- Combination
- EQUIPMENT AND TOOLS
- Forceps
- Brush
- Needle
- Radial Probe Endobronchial Ultrasound (RP-EBUS)
- Airway Balloon
- Basket
- Bronchial Blocker
- Endobronchial Valves
- Thermal Airway Treatment
- Cryotherapy
- Brachytherapy
- Phototherapy
- AIRWAY PROCEDURES
- Airway Stent
- Transbronchial Needle Aspiration Guided by Endobronchial Ultrasound (EBUS-TBNA)
- Foreign Body Removal
- Airway Dilation
- Tumor Debulking
- EMERGING TECHNOLOGIES
- Thin CP-EBUS/Next-Generation CP-EBUS
- Navigational Bronchoscopy
- Robotic-Assisted Bronchoscopy
- CHAPTER 78: Mastery Keys: Bronchoscopic Anatomy of Tracheobronchial Tree
- Right Bronchial Tree (Fig. 78.2)
- Left Bronchial Tree (Fig. 78.2)
- Bronchopulmonary Segments (Fig. 78.2)
- CHAPTER 79: Resection and Reconstruction of the Trachea
- INTRODUCTION
- ETIOLOGY
- CLINICAL PRESENTATION
- INDICATIONS FOR TRACHEAL SURGERY
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Basic Principles
- Anesthesia
- Anterior Cervical Approach
- Transthoracic Approach
- Carinal Resection
- Laryngotracheal Resection in Benign Stenosis
- Laryngotracheal Resection for Tumor
- Tracheoesophageal Fistula
- Reoperative Tracheal Surgery
- POSTOPERATIVE CARE
- COMPLICATIONS OF TRACHEAL RESECTIONS
- OUTCOMES
- CHAPTER 80: Chest Wall Resection and Reconstruction
- INTRODUCTION
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE FOR RESECTION AND RECONSTRUCTION OF THE BONY CHEST WALL
- General Considerations
- Principles Governing the Use of Prosthetic Materials
- Synthetic Materials
- Biologic Materials
- Technical Details Related to the Location of the Chest Wall Resection
- COMPLICATIONS OF BONY CHEST WALL RESECTION AND RECONSTRUCTION AND THEIR MANAGEMENT
- SURGICAL TECHNIQUE FOR SOFT TISSUE RECONSTRUCTION
- General Principles
- Planning of Soft Tissue Reconstruction
- Surgical Technique Related to the Location of Chest Wall Reconstruction
- COMPLICATIONS OF SOFT TISSUE RECONSTRUCTION AND THEIR MANAGEMENT
- OUTCOMES
- CHAPTER 81: Mastery Keys: Surgical Anatomy of Chest Wall
- SKELETON OF THORACIC WALL (Fig. 81.1)
- INTRINSIC MUSCULATURE (Fig. 81.2)
- EXTRINSIC MUSCULATURE (FIGS. 81.3 TO 81.5)
- NERVES OF THORACIC WALL (Fig. 81.6)
- VASCULATURE OF THORAX (FIGS. 81.2, 81.6, AND 81.7)
- DIAPHRAGM (Fig. 81.8)
- CHAPTER 82: Pulmonary Resection
- INTRODUCTION
- History of Pulmonary Resection for Lung Cancer
- Future of “Minimally Invasive Surgery”
- SURGICAL TECHNIQUE
- Thoracotomy
- Pulmonary Resection Procedures
- POSTOPERATIVE CARE AND MANAGEMENT OF COMPLICATIONS
- CHAPTER 83: Video-Assisted Thoracic Surgery (VATS) Resection
- INTRODUCTION
- History
- Current Prevalence
- INDICATIONS/CONTRAINDICATIONS
- SURGICAL TECHNIQUE
- Instrumentation
- Anesthesia
- Positioning
- Port-Site Placement
- Procedure
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- Disparities in VATS
- CHAPTER 84: Mastery Keys: Surgical Anatomy of Lungs
- CHAPTER 85: Robotic-Assisted Thoracoscopic Surgery and Resection
- INTRODUCTION
- Adoption and Learning Curve
- Robotic Platform and Instruments
- Principles of Robot-Assisted Thoracic Surgery
- INDICATIONS
- CONTRAINDICATIONS
- PREOPERATIVE AND INTRAOPERATIVE PLANNING
- Preoperative Planning
- Intraoperative Set Up
- SURGICAL TECHNIQUE
- Robotic Lobectomy
- Robotic Segmentectomy
- Upper Lobe Segmentectomy
- Lower Lobe Segmentectomy
- Superior Segmentectomy (S6)
- Basilar Segmentectomy (S7–10)
- Advanced Lung Cancer Resections: Sleeve Lobectomy and Bronchoplasty/Chest Wall
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- FUTURE DIRECTIONS
- CONCLUSION
- CHAPTER 86: Open Procedures for Esophagectomy
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Ivor Lewis Esophagogastrectomy
- McKeown Esophagogastrectomy
- Esophagogastrectomy via Left Thoracoabdominal Incision
- Colon Interposition for Esophageal Reconstruction
- Additional Procedures for Esophageal Reconstruction
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES AND FOLLOW-UP
- CHAPTER 87: Mastery Keys: Surgical Anatomy of Thoracic and Abdominal Esophagus
- ARTERIAL SUPPLY (Fig. 87.3)
- VENOUS DRAINAGE
- LYMPHATIC DRAINAGE (Fig. 87.1B)
- INNERVATION (Fig. 87.2B)
- CHAPTER 88: Minimally Invasive Esophagectomy
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY OF ESOPHAGEAL CANCER
- CLINICAL PRESENTATION AND DIAGNOSIS
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Anesthesia Considerations
- Minimally Invasive Ivor Lewis Esophagectomy
- Thoracic Phase
- Anastomosis
- Completion
- Minimally Invasive McKeown Esophagectomy
- Lymph Node Harvest
- Postoperative Care
- Complications/Management
- Outcomes
- CHAPTER 89: Esophageal Cancer: Robotic-Assisted Minimally Invasive Esophagectomy
- INTRODUCTION
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Laparoscopy
- Thoracoscopy
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- Conduit-Airway Fistula
- Bleeding
- Recurrent Laryngeal Nerve Injury
- Paraconduit Hernia
- OUTCOMES
- Operative Outcomes
- Quality of Life Outcomes
- Comparison With Other Approaches
- Learning Curve
- CHAPTER 90: Transhiatal Esophagectomy
- INTRODUCTION
- PATHOPHYSIOLOGY
- INDICATIONS AND CONTRAINDICATIONS
- PATIENT SELECTION AND PREOPERATIVE PREPARATION
- SURGICAL TECHNIQUE
- Abdominal Phase
- Cervical Phase
- Mediastinal (Transhiatal) Dissection
- Cervical Esophagogastric Anastomosis
- POSTOPERATIVE CARE
- COMPLICATIONS AND THEIR MANAGEMENT
- Mediastinal Bleeding
- Tracheal Injury
- OUTCOMES
- CHAPTER 91: The Management of Pleural Disease
- ANATOMY
- Function of the Pleura
- PLEURAL EFFUSION
- DIAGNOSIS
- Pleural Fluid Analysis
- SURGICAL TECHNIQUE
- Surgical Pleurodesis Technique
- COMPLICATIONS/MANAGEMENT
- Re-Expansion Pulmonary Edema
- Hepatic Hydrothorax
- Chylothorax
- Empyema
- Hemothorax
- PNEUMOTHORAX
- PRIMARY SPONTANEOUS PNEUMOTHORAX
- Treatment of PSP
- SECONDARY SPONTANEOUS PNEUMOTHORAX
- Treatment of SSP
- TRAUMATIC PNEUMOTHORAX
- TENSION PNEUMOTHORAX
- Special Circumstances
- PLEURAL MESOTHELIOMA
- PATHOGENESIS
- HISTOLOGY
- EPIDEMIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- Physical Examination
- Imaging
- Diagnosis
- TREATMENT
- Extrapleural Pneumonectomy
- CHAPTER 92: Management of Mediastinal Masses
- INTRODUCTION
- DIAGNOSIS AND CLINICAL PRESENTATION: GENERAL PRINCIPLES
- Imaging
- Laboratory Studies
- Role for Biopsy
- Operative and Anesthetic Considerations
- ANTERIOR MEDIASTINAL MASSES
- Thymic Epithelial Neoplasms
- Germ Cell Tumors
- Lymphomas
- Thyroid and Endocrine Lesions
- Middle Mediastinal Masses
- Posterior Mediastinal Masses
- CHAPTER 93: Mastery Keys: Surgical Anatomy of Mediastinum (Noncardiac)
- SUPERIOR MEDIASTINUM (Fig. 93.2)
- GREAT VESSELS (FIGS. 93.2, 93.3 AND 93.6)
- Nerves (Figs. 93.3, 93.4, and 93.8)
- Trachea (Fig. 93.4)
- Esophagus (Fig. 93.2)
- ANTERIOR MEDIASTINUM (Fig. 93.1)
- Thymus (Fig. 93.3A)
- MIDDLE MEDIASTINUM (FIGS. 93.3 AND 93.5)
- POSTERIOR MEDIASTINUM
- Thoracic Aorta (Figs. 93.2, 93.4, and 93.6)
- Esophagus (Figs. 93.2 and 93.6B)
- Azygos System of Veins (Figs. 93.6 and 93.7)
- Thoracic Duct (Fig. 93.7)
- Lymph Nodes of Mediastinum (Fig. 93.8)
- Thoracic Sympathetic Trunk (Fig. 93.9)
- SECTION VII: BENIGN FOREGUT AND STOMACH
- Part A: The Esophagus
- CHAPTER 94: Minimally Invasive Antireflux Surgery—Fundoplication
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- Medical
- Surgical
- INDICATIONS/CONTRAINDICATIONS
- A Note on Barrett Esophagus
- PREOPERATIVE PLANNING
- Anatomic Assessment
- Functional Assessment
- SURGICAL TECHNIQUE
- Basic Tenets of Antireflux Surgery
- Choice of Approach
- Technical Principles of Fundoplication
- Informed Consent
- Patient Positioning and Equipment
- Abdominal Access and Port Placement
- Initial Dissection
- Fundoplication
- Port Removal and Closure
- Minimally Invasive Partial Fundoplication
- POSTOPERATIVE CARE
- Pain Control
- Mobilization
- Oral Intake
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 95: Mastery Keys: Anatomy of Diaphragm
- CHAPTER 96: Minimally Invasive Paraesophageal Hernia Repair
- INTRODUCTION
- CLINICAL PRESENTATION
- DIAGNOSIS
- INDICATION FOR TREATMENT
- PRINCIPLES OF REPAIR
- SURGICAL ANATOMY
- SURGICAL TECHNIQUE
- Preparation and Positioning
- Incisions and Exposure
- Hernia Sac Reduction and Crural Dissection
- Assessing Esophageal Length
- Crural Closure
- Assessing for Tension and Relaxing Incisions
- Fundoplication
- CONCLUDING THE OPERATION
- POSTOPERATIVE MANAGEMENT
- OUTCOMES
- CHAPTER 97: Endoluminal Therapies for Gastroesophageal Reflux Disease
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS AND CLINICAL PRESENTATION
- MULTIMODALITY THERAPY
- INDICATIONS AND CONTRAINDICATIONS
- RADIO FREQUENCY ENERGY APPLICATION TO THE LOWER ESOPHAGEAL SPHINCTER (STRETTA)
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE AND COMPLICATIONS
- OUTCOMES
- TRANSORAL INCISIONLESS FUNDOPLICATION (ESOPHYX)
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE AND COMPLICATIONS
- OUTCOMES
- ANTIREFLUX MUCOSAL INTERVENTIONS
- SURGICAL TECHNIQUE
- OUTCOMES
- SUMMARY
- CHAPTER 98: Revisional Operations for Fundoplication Failure
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Step 1. Controlling the Hiatal Contents (Fig. 98.6)
- Step 2. Performing the External Hiatal Dissection (Fig. 98.7)
- Step 3. Dissecting the Mediastinum and Establishing Intra-Abdominal Esophageal Length (Fig. 98.8)
- Step 4. Taking Down the Fundoplication and Restoring the Stomach to Normal Anatomy (Fig. 98.9)
- Step 5. Identifying the GE Junction Definitively
- Step 6. Closing the Hiatus (Fig. 98.13)
- Step 7. Performing an Appropriate Antireflux Procedure (Fig. 98.14)
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- Long-Term Follow-Up
- CHAPTER 99: Magnetic Sphincter Augmentation for GERD
- INTRODUCTION
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- COMPLICATIONS
- Erosions
- OUTCOMES
- CHAPTER 100: Nissen–Rossetti Antireflux Fundoplication (Open Procedure)
- INDICATIONS
- PREOPERATIVE PLANNING
- Preoperative Investigations
- SURGICAL TECHNIQUE
- Positioning and Instrumentation
- Hiatal Dissection
- Hiatal Repair
- Fundoplication
- POSTOPERATIVE CARE
- TECHNIQUE FOR LARGE HIATAL HERNIA
- ADDITIONAL PROCEDURES
- REOPERATIVE SURGERY
- COMPLICATIONS
- Postfundoplication Side Effects
- Failure
- OUTCOMES
- CONCLUSIONS
- ACKNOWLEDGMENT
- CHAPTER 101: Modified Hill Repair for Gastroesophageal Reflux
- INDICATIONS AND PREOPERATIVE PLANNING
- OPEN HILL OPERATION: SURGICAL TECHNIQUE
- RESULTS
- LAPAROSCOPIC HILL OPERATION: SURGICAL TECHNIQUE
- DISCUSSION
- ACKNOWLEDGMENT
- CHAPTER 102: Minimally Invasive Treatment of Achalasia and Other Esophageal Dysmotility
- INTRODUCTION
- ETIOLOGY/PHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- HELLER MYOTOMY: INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PREPARATION
- SURGICAL TECHNIQUE
- Laparoscopic Esophagocardiomyotomy
- Robotic-Assisted Laparoscopic Esophagomyotomy
- Thoracoscopic Esophagomyotomy
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- OTHER ESOPHAGEAL MOTILITY DISORDERS
- Primary Esophageal Motility Disorder
- HYPERTENSIVE LOWER ESOPHAGEAL SPHINCTER
- CONCLUSION
- CHAPTER 103: Peroral Endoscopic Myotomy for Achalasia
- INTRODUCTION
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Setup
- Diagnostic Endoscopy
- Mucosotomy
- Submucosal Tunnel Creation
- Myotomy
- Endoscopic Functional Luminal Imaging Probe
- Mucosal Closure
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- Symptomatic Outcomes and GERD
- POEM as a Revisional Operation
- When POEM Is Preferred Over Heller
- When Heller Is Preferred Over POEM
- CONCLUSION
- Part B: The Stomach and Duodenum
- CHAPTER 104: Pathology and Treatment of Zenker Diverticulum
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS/PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Positioning
- Technique
- Postoperative Care
- Endoscopic Approaches
- Positioning
- Technique
- COMPLICATIONS
- Outcomes
- CHAPTER 105: Mastery Keys: Surgical Anatomy of Cervical Esophagus
- CHAPTER 106: Percutaneous Endoscopic Gastrostomy
- INTRODUCTION
- INDICATIONS AND CONTRAINDICATIONS
- TECHNIQUE
- POTENTIAL COMPLICATIONS
- EXPANDED APPLICATIONS OF PEG TECHNIQUE
- CONCLUSION
- CHAPTER 107: Mastery Keys: Surgical Anatomy of Stomach
- VASCULATURE (Fig. 107.4)
- Left Gastric Artery
- Splenic Artery
- Common Hepatic Artery
- INNERVATION
- Parasympathetic Innervation
- Sympathetic Innervation (Fig. 107.6C)
- Intramural Plexuses
- LYMPHATIC DRAINAGE
- CHAPTER 108: Surgical Management of Gastroparesis
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- CLINICAL PRESENTATION/DIAGNOSIS
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- SURGICAL TECHNIQUES
- PEG Decompression/Feeding Tube
- Per-Oral Pyloromyotomy
- Pyloroplasty
- Gastric Electric Stimulation
- Sleeve Gastrectomy
- Subtotal/Total Gastrectomy
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- Per-Oral Pyloromyotomy
- Laparoscopic Pyloroplasty
- Implantable Gastric Stimulator
- Sleeve Gastrectomy
- Sub-Total, Total Gastrectomy
- CONCLUSION
- CHAPTER 109: Endoscopic Management of Gastroparesis
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS AND CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Step 1: Submucosal Injection
- Step 2: Mucosal Incision
- Step 3: Tunneling
- Step 4: Division of the Pylorus
- Step 5: Closure of the Mucosotomy
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 110: Selective and Nonselective Vagotomies
- INTRODUCTION
- INDICATIONS
- ANATOMY
- SURGICAL TECHNIQUE
- Preoperative Preparation
- Open Truncal Vagotomy
- Open Selective Vagotomy and Pyloroplasty
- Heineke–Mikulicz Pyloroplasty
- Finney Pyloroplasty
- Highly Selective Vagotomy Open
- Laparoscopic
- POSTOPERATIVE CARE
- COMPLICATIONS
- OUTCOMES
- ACKNOWLEDGMENT
- CHAPTER 111: Mastery Keys: Surgical Anatomy of Vagus Nerve
- NECK (Fig. 111.2)
- THORAX
- ABDOMEN
- CHAPTER 112: Distal Gastrectomy: Open and Minimally Invasive Techniques
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Resection
- Reconstruction
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- CHAPTER 113: Gastric Cancer
- INTRODUCTION
- DIAGNOSIS/CLINICAL PRESENTATION
- STAGING
- MULTIMODAL THERAPY
- PREOPERATIVE PLANNING
- SURGICAL CONSIDERATIONS
- Extent of Luminal Resection
- Extent of Lymph Node Dissection
- Extent of Adjacent Organ Resection
- Minimally Invasive Approaches
- SURGICAL TECHNIQUE
- Subtotal or Total Gastrectomy and D2 Lymphadenectomy
- Greater Curvature Mobilization
- Infrapyloric Mobilization
- Suprapyloric Mobilization
- Duodenal Transection
- D2 Lymphadenectomy
- Gastric or Esophageal Transection
- RECONSTRUCTION
- POSTOPERATIVE CARE
- COMPLICATIONS
- OUTCOMES
- CHAPTER 114: Gastrointestinal Stromal Tumors
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- Role for Germline Testing
- DIAGNOSIS AND CLINICAL PRESENTATION
- STAGING
- RISK STRATIFICATION
- MULTIMODAL THERAPY
- SURGICAL TECHNIQUE
- Gastric GIST
- Endoscopic Full Thickness Resection (EFTR)
- Submucosal Tunneling Endoscopic Resection (STER)
- Transgastric Resection of GIST/Laparoendoscopic Cooperative Surgery (LECS)
- Duodenal GIST
- Jejunal and Ileal GIST
- Rectal GIST
- Esophageal GIST
- Unresectable, Recurrent, and Metastatic Disease
- POSTOPERATIVE CARE
- Surveillance
- Adjuvant Therapy
- OUTCOMES
- CHAPTER 115: Postgastrectomy Syndromes and Related Bariatric Problems in the Current Era
- INTRODUCTION
- GENERAL REVIEW OF RELEVANT OPERATIONS
- Gastric Resections
- Therapeutic Vagotomy
- Esophagogastrectomy Procedures
- Nonresective Procedures at the Esophagogastric Junction
- Bariatric Procedures
- Mechanical Disorders
- Functional Disorders
- Metabolic
- CHAPTER 116: Superior Mesenteric Artery Syndrome
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- Differential Diagnosis
- MANAGEMENT
- SURGICAL TECHNIQUE
- Duodenojejunostomy
- Division of the Ligament of Treitz
- OUTCOMES
- Part C: Bariatric and Metabolic Diseases
- CHAPTER 117: Diabetes and Other Metabolic Diseases
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- Indications
- Contraindications
- Preoperative Considerations
- SURGICAL TECHNIQUE
- Common Surgical Procedures for Obesity and Metabolic Disease
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- Safety and Complications of Metabolic Surgery
- Mechanisms of Metabolic Change
- OUTCOMES
- Weight Loss
- Diabetes
- Dyslipidemia
- Cardiovascular Disease
- Life Expectancy and Mortality
- CONCLUSIONS
- CHAPTER 118: Minimally Invasive Roux-en-Y Gastric Bypass
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Jejunojejunostomy
- Concomitant Operations
- Final Steps
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CONCLUSIONS
- CHAPTER 119: Minimally Invasive Vertical Sleeve Gastrectomy
- INTRODUCTION
- INDICATIONS AND CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- COMPLICATIONS AND THEIR MANAGEMENT
- OUTCOMES
- CHAPTER 120: The Laparoscopic Gastric Band Technique of Placement
- INTRODUCTION
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Perioperative Care
- Operative Position and Port Placement
- Dissection at the Angle of His
- Dissection of the Anterior Fat Pad
- Dissection on the Lesser Curve
- Passing the Lap Band Placer
- Selection of Lap Band Size
- Positioning, Calibrating, and Closing the Lap Band
- Anterior Fixation
- Fixation of the Access Port
- POSTOPERATIVE CARE
- COMPLICATIONS
- OUTCOMES
- CHAPTER 121: Laparoscopic Biliopancreatic Diversion with Duodenal Switch
- INTRODUCTION
- History of the Procedure
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Laparoscopic BPD-DS Technique
- Laparoscopic SADI-S Technique
- Robotic Technique
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- BPD-DS Results
- SADI-S Results
- BPD-DS as a Revision after Failed Weight Loss
- CHAPTER 122: Endoscopic Primary Bariatric Therapies
- INTRODUCTION
- ENDOLUMINAL SPACE-OCCUPYING DEVICES
- Intragastric Balloons
- Orbera (Apollo Endosurgery, Austin, TX)
- Spatz3 (Spatz FGIA Inc., Fort Lauderdale, FL)
- Obalon (ReShape Lifesciences Inc., San Clemente, CA)
- ReShape Duo Integrated Dual Balloon System (ReShape Medical Inc, San Clemente, CA)
- TransPyloric Shuttle (BAROnova, Goleta, CA)
- RESTRICTIVE THERAPY
- Endoscopic Sleeve Gastroplasty
- Primary Obesity Surgery Endoluminal (POSE)
- MALABSORPTIVE THERAPY
- AspireAssist (Aspire Bariatrics, King of Prussia, PA)
- EndoBarrier Gastrointestinal Liner System (GI Dynamics, Boston, MA)
- Revita System (Fractyl Laboratories, Inc., Lexington, MA)
- CONCLUSION
- CHAPTER 123: Management of Acute Complications of Bariatric Surgery
- INTRODUCTION
- COMPLICATIONS AFTER SLEEVE GASTRECTOMY
- Gastrointestinal Leak
- Bleeding
- Bowel Obstruction: Stenosis or Twisting
- Portomesenteric Vein Thrombosis
- COMPLICATIONS AFTER ROUX-EN-Y GASTRIC BYPASS
- Gastrointestinal Leak
- Bleeding
- Bowel Obstruction
- Marginal Ulcer
- COMPLICATIONS FOLLOWING LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING PROCEDURES
- Gastric Prolapse
- Band Erosion
- CONCLUSION
- CHAPTER 124: Revisional Bariatric Surgery
- INTRODUCTION
- ETIOLOGY/PATHOPHYSIOLOGY
- Diagnosis/Clinical Presentation
- Preoperative Planning
- Revisions and Conversions for Complications
- Revisions for Complications of Roux-en-Y Gastric Bypass
- Complications of Sleeve Gastrectomy
- Revisions for Weight Regain and Weight-Related Comorbid Diseases
- POSTOPERATIVE CARE
- OUTCOMES
- CHAPTER 125: Median Arcuate Ligament Syndrome (MALS)
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- RADIOLOGIC STUDIES
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Laparoscopic Technique (Video 125.1)
- Robotic Technique
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- Case 1
- Case 2
- Case 3
- Patient Selection
- OUTCOMES
- SECTION VIII: Colon and Rectal Surgery
- Part A: Small Intestine
- CHAPTER 126: Clinical Anatomy for Procedures Involving the Small Bowel, Colon, Rectum, and Anus
- INTRODUCTION
- SMALL BOWEL ANATOMY FOR COLORECTAL PROCEDURES
- CECUM AND APPENDIX
- ASCENDING COLON
- TRANSVERSE COLON
- DESCENDING COLON
- SIGMOID COLON
- BLOOD SUPPLY OF THE COLON
- LYMPHOID DRAINAGE AND INNERVATION OF THE COLON
- THE URETERS
- OMENTUM
- RECTUM
- ANUS
- ANORECTAL BLOOD SUPPLY
- LYMPHATIC DRAINAGE OF THE ANORECTUM
- INNERVATION OF THE ANORECTUM
- Replacement of Organ Function
- Obtaining Extra Bowel Length
- Buttressing Anastomoses/Repairs
- Importance of Anatomical Knowledge in Avoiding Organ Injury
- CHAPTER 127: Small Bowel Obstruction after Total Colectomy
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- CLINICAL PRESENTATION
- CONSERVATIVE THERAPY
- INDICATIONS/CONTRAINDICATIONS
- Small Bowel Obstruction within 6 Weeks of a Prior Laparotomy
- Small Bowel Obstruction Following a Remote Laparotomy
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Open Lysis of Adhesions
- Laparoscopic Approach
- Desmoids
- Crohn’s Disease
- Intra-abdominal Abscesses
- Special Scenario of Small Bowel Adherent in the Pelvis after a Prior Pelvic Procedure
- Radiation
- Malignant Obstruction
- Assessing for Ischemic Bowel
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 128: The Continent Ileostomy
- INTRODUCTION
- HISTORICAL BACKGROUND AND RATIONALE
- CURRENT INDICATIONS AND CONTRAINDICATIONS
- THE OPERATION
- POSTOPERATIVE AND POSTHOSPITALIZATION CARE
- RESULTS
- REVISIONAL SURGERY
- Pouch Malfunction from Valve Failure
- Failed Ileoanal Anastomosis Converted to Kock Pouch
- POUCHITIS SYNDROME
- QUALITY OF LIFE
- ACKNOWLEDGMENTS
- CHAPTER 129: Technique of Ileostomy Construction and Closure
- INTRODUCTION
- INDICATIONS/CONTRAINDICATIONS
- End Ileostomy
- Loop Ileostomy
- PREOPERATIVE PLANNING
- Preoperative Consent
- Ostomy Education
- Ostomy Marking
- SURGICAL TECHNIQUE
- End Ileostomy
- Loop Ileostomy
- End Loop Ileostomy
- Divided Loop Ileostomy
- Trephine Ileostomy Creation
- POSTOPERATIVE CARE
- Output Management
- Ostomy Care
- COMPLICATIONS AND MANAGEMENT
- Early Complications
- After Discharge or Late Complications
- ILEOSTOMY CLOSURE
- Technique
- Complications
- CHAPTER 130: Gastrointestinal-Cutaneous Fistulas
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- Surgical
- Spontaneous
- DIAGNOSIS/CLINICAL PRESENTATION
- Clinical Presentation
- Diagnostic Testing
- MULTIMODAL THERAPY
- Source Control
- Wound Care
- Measurement and Reduction of Fistula Output
- Special Medication Considerations in Crohn’s Disease
- Nutrition
- INDICATIONS/CONTRAINDICATIONS
- Likelihood of Nonoperative Closure
- PREOPERATIVE PLANNING
- Timing
- Nutrition
- Optimization of Additional Patient Risk Factors
- Imaging
- Bowel Preparation and Antibiotics
- SURGICAL TECHNIQUE
- Endoscopic
- Surgical
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 131: Surgical Treatment of Small Bowel Crohn Disease
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- Pathoetiology
- Prevalence
- Classification
- Natural History
- CLINICAL PRESENTATION/DIAGNOSIS
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- Hemorrhage
- Intra-Abdominal Sepsis
- Obstruction
- Enteric Fistulas
- Extraintestinal Manifestations
- Growth Retardation
- Neoplasia
- Failed Medical Therapy
- Preoperative Planning
- SURGICAL TECHNIQUE
- Operative Options and Tenets
- Resection
- Bypass
- Strictureplasty
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- Short-Term
- Long-Term
- CONCLUSIONS
- CHAPTER 132: Neuroendocrine and Other Tumors
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS AND CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- INDICATIONS AND CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Appendix
- Small Bowel
- Colon
- Rectum
- POSTOPERATIVE CARE
- COMPLICATIONS AND MANAGEMENT
- OUTCOMES
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS AND CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- INDICATIONS AND CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Small Intestine
- Colon and Rectum
- POSTOPERATIVE CARE
- COMPLICATIONS AND MANAGEMENT
- OUTCOMES
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS AND CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- INDICATIONS AND CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- COMPLICATIONS AND MANAGEMENT
- OUTCOMES
- CHAPTER 133: Management of the Patient with Intestinal Failure
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Bowel Interposition
- Techniques to Lengthen and Taper Bowel
- Intestinal Transplantation
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- Part B: Colon, Rectum, Anus
- CHAPTER 134: Appendiceal Carcinoma
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS FOR SURGERY
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- MULTIMODALITY THERAPY
- OUTCOMES
- CHAPTER 135: Large Bowel Obstruction
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- Acute Large Bowel Obstruction
- Obstruction due to Colorectal Cancer
- Obstruction due to Intussusception
- Subacute/Chronic Large Bowel Obstruction
- Chronic Obstruction as a Result of Inflammatory Disease
- Pseudoobstruction, Oglivie Syndrome
- INDICATIONS AND CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Technique of Colonic Decompression in Sigmoid Volvulus
- Technique of Colon Decompression with Self-Expanding Metallic Stent (SEMS)
- The Steps Involved in the TTS Colonic SEMS Placement
- On table Colonic Lavage with Segmental Colectomy and Primary Anastomosis
- Resection with End Colostomy (Hartmann Procedure)
- Loop Colostomy
- Loop Ileostomy
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 136: Surgical Treatment of Colonic and Perianal Crohn Disease
- INTRODUCTION
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- Surgery
- PREOPERATIVE PLANNING
- Endoscopic Assessment
- Radiologic Assessment
- Preoperative Optimization
- Surgical Options
- POSTOPERATIVE CARE
- Postoperative Management
- COMPLICATION/MANAGEMENT
- OUTCOMES
- Recurrence of Crohn Disease after Proctocolectomy
- DIAGNOSIS/CLINICAL PRESENTATION
- Nonfistulizing Manifestations of Crohn Disease
- Fistulizing Manifestations–Perianal Abscess and Fistulas
- CONCLUSION
- CHAPTER 137: Surgery for Toxic Megacolon in Ulcerative Colitis
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Exploration and Planning
- Diversion Procedure (Ileostomy–Colostomy)
- Subtotal or Total Colectomy
- Proctocolectomy with End Ileostomy/Restorative Procedure
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- Wound Infection/Fascial Dehiscence
- Intra-Abdominal/Pelvic Abscesses
- Stoma Complications
- Hemorrhage
- OUTCOMES
- CHAPTER 138: Total Proctocolectomy and Intersphincteric Proctectomy for Benign Disease
- INTRODUCTION
- INDICATIONS
- Total Proctocolectomy
- Total Proctocolectomy with Intersphincteric Proctectomy
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Total Proctocolectomy
- Intersphincteric Dissection
- POSTOPERATIVE CARE
- Complications/Management
- CONCLUSION
- CHAPTER 139: Ileoanal Pouch Procedure for Ulcerative Colitis and Familial Adenomatous Polyposis
- INTRODUCTION
- Etiology and Pathophysiology
- DIAGNOSIS/CLINICAL PRESENTATION
- Inflammatory Bowel Disease
- Familial Adenomatous Polyposis
- “Other” Conditions
- INDICATIONS AND CONTRAINDICATIONS
- Fulminant Colitis
- Toxic Megacolon
- Primary Sclerosing Cholangitis
- Incompetent Anal Sphincter
- FAP Patients Requiring Whipple
- PREOPERATIVE PLANNING
- Inflammatory Bowel Disease Elective Versus Urgent
- Familial Adenomatous Polyposis
- Preoperative Planning in the Setting of Rectal Cancer
- SURGICAL TECHNIQUE
- Common Techniques to Obtain Small Bowel Mesenteric Length Regardless of Method of Access
- Operations for Benign Versus Malignant Disease
- Special Considerations for Robotic and Laparoscopic Surgery
- POSTOPERATIVE CARE
- COMPLICATIONS AND THEIR MANAGEMENT
- OUTCOME
- CHAPTER 140: Total Colectomy and Ileorectal Anastomosis
- INTRODUCTION
- INDICATIONS/CONTRAINDICATIONS
- Inflammatory Bowel Disease
- Colonic Neoplasia
- Lower Gastrointestinal Hemorrhage
- Chronic Constipation and Colonic Inertia
- Restoration of Intestinal Continuity Following Subtotal Colectomy
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Open Resection
- Laparoscopic Resection
- POSTOPERATIVE MANAGEMENT
- COMPLICATIONS
- OUTCOMES
- CHAPTER 141: Surgery for Diverticulitis
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS FOR SURGERY IN UNCOMPLICATED DIVERTICULITIS
- Severity of Attacks and Current Symptoms
- Risk of Subsequent Attacks of Diverticulitis
- Risk of Developing Complicated Diverticulitis
- Risk of Developing Free Perforation/Risk of Requiring Emergency Surgery and Stoma After Recovery From an Episode of Uncomplicated Diverticulitis
- Young Patients and Diverticulitis
- INDICATIONS FOR SURGERY IN COMPLICATED DIVERTICULITIS
- Diverticular Fistulas
- Diverticular Strictures
- Diverticular Abscess
- Perforated Diverticulitis With Purulent or Fecal Peritonitis
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Open Sigmoid Colectomy
- Laparoscopic Colectomy
- Robotic Sigmoid Colectomy
- Hartmann Resection
- Laparoscopic Lavage
- Reoperative Surgery
- POSTOPERATIVE CARE
- OUTCOMES
- Immediate Postoperative Adverse Events
- Risk of Persistent Abdominal Symptoms After Resection
- Risk of Recurrent Diverticulitis After Resection
- CONCLUSIONS
- CHAPTER 142: Technique of Colostomy Construction and Closure
- INTRODUCTION
- INDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Colonic Mobilization
- Stoma Aperture
- Colon Delivery
- End Colostomy Maturation
- Alternative Configurations: Loop-End, Blowhole, End-Loop, Diverting Colostomy
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- Acute Postoperative Complications
- COLOSTOMY CLOSURE
- Closure of Diverting Loop Colostomy
- End Colostomy Closure
- OUTCOMES
- CHAPTER 143: Care of Stomas
- INTRODUCTION
- STOMA ANATOMY AND PHYSIOLOGY
- PREOPERATIVE PLANNING
- Role of the Wound, Ostomy, and Continence Nurse
- Ostomy Siting
- POSTOPERATIVE CARE
- Ostomy Appliances
- Peristomal Skin Care
- COMPLICATIONS/MANAGEMENT
- Diet, Medications, Lifestyle
- Perioperative Care Pathways to Reduce Hospital Readmission
- Complications and Management
- Stenosis
- CONCLUSIONS
- PATIENT RESOURCES
- CHAPTER 144: Open and Minimally Invasive Right Hemicolectomy for Cancer
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- MULTIMODALITY THERAPY
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Open Right Hemicolectomy
- Laparoscopic Right Hemicolectomy
- Robotic Right Hemicolectomy
- SURGICAL TECHNIQUE: EXTENT OF LYMPHADENECTOMY
- POSTOPERATIVE CARE
- OUTCOMES
- CONCLUSION
- COMPLICATIONS
- CHAPTER 145: Open and Minimally Invasive Left Hemicolectomy for Neoplasms of the Descending Colon, Sigmoid, and Upper Rectum
- INTRODUCTION
- DIAGNOSIS/CLINICAL PRESENTATION
- Preoperative Staging
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Positioning
- Principles of Resection
- Lateral to Medial Approach
- Medial to Lateral Approach
- Splenic Flexure Mobilization
- Mesorectal Anterior Excision
- Anastomosis and Extraction
- Open Considerations
- Laparoscopic Considerations
- Robotic Considerations
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- Anastomotic Leaks
- Pulmonary Embolus/DVT
- Urinary Retention
- Retrograde Ejaculation
- Outcomes
- CHAPTER 146: Total Mesorectal Excision (TME)
- INTRODUCTION
- Reflections on the Importance of TME as the Prototype in Principle for All Visceral Cancer Operations
- HISTORICAL CONSIDERATIONS
- THE RECTAL CANCER WORLD IN 2022
- GENERAL CONSIDERATIONS
- TOTAL MESORECTAL EXCISION (TME)—AN EMBRYOLOGIC REDEFINITION OF MILES’ “HIGHLY DANGEROUS TISSUES”
- PREOPERATIVE IMAGING
- CANCER BOARD PLANNING (MULTIDISCIPLINARY TEAM—MDT)
- Summary of the Cancer Board (MDT) Sequence
- SPECIAL CONSIDERATIONS
- Choice of Tissue Block to be Excised—TME or “TME Plus”, “TME Minus”, or Partial Mesorectal Excision (PME) or Local Excision
- The Ultra-Low Rectal Cancer
- Surveillance or Immediate Surgery After an Excellent Response to Neoadjuvant Therapy
- THE SURGERY
- BEFORE THE OPERATION IN THE OR
- Bimanual Pelvic Examination
- Surgical Technique—Principles Applicable to All Methods
- The Holy Plane and the Confusions of Intraplanar Fat
- Stepwise Detail for All Abdominal Approaches
- ANTERIOR AND ANTEROLATERAL DISSECTION—DENONVILLIERS (RECTOGENITAL) SEPTUM
- Anterior Dissection in the Female
- Dissection of the Most Distal Mesorectum
- MANAGEMENT OF THE ANORECTUM DISTAL TO THE CANCER—STAPLING TECHNIQUES—MORAN TRIPLE-STAPLING
- Avoidance of a Permanent Colostomy
- Colon Pouch or Coloplasty?
- STAPLED LOW PELVIC RECONSTRUCTION
- Short Colon Pouch or a Side-to-End Anastomosis to Low Rectum or Anal Canal
- Transanal Transection and Single Stapling (TTSS)
- Pelvic Drainage
- AUDIT OF THE EXCISED CANCER SPECIMEN
- Open Surgery
- Manual Palpation and Inspection—Laparotomy
- CONCLUSION
- Data
- The Basingstoke Experience of Open TME—Total Mesorectal Excision 1978–1997
- CHAPTER 147: Transanal Total Mesorectal Excision
- INTRODUCTION
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- PROCEDURE-SPECIFIC COMPLICATIONS
- Urethral Injury
- CO2 Embolism
- OUTCOMES
- TaTME Training and the Learning Curve
- CONCLUSIONS
- CHAPTER 148: The Assessment of Patients with Rectal Cancer After Neoadjuvant Therapy: Changing Surgical Paradigms
- INTRODUCTION
- Baseline Assessment
- CLINICAL ASSESSMENT
- Digital Rectal Examination
- Endoscopic Assessment
- Magnetic Resonance Imaging
- THERAPY
- Pathologic Findings
- Neoadjuvant Treatment
- Assessment of Tumor Response
- Timing
- Complete Clinical Response (cCR)
- Radiologic Assessment
- Near-Complete Clinical Response
- FOLLOW-UP
- Local Regrowths
- Distant Metastases
- FUTURE PERSPECTIVES
- CHAPTER 149: Open and Minimally Invasive Sphincter- Preserving Radical Resection for Malignant Disease of the Middle and Lower Thirds of the Rectum
- INTRODUCTION
- ANATOMY
- Perirectal Tissue Planes and Spaces
- Autonomic Nervous System
- Vascular Supply and Lymphatic Drainage
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Colon Mobilization and Division of Blood Supply
- Total Mesorectal Excision and Autonomic Nerve Preservation
- Transanal TME
- Distal Resection
- Reconstructive Techniques
- Anastomotic Techniques
- Immunofluorescence
- Hydro-Pneumatic Testing
- Diversion
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- Anastomotic Leak
- OUTCOMES
- Oncologic Outcomes
- Functional Outcomes
- Outcomes of Open versus Minimally Invasive Proctectomy
- CHAPTER 150: Abdominoperineal Resection of the Rectum for Rectal Cancer
- INTRODUCTION
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- Extent of Resection
- Ostomy Marking
- Abdominal Dissection–Minimally Invasive versus Open Technique
- Perineal Dissection–Prone versus Lithotomy
- Perineal Reconstruction Options
- Pain Management
- SURGICAL TECHNIQUE
- Anatomical Relationships and Considerations
- Open Abdominal Dissection
- Minimally Invasive Abdominal Dissection
- Perineal Part: Prone Position
- Perineal Part: Lithotomy Position
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 151: The Approach to Reoperative Pelvic Surgery in Rectal Cancer
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- INDICATIONS AND CONTRAINDICATIONS
- PREOPERATIVE CONSIDERATIONS
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- COMPLICATIONS, MANAGEMENT, AND OUTCOMES
- SUMMARY
- ACKNOWLEDGMENTS
- CHAPTER 152: Sacral Resection for Recurrent Rectal Cancers
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS AND CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- CLINICAL ASSESSMENT
- Tumor Marker—Carcinogenic Embryonic Antigen (CEA)
- Computed Tomography
- Magnetic Resonance Imaging
- Positron Emission Tomography
- SURGICAL TECHNIQUE
- Classification of Sacrectomy
- Sacrectomy: The Abdominopelvic Phase
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 153: Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Cancers of the Appendix and Colon
- INTRODUCTION
- DIAGNOSIS/CLINICAL PRESENTATION
- PREOPERATIVE EVALUATION
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Hyperthermic Intraperitoneal Chemotherapy Administration
- Re-Exploration and Definitive Closure
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CONCLUSIONS
- CHAPTER 154: Management of Retrorectal Tumors
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- Congenital Tumors
- Neurogenic Tumors
- Osseous Tumors
- CLINICAL PRESENTATION AND DIAGNOSIS
- MULTIMODAL THERAPY
- SURGICAL INDICATIONS AND CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Posterior Approach
- Anterior Approach
- Combined Anterior and Posterior Approach
- POSTOPERATIVE CARE
- COMPLICATIONS AND THEIR MANAGEMENT
- OUTCOMES
- SUMMARY
- CHAPTER 155: Rectal Prolapse
- INTRODUCTION
- ETIOLOGY AND PATHOGENESIS
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS AND CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUES AND OUTCOMES
- Anal Encirclement (Thiersch Procedure)
- Mucosal Sleeve Resection (Delorme Procedure)
- Perineal Proctosigmoidectomy (Altemeier Procedure)
- Sutured Rectopexy
- Mesh Rectopexy
- Resection Rectopexy
- POSTOPERATIVE CARE
- COMPLICATIONS
- CHAPTER 156: Anorectal Disorders
- CLINICAL PRESENTATION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS
- TREATMENT: CONSERVATIVE
- Nonspecific Medical Therapy
- Specific First-Line Therapy: Nitric Oxide Donors or Calcium Channel Blockade
- Specific Second-Line Therapy: Botulinum Toxin
- SURGICAL TECHNIQUE
- Closed Lateral Subcutaneous Internal Sphincterotomy
- Open Internal Sphincterotomy
- CLINICAL PRESENTATION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS
- Conservative Therapy
- SURGICAL TECHNIQUE
- Drainage of Perianal Abscess
- Ischiorectal Abscess
- Drainage of Intersphincteric Abscess
- Drainage of Supralevator Abscess
- Drainage of Submucous Abscess
- CLINICAL PRESENTATION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS
- SURGICAL TECHNIQUE
- COMMON AVAILABLE TREATMENTS
- Fistulotomy (Lay Open)
- Staged Seton Fistulotomy
- Flap Repair: Fistulectomy and Anorectal Advancement Flap
- The LIFT Operation
- VAFT
- Anal Plug
- Injectables
- CLINICAL PRESENTATION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS
- TREATMENT
- Conservative Therapy
- Outpatient Therapy
- Rubber-Band Ligation
- Hemorrhoid Artery Ligation
- Cautery or Laser Hemorrhoidectomy
- Suture Ligation of Hemorrhoids: LigaSure
- Harmonic Scalpel Hemorrhoidectomy
- Radiofrequency Ablation
- Rectoanal Excision and Repair: Mucosectomy
- MAJOR RESECTIONAL PROCEDURES
- Hemorrhoidectomy
- Open Hemorrhoidectomy
- Closed Hemorrhoidectomy
- COMPLICATIONS OF CONVENTIONAL HEMORRHOIDECTOMY/MANAGEMENT
- Stapled Hemorrhoidopexy
- CLINICAL PRESENTATION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS
- TREATMENT
- CLINICAL PRESENTATION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS
- SURGICAL TECHNIQUE
- Management of Pilonidal Abscess
- Elective Treatment of Pilonidal Sinus
- Fibrin Glue
- CLINICAL PRESENTATION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS
- SURGICAL TECHNIQUE
- CLINICAL PRESENTATION
- Obstetric RVF
- ETIOLOGY AND PATHOLPHYSIOLOGY
- Forniceal Fistulae
- Septal Fistulae
- Perineal Fistulae
- DIAGNOSIS
- SURGICAL TECHNIQUE
- Preliminary Fecal Diversion
- Definitive Treatment
- CLINICAL PRESENTATION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS
- CONSERVATIVE THERAPY
- SURGICAL TECHNIQUE
- Drainage of Pus
- Defunction
- Selective Treatment
- CHAPTER 157: Management of Premalignant and Malignant Neoplasms of the Anal Canal and Perianal Area
- INTRODUCTION
- ANATOMY
- ETIOLOGY AND PATHOPHYSIOLOGY
- Nomenclature
- Risk Factors
- DIAGNOSIS/CLINICAL PRESENTATION
- Screening
- Anal Cytology
- High-Resolution Anoscopy
- Pathology
- Topical Treatment
- Vaccination
- Ablative Treatment
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS AND CLINICAL PRESENTATION
- Workup and Staging
- MULTIMODAL THERAPY
- OUTCOMES
- Recurrent Disease and Salvage Surgical Treatment
- PERIANAL PAGET DISEASE
- DIAGNOSIS/CLINICAL PRESENTATION
- Surgical Treatment
- Topical and Nonsurgical Treatment
- MELANOMA
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- SURGICAL TREATMENT
- ANAL ADENOCARCINOMA
- CHAPTER 158: Transanal Excision of Rectal Neoplasms
- INTRODUCTION
- DIAGNOSIS
- INDICATIONS AND CONTRAINDICATIONS
- Special Circumstances and Controversies
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUES
- Parks Transanal Excision
- Transanal Endoscopic Microsurgery
- Transanal Endoscopic Operation
- Transanal Minimally Invasive Surgery (TAMIS)
- Robotic TAMIS (R-TAMIS)
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- Clinical Outcomes
- Functional Outcomes
- CHAPTER 159: Functional Bowel Disorders
- INCONTINENCE
- Clinical Presentation
- Etiology and Pathophysiology
- Diagnosis
- Conservative Treatment
- Surgical Technique
- RECTAL PROLAPSE
- Clinical Presentation
- Etiology and Pathophysiology
- Diagnosis
- Surgical Technique
- MEGABOWEL
- Clinical Presentation
- Etiology and Pathophysiology
- Diagnosis
- Conservative Therapy
- Surgical Treatment
- SLOW TRANSIT CONSTIPATION
- Clinical Presentation
- Etiology and Pathophysiology
- Diagnosis
- Conservative Treatment
- Surgical Treatment
- OBSTRUCTIVE DEFECATION SYNDROME
- Clinical Presentation
- Etiology and Pathophysiology
- Diagnosis
- Conservative Treatment
- Surgical Treatment
- VOLUME II
- SECTION IX: Biliary Tract, Liver, Pancreas, and Spleen
- Part A: The Liver and Biliary Tract
- CHAPTER 160: Diagnostic Considerations in Biliary and Liver Disease
- DIAGNOSIS/CLINICAL PRESENTATION
- BILIARY DISEASE
- Gallbladder Pathologies
- Biliary Dyskinesia
- Acute Calculous Cholecystitis
- Acalculous Cholecystitis
- Porcelain Gallbladder
- Adenomyomatosis of the Gallbladder
- Gallbladder Polyps
- Gallbladder Cancer
- BILIARY OBSTRUCTION
- Choledocholithiasis
- Cholangitis
- Biliary Obstruction Without Gallstones
- DIAGNOSTIC APPROACH TO LIVER MASSES
- Cystic Lesions
- Benign Solid Lesions
- Malignant Solid Lesions
- LIVER METASTASIS FROM PRIMARY OF ANOTHER ORIGIN
- Colorectal Metastasis
- Neuroendocrine Metastasis
- HEPATOBILIARY DISEASE IN THE PREGNANT PATIENT
- CHAPTER 161: Approaches to Drainage of Hepatic, Perihepatic, and Subhepatic Abscesses
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS AND CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- Antibiotic Therapy
- Source Control
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- CHAPTER 162: Mastery Keys: Anatomy of Peritoneal Spaces
- PERITONEAL REFLECTIONS OF DIAPHRAGM TO LIVER (Fig. 162.1)
- SPACES/RECESSES RELATED TO LIVER (FIGS. 162.1 AND 162.2)
- OMENTAL BURSA (FIGS. 162.2 AND 162.3)
- INFRAMESOCOLIC COMPARTMENT (Fig. 162.2)
- FOLDS AND FOSSAE OF PELVIS (Fig. 162.4)
- FOLDS AND FOSSAE RELATED TO UMBILICUS
- CHAPTER 163: Hepatic Abscess
- ETIOLOGY AND PATHOPHYSIOLOGY
- Pyogenic Liver Abscess
- Amebic Liver Abscess
- Cystic Echinococcosis
- DIAGNOSIS/CLINICAL PRESENTATION
- IMAGING
- Pyogenic Hepatic Abscess
- Hepatosplenic Candidiasis
- Amebic Hepatic Abscess
- Cystic Echinococcosis
- MULTIMODALITY MANAGEMENT
- Antimicrobial Management
- INTERVENTIONAL MANAGEMENT
- Pyogenic Hepatic Abscess
- Hepatosplenic Candidiasis
- Entamoeba Hepatic Abscess
- Cystic Echinococcosis
- CHAPTER 164: Cholecystostomy, Cholecystectomy, and Intraoperative Evaluation of the Biliary Tree
- INTRODUCTION
- SURGICAL ANATOMY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Open Cholecystectomy
- Intraoperative Cholangiogram
- Common Bile Duct Exploration
- Subtotal Cholecystectomy
- Open Cholecystostomy
- Additional Procedures
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 165: Mastery Keys: Anatomy of Gallbladder and Extrahepatic Biliary Tract
- GALLBLADDER
- EXTRAHEPATIC BILIARY TRACT
- CHAPTER 166: Laparoscopic Cholecystectomy, Intraoperative Cholangiography, and Common Bile Duct Exploration
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- Cholelithiasis
- Biliary Colic
- Acute Cholecystitis
- Biliary Dyskinesia
- Choledocholithiasis
- Cholangitis
- Gallstone Pancreatitis
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- MULTIMODAL THERAPY
- PREOPERATIVE PLANNING
- Preoperative Testing
- Operative Equipment
- SURGICAL TECHNIQUE
- Anesthesia
- Pneumoperitoneum
- Trocar Placement
- Exposure of the Porta Hepatis
- Stripping the Peritoneum
- Pedunculation of the Gallbladder
- The Critical View of Safety
- Control of the Cystic Duct and Cystic Artery
- Resection of the Gallbladder
- Removal of the Gallbladder
- Other Techniques
- Other Special Considerations
- Additional Operative Considerations
- Methods to Delineate Anatomy
- Bailout Maneuvers
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- Hemorrhage
- Stone or Biliary Contamination
- Bile Duct Injury
- Intraoperative Diagnosis
- Postoperative Diagnosis
- Common Bile Duct Stones
- OUTCOMES
- Post-Cholecystectomy Syndrome
- Hernia
- Future Directions
- CHAPTER 167: Reconstruction of the Bile Duct: Anatomic Principles and Surgical Techniques
- INTRODUCTION
- INDICATIONS AND CONTRAINDICATIONS FOR BILE DUCT RECONSTRUCTION
- ANATOMICAL CONSIDERATIONS
- DIAGNOSIS/CLINICAL PRESENTATION
- Clinical Presentation
- Diagnoses
- Preoperative Planning for BDR
- Cross-Sectional Imaging
- Preoperative Patient Preparation
- SURGICAL TECHNIQUES
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 168: Current Application of Endoscopic Sphincterotomy, Lateral Choledocoduodenostomy, and Transduodenal Sphincteroplasty
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- Anatomy of the Distal Common Bile Duct and Pancreatic Duct
- Physiology of the Oddi Sphincter
- Pathophysiology
- DIAGNOSIS/CLINICAL PRESENTATION
- Evaluation of Patients With Biliary-Type Pain
- Sphincter of Oddi Dysfunction
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- ERCP and Endoscopic Sphincterotomy
- Alternative Procedures
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- INDICATIONS/CONTRAINDICATIONS
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- INDICATIONS/CONTRAINDICATIONS
- TECHNIQUE
- Postoperative Care
- COMPLICATIONS/MANAGEMENT
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- TECHNIQUE
- POSTOPERATIVE MANAGEMENT
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- ACKNOWLEDGMENT
- CHAPTER 169: Primary Sclerosing Cholangitis
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- EPIDEMIOLOGY
- DIAGNOSIS
- NATURAL HISTORY AND CLINICAL PRESENTATION
- Overview
- Nonmalignant Complications and Disease Associations
- Malignant Complications and Disease Associations
- MANAGEMENT
- Overview
- Medical Management
- Role of Endoscopic Retrograde Cholangiopancreatography
- PSC-Associated Neoplasia Surveillance
- Liver Transplantation
- CHAPTER 170: Cholecystojejunostomy and Choledochojejunostomy/Hepaticojejunostomy
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- MULTIMODAL THERAPY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Open Technique
- Minimally Invasive Technique
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 171: Operative Treatment of Choledochal Cysts
- INTRODUCTION
- EPIDEMIOLOGY
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INVESTIGATIONS AND PREOPERATIVE PLANNING
- CHOLEDOCHAL MALFORMATIONS CLASSIFICATION
- MALIGNANCY RISK
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE AND COMPLICATIONS/MANAGEMENT
- CHAPTER 172: Hepatic Resection for Primary and Metastatic Tumors
- INTRODUCTION
- INDICATIONS AND CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- Anesthetic Considerations
- SURGICAL TECHNIQUE
- Patient Positioning, Incision, and Exposure
- Parenchymal Transection
- Pringle Maneuver
- Right Hepatectomy
- Anterior Approach
- Extended Right Hepatectomy
- Left Hepatectomy
- Extended Left Hepatectomy
- Drainage
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 173: Mastery Keys: Anatomy of Liver
- SURFACES AND FISSURES (Fig. 173.1)
- RELATIONSHIPS OF LIVER (FIGS. 173.1 AND 173.2)
- FUNCTIONAL SUBDIVISIONS AND HEPATIC SEGMENTATION (FIGS. 173.3B TO 173.5)
- PORTA HEPATIS (FIGS. 173.1, 173.6 TO 173.8)
- Hepatic Artery
- Portal Vein
- Bile Duct
- HEPATIC VEINS (Fig. 173.9)
- LYMPHATIC DRAINAGE (Fig. 173.10)
- INNERVATION (Fig. 173.11)
- CHAPTER 174: High Malignant Biliary Tract Obstruction
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- CLINICAL PRESENTATION
- SURGICAL INDICATIONS AND CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- Preoperative Biliary Drainage
- Preoperative Portal Embolization
- SURGICAL TECHNIQUES
- Staging Laparoscopy
- Hepatectomy: Rationale and Planning
- Hepatectomy: Exposure and Portal Dissection
- Hepatectomy: Optimizing the Hepatic Duct Margin, Parenchymal Transection, and Reconstruction
- PALLIATIVE PROCEDURES
- LIVER TRANSPLANTATION
- POSTOPERATIVE CARE
- Initial Hospital Course
- Complications and their Management
- Multimodal Therapy
- OUTCOMES
- SUMMARY
- CHAPTER 175: The Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) Approach
- INTRODUCTION
- PREOPERATIVE PLANNING
- Patient Selection and Preoperative Evaluation
- Future Liver Remnant Assessment
- Surgical Technique
- Classic Technique
- Surgical Variants of the Classic ALPPS Procedure
- PERIOPERATIVE PATIENT MANAGEMENT
- OUTCOMES
- ALPPS Safety: Morbidity and Mortality
- Oncologic Results
- CONCLUSIONS
- CHAPTER 176: Minimally Invasive Hepatectomy
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- Epidemiology
- Benign Indications for Minimally Invasive Liver Surgery
- Malignant Indications for Minimally Invasive Liver Surgery
- Intrahepatic Cholangiocarcinoma
- Hilar Cholangiocarcinoma
- Colorectal Liver Metastases
- MULTIMODAL THERAPY
- Minimally Invasive Surgery and Chemoradiotherapy
- OUTCOMES
- Laparoscopic Advantages
- Potential Laparoscopic Disadvantages
- INDICATIONS/CONTRAINDICATIONS
- Difficulty of Minimally Invasive Hepatectomy
- Learning Curve for Minimally Invasive Hepatectomy
- PREOPERATIVE PLANNING
- Preoperative Considerations
- Surgical Planning and Relevant Anatomy
- Virtual Hepatectomy
- Future Liver Remnant: Goals and Cutoffs
- Portal Vein Embolization (PVE)
- NONSURGICAL TECHNIQUES
- Anesthetic Management
- Postoperative Considerations
- Bleeding Checklist
- SURGICAL TECHNIQUE
- Patient Positioning
- Port Placement
- Initial Evaluation
- Inflow Control
- Parenchymal Transection
- Indocyanine Green (ICG) Utilization in Liver Resection
- Vascular and Segmental Identification
- Drain Placement
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- Unplanned Conversion
- Robotic Hepatectomies
- CONCLUSION
- Part B: The Pancreas
- CHAPTER 177: Operative Interventions for Chronic Pancreatitis
- ABSTRACT
- INTRODUCTION
- INITIAL CLINICAL EVALUATION
- Etiology and Pathophysiology
- PREOPERATIVE PLANNING
- Physical Examination
- Laboratory Tests
- Imaging Studies
- INDICATIONS
- Anatomic and Morphologic Subtypes of Chronic Pancreatitis
- SURGICAL TECHNIQUES
- Resection Operations
- Drainage Operation
- Combined Resection and Drainage Operation
- Total Pancreatectomy
- COMPLICATIONS/MANAGEMENT
- Drainage Operations
- Resection and Drainage Operations
- Total Pancreatectomy with Islet Autotransplantation
- Minimally Invasive Surgery
- OUTCOMES
- CHAPTER 178: Mastery Keys: Surgical Anatomy of Duodenum and Pancreas
- DUODENUM
- PANCREAS
- Parts of Pancreas
- Pancreatic Ducts (Figs. 178.4 and 178.5)
- Blood Supply of Duodenum and Pancreas
- Lymphatic Drainage (Fig. 178.7A)
- Innervation (Fig. 178.7B)
- CHAPTER 179: Parenchyma-sparing, Duodenum-Preserving Pancreatic Head Resection for Inflammatory Tumor, Cystic Neoplasm and Neuroendocrine Adenoma of the Pancreatic Head
- INTRODUCTION
- PANCREATODUODENECTOMY OR DUODENUM-PRESERVING PANCREATIC HEAD RESECTION FOR BENIGN PANCREATIC HEAD TUMORS?
- SURGERY-ASSOCIATED METABOLIC LATE MORBIDITY AND POSTOPERATIVE COMPLICATIONS FOLLOWING DPPHR
- DUODENUM-PRESERVING SUBTOTAL PANCREATIC HEAD RESECTION FOR INFLAMMATORY TUMORS OF THE PANCREATIC HEAD IN CHRONIC PANCREATITIS
- TECHNIQUES OF DPPHR FOR CHRONIC PANCREATITIS
- RESULTS AFTER SUBTOTAL DUODENUM-PRESERVING PANCREATIC HEAD RESECTION FOR CHRONIC PANCREATITIS
- ADVANTAGES OF DPPHR COMPARED TO PD FOR CHRONIC PANCREATITIS
- INDICATION FOR DPPHR FOR BENIGN IPMN, MCN, AND SPN
- PREOPERATIVE PLANNING
- OUTCOMES
- Results after Duodenum-Preserving Subtotal and Total Pancreatic Head Resection for Cystic Neoplasms
- Contraindication to the Use of DPPHR
- DPPHR for Pancreatic Neuroendocrine Tumors
- Tumor Enucleation or DPPHR for PNETs?
- Total DPPHR for Periampullary Tumors
- CHAPTER 180: Minimally Invasive/Robotic Pancreatectomy
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- PREOPERATIVE PLANNING
- Patient Selection
- SURGICAL TECHNIQUE
- Robotic Distal Pancreatectomy and Splenectomy
- Robotic Pancreaticoduodenectomy
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- Postoperative
- CHAPTER 181: Management of Necrotizing Pancreatitis
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 182: Management of Complications of Acute and Chronic Pancreatitis: Endoscopic, Laparoscopic, and Open Approaches to Pancreatic Pseudocysts and Pancreatic Necrosis
- INTRODUCTION
- PANCREATIC PSEUDOCYSTS
- Indications for Treatment
- Procedural Interventions
- PANCREATIC NECROSIS
- Indications for Treatment
- Procedural Interventions
- Disconnected Pancreatic Duct Syndrome
- Percutaneous Drainage or Dual Modality Drainage
- Adverse Events of Endoscopic Drainage Techniques
- SURGICAL MANAGEMENT OF PANCREATIC AND PERIPANCREATIC NECROSIS
- Preoperative Planning
- Surgical Techniques
- Postoperative Care
- Complications
- CHAPTER 183: Pancreaticoduodenectomy and Total Pancreatectomy for Cancer
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- Pretreatment Diagnostic Evaluation and Workup
- INDICATIONS/CONTRAINDICATIONS AND MULTIMODAL THERAPY
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Pancreaticoduodenectomy: Open Approach
- Vascular Resection and Reconstruction
- Management of the Jejunal and Ileal Branches
- Important Arterial Anatomy Variations
- Reconstruction
- Closure
- Pancreaticoduodenectomy: Robotic Approach
- Total Pancreatectomy
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 184: Splanchnic Denervation of the Pancreas for Intractable Pain
- INTRODUCTION
- ANATOMY
- PAIN MANAGEMENT AND INDICATIONS FOR SPLANCHNIC DENERVATION OF THE PANCREAS
- OPERATIVE TECHNIQUES
- Open CPN
- Bilateral Thoracoscopic Splanchnicectomy
- CONCLUSION
- ACKNOWLEDGMENT
- CHAPTER 185: Pancreatic Neuroendocrine Tumors
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS AND CLINICAL PRESENTATION
- Symptoms and Diagnosis
- Pathologic Diagnosis, Classification, and Grading
- MULTIMODAL THERAPY
- Systemic Therapy
- Liver-Directed Regional Therapy
- INDICATIONS FOR SURGERY
- PREOPERATIVE PLANNING
- Serum Tumor Markers
- Preoperative Staging
- SURGICAL TECHNIQUE
- Surgery for Localized NF-PNET
- Minimally Invasive Versus Open Technique
- Surgery for Metastatic NF-PNET
- Hepatic Resection and Ablation
- Transplantation
- RELATIVE CONTRAINDICATIONS TO SURGERY
- Locally Advanced Disease
- Incidental Small (<2 cm) NF-PNETS
- PNEC and High-Grade (G3) NF-PNET
- DIAGNOSIS/CLINICAL PRESENTATION
- Gastrinoma
- Insulinoma
- Rare Functional Endocrine Tumors
- SURGICAL TREATMENT OF PNET IN INHERITED SYNDROMES
- Multiple Endocrine Neoplasia Type 1 Syndrome
- Von Hippel–Lindau Disease
- Neurofibromatosis Type 1 (NF-1)
- OUTCOMES
- SUMMARY
- Part C: The Spleen
- CHAPTER 186: Benign Disease of the Spleen
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- COMPLICATIONS/MANAGEMENT
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- OUTCOMES
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- OUTCOMES
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- SURGICAL TECHNIQUE
- COMPLICATIONS
- Outcomes
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- MEDICAL THERAPIES
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 187: Mastery Keys: Surgical Anatomy of Spleen
- VASCULAR SUPPLY
- INNERVATION AND LYMPHATIC DRAINAGE
- CHAPTER 188: Splenectomy for Hematologic Disease and Malignant Conditions of the Spleen
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS AND CLINICAL PRESENTATION
- Diagnostic Biopsy for Lymphoma
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 189: Minimally Invasive Splenectomy
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- Role in Infection and Immunity
- INDICATIONS AND CONTRAINDICATIONS FOR SURGERY
- DIAGNOSIS AND CLINICAL PRESENTATION
- Benign Hematologic Conditions
- Malignant Conditions
- MULTIMODAL THERAPY
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Patient Positioning
- Multiport Laparoscopic Splenectomy (LS)
- Hand-Assisted Laparoscopic Splenectomy (HALS)
- Single-Port Access Splenectomy (SPA)
- Robotic Splenectomy
- POSTOPERATIVE CARE
- COMPLICATIONS AND MANAGEMENT
- COMPARATIVE OUTCOMES
- SECTION X: Solid Organ Transplantation
- Part A: General Considerations in Organ Transplantation
- CHAPTER 190: Immunosuppression in Organ Transplantation
- INTRODUCTION
- PHYSIOLOGIC IMMUNITY AND ALLOIMMUNITY
- Innate Immunity
- Antigen Recognition
- T-Cell Production
- T-Cell Function and Immune Regulation
- Costimulation
- B-Cell Maturation and Function
- COMPLICATIONS/MANAGEMENT
- Rejection
- IMMUNOSUPPRESSION
- Corticosteroids
- Purine Analogs
- Calcineurin Inhibitors
- Mechanistic Target of Rapamycin Inhibitors
- Lymphocyte-Depleting Agents
- Costimulation Blockade
- Additional Immunomodulating Therapies
- OUTCOMES
- CHAPTER 191: Multiorgan Donor Recovery
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Positioning
- Preparation
- Surgery
- Liver Recovery
- Pancreas Recovery
- Kidney Recovery
- Vessel Recovery/Closure
- Part B: Portal Hypertension
- CHAPTER 192: Anatomy of the Portal System and Experience With Portacaval Shunt
- INTRODUCTION
- DESCRIPTIVE ANATOMY
- APPLIED ANATOMY
- Portosystemic Shunts
- AUTHOR’S EXPERIENCE WITH PORTACAVAL SHUNT
- Emergency Portacaval Shunt
- Elective Portacaval Shunt
- Extrahepatic Portal Hypertension
- Budd–Chiari Syndrome
- EXPLODING SOME MYTHS
- PANCREATICODUODENECTOMY
- HEPATIC RESECTION
- IMAGING PORTAL ANATOMY
- ACKNOWLEDGMENT
- CHAPTER 193: Mastery Keys: Surgical Anatomy of Portal Venous System
- CHAPTER 194: Endoscopic Therapy in the Management of Esophageal Varices
- PORTAL HYPERTENSION
- Cause
- Natural History
- Treatment Principles
- MANAGEMENT OF ACUTE VARICEAL BLEEDING
- Choice of Therapy
- General Strategy
- Initial Measures
- PHARMACOLOGIC THERAPY
- Emergency Endoscopy and Immediate Endoscopic Therapy
- FAILED EMERGENCY ENDOSCOPIC THERAPY
- BALLOON TUBE TAMPONADE
- ESOPHAGEAL STENT PLACEMENT
- ALTERNATIVE EMERGENCY MANAGEMENT OPTIONS
- LONG-TERM MANAGEMENT
- Evaluation of Liver Function
- Injection Sclerotherapy
- Esophageal Variceal Ligation
- ALTERNATIVE LONG-TERM MANAGEMENT OPTIONS
- Pharmacologic Therapy
- SURGICAL SHUNTS
- Devascularization and Transection Operations
- Transjugular Intrahepatic Portosystemic Shunt
- LIVER TRANSPLANTATION
- INJECTION SCLEROTHERAPY
- Technical Variants
- Elective Sclerotherapy Technique
- EMERGENCY SCLEROTHERAPY
- Intravariceal Injection
- Combined Paravariceal and Intravariceal Injection
- COMPLICATIONS
- ENDOSCOPIC VARICEAL BAND LIGATION
- Single Band Application
- Multiband Application
- COMPLICATIONS
- GASTRIC VARICES
- Endoscopic Therapy for Gastric Varices
- CONCLUSION
- CHAPTER 195: Small-Diameter Prosthetic Interposition Shunt
- OPERATIVE INDICATIONS FOR SMALL-DIAMETER PROSTHETIC H-GRAFT PORTACAVAL SHUNTS
- SURGICAL TECHNIQUE
- ACKNOWLEDGMENT
- CHAPTER 196: Distal Splenorenal Shunts: Hemodynamics of Total Versus Selective Shunting
- INTRODUCTION
- INDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- MODIFICATION OF THE DSRS OPERATION
- Temporary Clamping of the Splenic Artery
- Renosplenic End-to-Side Shunt
- Splenocaval Shunt
- POSTOPERATIVE MANAGEMENT
- QUESTIONS FREQUENTLY ASKED ABOUT THE SELECTIVE SHUNT
- How Effective is the Shunt in Preventing Rebleeding?
- What is the Incidence of Shunt Occlusion?
- Is There a Role for the Selective Shunt in Patients with Ascites?
- What is the Incidence of Encephalopathy After the Selective Shunt?
- How Durable is Selectivity of the Selective Shunt?
- Is There a Difference in Survival after Selective as Opposed to Total Shunt Operation?
- Operative Technique for CSRS
- POSTOPERATIVE MANAGEMENT
- ACKNOWLEDGMENT
- CHAPTER 197: Central Splenorenal Shunts
- INTRODUCTION
- CENTRAL SPLENORENAL SHUNT
- ACKNOWLEDGMENT
- CHAPTER 198: TIPS and Other Direct Treatments of Portal Hypertension for Solid Organ Transplantation
- INTRODUCTION TO PORTAL HYPERTENSION
- COMPLICATIONS OF PORTAL HYPERTENSION
- Ascites
- Gastrointestinal Bleeding
- Other Complications of Portal Hypertension
- ABDOMINAL SURGERIES IN PATIENTS WITH PORTAL HYPERTENSION
- TIPS PROCEDURE
- Indications and Contraindications
- Outcomes of TIPS
- Preprocedural Planning for TIPS
- TIPS Technique
- Postprocedural Care After TIPS
- Direct Inferior Vena Cava to Portal Vein Shunt (DIPS)
- Variceal Embolization Techniques: Balloon-Occluded Retrograde Transvenous Obliteration (BRTO), Plug-Assisted Retrograde Transvenous Obliteration (PARTO), Coil-Assisted Retrograde Transvenous Obliteration (CARTO)
- Complications of TIPS
- PORTAL VEIN THROMBOSIS, ACUTE AND CHRONIC
- Epidemiology
- Liver Transplant in PVT
- Impact of TIPS and PVT Recanalization on Liver Transplant
- SUMMARY
- ACKNOWLEDGMENT
- Part C: The Liver and Biliary Tract
- CHAPTER 199: Complex Hepatic Resection for Primary and Metastatic Tumors
- INTRODUCTION
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- ANESTHETIC CONSIDERATIONS
- SURGICAL TECHNIQUE
- Patient Positioning Incision and Exposure
- Hepatic Artery Resection
- Portal Vein Reconstruction
- Hepatic Vein Reconstruction
- IVC Reconstruction
- Cold Perfusion Techniques
- In Situ Hypothermic Perfusion
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 200: Regional Therapies for Hepatic Malignancies
- INTRODUCTION
- IMAGE-GUIDED LOCOREGIONAL CANCER THERAPIES
- Thermal Ablation
- Transarterial Embolization
- Transarterial Chemoembolization
- Transarterial Radioembolization
- BRIDGING TO LIVER TRANSPLANT
- Bridging With Thermal Ablation
- Bridging With TACE
- Bridging With TARE
- DOWNSTAGING TO TRANSPLANT
- Downstaging With Thermal Ablation
- Downstaging With TACE
- Downstaging With TARE
- CONVERSION TO RESECTION CANDIDACY
- DEFINITIVE REGIONAL TREATMENTS FOR PATIENTS UNABLE TO RECEIVE RESECTION OR TRANSPLANTATION
- Definitive Treatment With Thermal Ablation
- Definitive Treatment With TACE
- Definitive Treatment With TARE
- CONCLUSION
- CHAPTER 201: Management of Hilar Cholangiocarcinoma
- INTRODUCTION
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- Preoperative Planning
- Portal Vein Embolization
- Preoperative Drainage of FLR
- MULTIMODAL THERAPY
- Role of Neoadjuvant Treatment
- SURGICAL TECHNIQUE
- Resection
- Liver Transplantation
- COMPLICATIONS/MANAGEMENT
- Inclusion and Exclusion Criteria
- Waitlist Management
- Technical Considerations
- Allograft Selection
- Common Complications
- OUTCOMES
- CHAPTER 202: Liver Transplantation for HCC
- INTRODUCTION
- EPIDEMIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- Transplant Eligibility
- Bridge to Transplant
- Transplant Prioritization
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- CONCLUSION
- CHAPTER 203: Liver Transplant for Non-HCC Malignancy
- INTRODUCTION
- Perihilar Cholangiocarcinoma (pCCA)
- Hepatoblastoma
- Hepatic Epithelioid Hemangioendothelioma
- Liver Metastasis from Neuroendocrine Tumors (MNETs)
- Colorectal Liver Metastasis
- INDICATIONS/CONTRAINDICATIONS
- OUTCOMES
- CHAPTER 204: Living Donor Liver Transplant
- INTRODUCTION
- MULTIMODAL THERAPY
- Indications/Contraindications
- PREOPERATIVE PLANNING
- Donor Evaluation
- Recipient Evaluation
- SURGICAL CONSIDERATIONS
- Donor Surgical Considerations
- Recipient Surgical Considerations
- SURGICAL TECHNIQUE
- Donor Surgical Technique
- POSTOPERATIVE CARE
- Donor Postoperative Care
- Recipient Postoperative Care
- COMPLICATIONS/MANAGEMENT
- Donor Complications
- Recipient Complications
- OUTCOMES
- Donor Outcomes and Long-Term Follow-Up
- Recipient Outcomes and Long-Term Follow-Up
- CHAPTER 205: Liver Transplant in Children
- INTRODUCTION
- INDICATIONS/CONTRAINDICATIONS
- Indications
- Contraindications
- PREOPERATIVE PLANNING
- Waitlist Ranking and Listing
- SURGICAL TECHNIQUE
- Recipient Operation
- Graft Implantation
- Reduced-Size and Split Liver Transplantation
- POSTOPERATIVE CARE
- Immunosuppression
- COMPLICATIONS/MANAGEMENT
- Rejection
- CHAPTER 206: Early and Late Complications of Liver Transplant
- INTRODUCTION
- SURGICAL COMPLICATIONS
- Primary Allograft Nonfunction
- Bleeding and Coagulopathy
- Vascular Complications
- Arterial Complications
- Portal Venous Complications
- Hepatic Venous Complications
- Biliary Complications
- Biliary Leaks
- Biliary Strictures
- MEDICAL COMPLICATIONS
- Renal Complications
- Immunologic Complications
- Malignancy
- Infectious Complications
- Metabolic Complications
- Neurologic and Psychiatric Complications
- Recurrent Disease
- SUMMARY
- Part D: Pancreas
- CHAPTER 207: Pancreas Transplantation
- INTRODUCTION
- INDICATIONS/CONTRAINDICATIONS
- Indications and Types of Pancreas Transplant
- PREOPERATIVE PLANNING
- Evaluation of the Recipient
- Evaluation of the Donor
- SURGICAL TECHNIQUE
- Donor Pancreatectomy
- BACK TABLE PREPARATION OF THE PANCREAS ALLOGRAFT
- Pancreas Allograft Implantation
- POSTOPERATIVE CARE
- Immunosuppression and Monitoring of Graft Function
- COMPLICATIONS AND MANAGEMENT
- Vascular Thrombosis
- Infectious Complications
- Bowel Obstruction
- Bleeding
- OUTCOMES
- CONCLUSION
- Part E: Renal
- CHAPTER 208: Renal Transplantation: Living Donor and Cadaveric
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- INDICATIONS/CONTRAINDICATIONS
- Assessing Risk of Surgery
- Assessing Suitability for Arterial and Venous Anastomoses
- Bladder Functionality
- Risk of Immunosuppression
- Psychosocial Considerations
- Immunologic Assessment
- LIVING DONOR EVALUATION
- SURGICAL TECHNIQUE
- Allograft Preparation
- Standard Retroperitoneal Approach
- Special Considerations
- SURGICAL TECHNIQUE
- Open Living Donor Nephrectomy
- Laparoscopic Live Donor Nephrectomy
- POSTOPERATIVE CARE
- Immunosuppression
- Hemodialysis in the Perioperative Setting
- Follow-Up
- COMPLICATIONS/MANAGEMENT
- Role for Biopsies
- Technical Complications
- OUTCOMES
- CHAPTER 209: Peritoneal Dialysis
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- Type of PD Catheters
- SURGICAL TECHNIQUE
- PD Catheter Insertion Techniques
- Catheter Length Selection
- Insertion Site and Tunnel Marking
- Open Surgical Technique
- Laparoscopic Technique
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- Early Technical Complications
- Other Catheter-Specific Early Complications
- Special Considerations
- Complications of Peritoneal Dialysis
- Use of Peritoneal Dialysis in the Perioperative Setting/Post Kidney Transplantation
- Removal of PD Catheter
- OUTCOMES
- SECTION XI: Abdominal Core Health
- Part A: Practical Considerations
- CHAPTER 210: Abdominal Core Health—A Holistic Approach to an Old Problem
- CHAPTER 211: Optimizing Patients for Abdominal Core Surgery
- INTRODUCTION
- OBESITY
- SMOKING
- DIABETES
- PREOPERATIVE CHLORHEXEDINE SOAP
- BOWEL PREPARATION
- LOSS OF DOMAIN ADJUNCTS
- BOTULINUM TOXIN
- PROGRESSIVE PREOPERATIVE PNEUMOPERITONEUM
- CONCLUSIONS
- CHAPTER 212: Abdominal Core Rehabilitation
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- MULTIMODAL THERAPY
- OUTCOMES
- Part B: Optimizing Abdominal Wall Closure and Hernia Prevention to Reduce Abdominal Core Dysfunction
- CHAPTER 213: Hernia Prophylaxis of the Midline Abdominal Incision
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- Incisional Hernia Formation and Fascial Closure
- Suture Material Choice
- Interrupted and Continuous Techniques
- Needle Selection
- Suture Gauge
- Knot Selection
- Suture Length to Wound Length Ratio
- INDICATIONS/CONTRAINDICATIONS
- Indications
- Contraindications
- PREOPERATIVE PLANNING
- Identifying the High-Risk Patient for Midline Incisional Hernia Formation
- Managing Midline Laparotomies in the High-Risk Patient
- SURGICAL TECHNIQUE
- Small Bites Technique With a High Suture Length to Wound Length Ratio
- Self-Locking Knot Technique
- Prophylactic Mesh Augmentation
- Retention Sutures
- POSTOPERATIVE CARE
- Abdominal Binders
- Lifting Restrictions
- Abdominal Core Health Programs
- COMPLICATIONS/MANAGEMENT
- Small Bite Technique With a High Suture Length to Wound Length Ratio
- Prophylactic Mesh Augmentation
- OUTCOMES
- Small Bite Technique With a High Suture Length to Wound Length Ratio
- Prophylactic Mesh Augmentation
- CHAPTER 214: Mastery Keys: Surgical Anatomy of the Anterolateral Abdominal Wall
- COMPONENTS OF ANTEROLATERAL ABDOMINAL WALL
- INNERVATION
- Lateral Cutaneous Branches
- Anterior Cutaneous Branches
- Arterial Supply
- Venous Drainage
- Lymphatic Drainage
- MUSCLES
- External Oblique
- Internal Oblique
- Transversus Abdominis
- Rectus Abdominis
- Pyramidalis
- CHAPTER 215: Hernia Prophylaxis of Stoma Sites
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- INDICATIONS/CONTRAINDICATIONS
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- Part C: Intrinsic Diseases of the Abdominal Wall
- CHAPTER 216: Open Approaches for Ventral Hernia
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- Preoperative Optimization
- Imaging and Operative Review
- Surgical Adjuncts to Increase Abdominal Space
- Mesh Use and Indications
- Concurrent Surgeries
- PERIOPERATIVE CARE
- Infection Prophylaxis
- Pain Control
- SURGICAL TECHNIQUE: PRIMARY REPAIR
- Umbilical and Epigastric Hernias
- Primary Umbilical Hernia Repair
- Primary Epigastric Hernia Repair
- Open Primary Incisional Hernia Repair
- SURGICAL TECHNIQUE: MESH-BASED REPAIRS
- Mesh Position
- Mesh Fixation
- Mesh-Based Umbilical and Epigastric Hernia Repair
- Open Preperitoneal Repair
- Open Intraperitoneal Repair
- Open Midline Incisional Hernias
- Open Mesh Incisional Hernia Repair
- MYOFASCIAL RELEASE TECHNIQUES
- External Oblique Release
- Rives–Stoppa Retrorectus Release
- Transversus Abdominis Release
- Off-Midline Hernias
- POSTOPERATIVE CARE
- Pain Control
- Activity
- Abdominal Binder
- Drain Management
- COMPLICATIONS/MANAGEMENT
- Seroma and Hematoma
- Mesh infection and Erosion
- Hernia Recurrence
- Respiratory Decompensation
- OUTCOMES
- Factors Affecting Recurrence After Repair
- Long-Term Outcomes
- CHAPTER 217: Minimally Invasive Approaches for Ventral Hernia
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS
- CONTRAINDICATIONS
- Relative Contraindications
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Laparoscopic Intraperitoneal Onlay Mesh
- Robotic-Assisted Approaches to Minimally Invasive Ventral Hernia Repair
- Robotic IPOM
- Robotic-Assisted Single-Dock Rives–Stoppa
- Robotic eTEP
- Robotic Transversus Abdominis Release (TAR)
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- Linea Semilunaris Disruption
- Missed Enterotomy
- Intraparietal Hernia
- OUTCOMES
- CHAPTER 218: Complex Situations in Abdominal Wall Reconstruction
- CONTAMINATED OPERATIVE FIELD
- PARASTOMAL HERNIA
- Stoma Reversal
- Permanent Stoma
- SUMMARY
- CHAPTER 219: Diastasis of the Abdominal Wall
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- Etiology
- Pathophysiology
- DIAGNOSIS/CLINICAL PRESENTATION
- Patient-Reported Physical Symptoms
- Clinical Findings
- Radiologic Findings
- Self-Report Forms
- Concomitant Hernias
- MULTIMODAL THERAPY
- Abdominal Core Stabilizing Training
- Surgery
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- Patient Selection
- SURGICAL TECHNIQUE
- Open Repairs
- Minimally Invasive Repairs
- POSTOPERATIVE CARE
- Postoperative Drainage
- Pain Management
- Nutrition
- Postoperative Rehabilitation
- Abdominal Binder
- POSTOPERATIVE COMPLICATIONS
- OUTCOMES
- ACKNOWLEDGMENTS
- CHAPTER 220: Open Approaches With Mesh for Inguinofemoral Hernia
- INTRODUCTION
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Lichtenstein–Amid Repair Technique
- PLUG AND PATCH TECHNIQUE
- PROLENE HERNIA SYSTEM REPAIR
- OPEN PREPERITONEAL REPAIRS
- TRANSINGUINAL/TRANSRECTUS SHEATH PREPERITONEAL SUBLAY REPAIR (TIPP/TREPP)
- TRANSRECTUS SHEATH PREPERITONEAL (TREPP) REPAIR
- OUTCOMES
- CHAPTER 221: Mastery Keys: Anatomy of Inguinal and Femoral Hernias
- HERNIAS
- Inguinal Hernias
- Femoral Canal and Femoral Hernias
- CHAPTER 222: Open Tissue-Based Approaches for Inguinofemoral Hernia
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY OF INGUINAL HERNIA
- DIAGNOSIS AND CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- INDICATIONS AND CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Common Steps
- Detailed Descriptions
- Full Shouldice
- SURGICAL TECHNIQUE—PURE TISSUE INGUINAL HERNIA—CRITICAL STEPS
- Mobilization of the External Oblique
- Nerve Identification and Handling
- Role of Neurectomy
- Separation and Division of the Cremaster Muscle
- High Ligation of the Hernia Sac
- Relaxing Incision and Suturing Techniques
- POSTOPERATIVE CARE
- COMPLICATIONS
- After Inguinal Hernia Repair
- OUTCOMES
- Long-Term Results and Value
- ACKNOWLEDGMENT
- CHAPTER 223: Minimally Invasive Approaches for Inguinofemoral Hernia
- INTRODUCTION
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Totally Extraperitoneal Approach
- Transabdominal Pre-Peritoneal Approach
- Preperitoneal Anatomy
- Critical View of the Myopectineal Orifice
- Mesh Placement
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 224: Mastery Keys: Minimally Invasive Inguinal or Femoral Hernia Repair
- CHAPTER 225: Athletic Pubalgia and Core Muscle Injury
- INTRODUCTION
- TERMINOLOGY
- ANATOMY AND PATHOPHYSIOLOGY
- DIAGNOSIS AND CLINICAL PRESENTATION
- Pubis-Related
- Inguinal-Related
- Adductor-Related
- Iliopsoas-Related
- Hip-Related
- INDICATIONS/CONTRAINDICATIONS
- SURGICAL TECHNIQUE AND OUTCOMES
- Open Primary Tissue Repair
- Open Tension-Free Mesh Repair
- Laparoscopic Posterior Mesh Repairs
- POSTOPERATIVE MANAGEMENT/REHABILITATION
- Part D: Extrinsic Diseases of the Abdominal Wall
- CHAPTER 226: Prosthetics, Fixation, and Treatment Related Complications
- INTRODUCTION
- MESH CONSTRUCTION AND TERMINOLOGY
- COMPLICATIONS COMMONLY RELATED TO MESH PLACEMENT
- Seroma
- Migration
- Eventration
- Mesh Infection
- Chronic Groin Pain After Inguinal Hernia Repair
- Chronic Pain after Ventral and Incisional Hernia Repair
- Primary Mesh Failure
- Secondary Mesh Failure
- FIXATION METHODS AND COMPLICATIONS
- FUTURE DIRECTIONS
- CHAPTER 227: Chronic Inguinal Pain: Treatment and Prevention
- INTRODUCTION
- ETIOLOGY
- Inguinal Neuroanatomy
- CLINICAL PRESENTATION AND DIAGNOSIS
- Clinical Evaluation of CPIP
- Imaging
- NONOPERATIVE MANAGEMENT
- MULTIMODAL THERAPY
- INDICATIONS AND CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Open Neurectomy
- Open Inguinal Mesh Removal
- Minimally Invasive Inguinal Mesh Removal
- Laparoscopic Retroperitoneal Triple Neurectomy
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- PREVENTION
- CONCLUSION
- Part E: Tumors of the Abdominal Wall
- CHAPTER 228: Benign Tumors of the Abdominal Wall
- INTRODUCTION
- ETIOLOGY AND PATHOGENESIS
- Benign Histopathologic Tumors
- Abdominal Wall Hernia
- Infections and Inflammatory Masses
- Hematoma
- Epidermoid Cyst (Sebaceous Cyst)
- Gynecologic Pathology
- CLINICAL ASSESSMENT, DIAGNOSTIC EVALUATION, AND TREATMENT
- Historical Assessment
- Examination
- Adjunctive Imaging and Diagnostic Testing
- OPERATIVE CONSIDERATIONS
- CONCLUSION
- CHAPTER 229: Malignant Tumors of the Abdominal Wall
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS TO SURGERY
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CLINICAL CASE
- SECTION XII: Vascular Surgery
- Part A: Cerebrovascular Disease
- CHAPTER 230: Carotid Bifurcation Disease: Carotid Endarterectomy, Transfemoral Stenting, and Transcarotid Artery Revascularization
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- Epidemiology
- Etiology
- Pathophysiology
- Risk Factors
- CLINICAL PRESENTATION
- TIA
- Stroke
- Amaurosis Fugax
- Miscellaneous Circumstances
- BEST MEDICAL THERAPY
- Antiplatelet Therapy
- Antihypertensive Therapy
- Statin Therapy
- Other Risk Factor Modifications
- INDICATIONS AND CONTRAINDICATIONS OF SURGERY AND STENTING
- Symptomatic Carotid Artery Disease
- Asymptomatic Carotid Artery Disease
- Special Circumstances
- Timing of Intervention
- CEA Versus TFCAS Versus TCAR
- PREOPERATIVE PLANNING
- History and Physical Examination
- Preoperative Assessment
- Preoperative Medications
- Radiologic Imaging
- SURGICAL AND ENDOVASCULAR TECHNIQUES
- CEA
- TFCAS
- TCAR
- POSTOPERATIVE CARE
- Postoperative Course
- Postoperative Surveillance
- COMPLICATIONS
- Complications of CEA
- Complications of TFCAS
- Complications of TCAR
- Recurrent Carotid Stenosis
- OUTCOMES
- CEA + BMT Versus BMT Alone
- CEA Versus TFCAS
- TCAR
- CONCLUSIONS
- CHAPTER 231: Mastery Keys: Surgical Anatomy of Carotid Arteries
- COMMON CAROTID ARTERY AND CAROTID BIFURCATION
- SUPERFICIAL STRUCTURES AND SURGICAL EXPOSURE
- INTERNAL JUGULAR VEIN (Fig. 231.2)
- VAGUS NERVE, CAROTID ARTERIES, AND RELATED STRUCTURES (FIGS. 231.2, 231.3, 231.4B)
- INTERNAL CAROTID ARTERY (FIGS. 231.1B, 231.2, 231.3)
- EXTERNAL CAROTID ARTERY (FIGS. 231.1B, 231.2, 231.3, 231.4B)
- CHAPTER 232: Brachiocephalic Reconstruction: Open and Endovascular
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- CLINICAL PRESENTATION
- DIAGNOSIS
- PATIENT SELECTION FOR INTERVENTION
- OPEN SURGICAL RECONSTRUCTION
- MEDIAN STERNOTOMY
- EXPOSURE OF BRACHIOCEPHALIC VESSELS
- CLAMPING THE AORTA
- INNOMINATE ENDARTERECTOMY
- BYPASS GRAFTS
- DIRECT RECONSTRUCTION OF BRACHIOCEPHALIC ANEURYSM
- CAROTID SUBCLAVIAN BYPASS
- SUBCLAVIAN ARTERY TRANSPOSITION
- ENDOVASCULAR RECONSTRUCTION
- LEFT SUBCLAVIAN INTERVENTION
- INNOMINATE ARTERY INTERVENTION
- LEFT COMMON CAROTID ARTERY INTERVENTION
- COMBINED INTERNAL AND COMMON CAROTID DISEASE
- POSTOPERATIVE MANAGEMENT
- OUTCOMES
- Part B: Aneurysm Disease
- CHAPTER 233: Open Thoracoabdominal Aortic Aneurysm Repair
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- Degenerative
- Chronic Aortic Dissection
- Connective Tissue Disorders
- Less Common Etiologies
- CLASSIFICATION AND NATURAL HISTORY
- Classification
- Natural History
- Indications for Intervention
- DIAGNOSIS AND CLINICAL PRESENTATION
- Clinical Presentation
- PREOPERATIVE PLANNING
- Diagnostic Imaging
- Patient Selection
- Preoperative Evaluation
- SURGICAL MANAGEMENT
- Treatment Options
- Perioperative Mechanical Circulatory Support
- Spinal Cord Protection
- TECHNICAL CONDUCT OF OPERATION
- Operating Room Setup
- Operative Exposure
- Cannulation and Initiation of Cardiopulmonary Bypass
- Conduct of Deep Hypothermic Circulatory Arrest and Proximal Reconstruction
- Management of Intercostal Arteries
- Visceral Reconstruction
- Distal Reconstruction
- Cardiopulmonary Bypass Termination and Hemostasis
- Closure
- POSTOPERATIVE CARE
- COMPLICATIONS AND MANAGEMENT
- Operative Mortality
- Spinal Cord Ischemia
- Pulmonary Complications
- Acute Kidney Injury
- Long-Term Outcomes
- CHAPTER 234: Mastery Keys: Anatomy of Aorta
- THORACIC AORTA
- Ascending Aorta (Fig. 234.1)
- Arch of Aorta (Figs. 234.1, and 234.2)
- Thoracic (Descending) Aorta (Figs. 234.2 to 234.4)
- Abdominal Aorta (Figs. 234.5, 234.6 and 234.7)
- Iliac Arteries (Figs. 234.5 and 234.6)
- CHAPTER 235: Open Infrarenal and Pararenal Aortic Aneurysm Repair
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Transabdominal Approach
- Retroperitoneal Approach
- POSTOPERATIVE CARE AND COMPLICATIONS
- CHAPTER 236: Endovascular Repair of Abdominal Aortic Aneurysm
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS, CLINICAL PRESENTATION, AND MEDICAL MANAGEMENT
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- Imaging
- ANATOMIC CONSIDERATIONS
- Aortic Neck
- Distal Aorta
- Access Vessels
- Common Iliac Arteries/Distal Seal Zone
- SURGICAL TECHNIQUE
- Device Selection
- Operative Technique
- Adjuncts
- COMPLICATIONS
- POSTOPERATIVE CARE
- POSTOPERATIVE SURVEILLANCE
- OUTCOMES
- CHAPTER 237: Femoral and Popliteal Artery Aneurysms
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- Surgical Therapy and Preoperative Planning
- SURGICAL TECHNIQUE
- OUTCOMES
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- SURGICAL TECHNIQUE/TREATMENT
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- SURGICAL TECHNIQUE
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- SURGICAL TECHNIQUE/TREATMENT
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- SURGICAL TECHNIQUE/TREATMENT
- Open Surgical Technique
- Endovascular Surgical Approach
- OUTCOMES
- CHAPTER 238: Mastery Keys: Anatomy of Femoral and Popliteal Arteries
- FEMORAL ARTERY
- POPLITEAL ARTERY
- CHAPTER 239: Treatment of Splenic Artery Aneurysms: Open and Endovascular
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- OPEN SURGICAL TECHNIQUE
- ENDOVASCULAR SURGICAL TECHNIQUE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES AND LONG-TERM FOLLOW-UP
- Part C: Chronic Lower Extremity Occlusive Disease
- CHAPTER 240: Treatment of Aortoiliac Occlusive Disease: Open Operations
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- MEDICAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Aortofemoral Bypass
- Retroperitoneal Approach to the Aorta
- Femoral–Femoral Bypass
- Axillofemoral Bypass
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- Long-Term Follow-Up
- CHAPTER 241: Aortoiliac Occlusive Disease: Endovascular Including FERIS
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE: ENDOVASCULAR TREATMENT OF ILIAC ARTERY DISEASE
- Candidacy for a Percutaneous Endovascular Approach
- Positioning
- Access
- Crossing the Lesion
- Treatment of Common Iliac Disease
- Isolated Common Iliac Artery Disease
- Treatment of External Iliac Artery Disease
- Closure Devices
- SURGICAL TECHNIQUE: FERIS
- Candidacy for FERIS
- Positioning
- Surgical Incision
- Exposure of the Common Femoral Artery
- Wire Access
- Femoral Endarterectomy
- SURGICAL TECHNIQUE: TREATMENT OF INFRARENAL AORTIC OCCLUSIVE DISEASE
- Endovascular Treatment of the Infrarenal Aorta
- Endologix AFX Device
- Other Techniques
- SURGICAL TECHNIQUE: ADJUNCTIVE TECHNIQUES
- Reentry Devices
- Contralateral Femoral Access
- Brachial Artery Access
- Balloon Inflow Control
- POSTOPERATIVE CARE
- COMPLICATIONS AND MANAGEMENT
- Iliac Artery Rupture
- Thrombosis
- Hematoma
- Wound Infection
- OUTCOMES
- CHAPTER 242: Peripheral Arterial Occlusive Disease: Open
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- Diagnosis
- Clinical Presentation
- PREOPERATIVE ASSESSMENT
- INDICATIONS/CONTRAINDICATIONS
- Indications for Infrainguinal Bypass
- PREOPERATIVE PLANNING
- Selection of Inflow Artery
- Selection of Outflow (Target) Artery
- Preoperative Assessment of Vein Quality
- Conduit Selection
- ANATOMY
- Surgical Anatomy of the Femoral, Popliteal, and Tibial Arteries
- SURGICAL TECHNIQUE
- Operative Technique for GSV, SSV, and Arm Vein Harvest
- Construction of a Spliced Vein Bypass
- Operative Technique for Femoral to Above-Knee Popliteal Bypass
- Operative Technique for Femoral to Below-Knee Popliteal Bypass
- Operative Technique for Tibial Bypass
- Intraoperative Bypass Graft Assessment
- Wound Closure
- Alternative Inflow Sources
- Intraoperative Troubleshooting and Pitfalls
- COMPLICATIONS/MANAGEMENT
- Graft Thrombosis
- Bleeding
- Infection and Lymphatic Leak
- POSTOPERATIVE MANAGEMENT
- OUTCOMES
- In Situ or RSVG
- CONCLUSIONS
- CHAPTER 243: Endovascular Therapy for Infrainguinal Arterial Occlusive Disease
- INTRODUCTION
- DIAGNOSIS/CLINICAL PRESENTATION
- PREPROCEDURE PLANNING
- PROCEDURAL TECHNIQUE
- Arterial Access and Diagnostic Imaging
- Crossing the Lesion
- Intervention
- Postprocedure Care
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- Femoropopliteal Disease Outcomes
- Tibial Disease Outcomes
- SUMMARY
- CHAPTER 244: Major and Minor Lower Extremity Amputation
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- TREATMENT
- Multidisciplinary Approach
- Avoiding Amputation
- Timing of Revascularization in the Setting of Minor Amputation
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- Determination of Amputation Level
- SURGICAL TECHNIQUE
- Basic Principles
- MINOR AMPUTATIONS
- Preoperative Considerations
- Partial Toe Amputation
- Ray Amputation
- Transmetatarsal Amputation
- MAJOR AMPUTATIONS
- Preoperative Considerations
- BELOW-KNEE AMPUTATION (OR TRANSTIBIAL AMPUTATION)
- Guillotine Amputation
- Long Posterior Myocutaneous Flap (Burgess)
- Skew Flap Transtibial Amputation
- ABOVE-KNEE AMPUTATION
- Through-Knee or Knee Disarticulation
- Transfemoral Amputation
- POSTOPERATIVE MANAGEMENT/COMPLICATIONS
- Minor Amputations
- Major Amputations
- OUTCOMES
- ACKNOWLEDGMENT
- CHAPTER 245: Mastery Keys: Anatomy of Lower Extremity Amputations
- ABOVE-KNEE AMPUTATION (Fig. 245.1)
- Below-Knee Amputation (Fig. 245.2)
- CHAPTER 246: The Prevention and Treatment of Problems With the Diabetic Foot
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS AND CLINICAL PRESENTATION
- MANAGEMENT
- IMPORTANCE OF PREVENTION
- MULTIDISCIPLINARY CARE OF THE DIABETIC FOOT WOUND
- SUMMARY
- Part D: Acute Lower Extremity Ischemia
- CHAPTER 247: Arterial Embolectomy and Lower Extremity Fasciotomy
- INTRODUCTION
- ETIOLOGY
- DIAGNOSIS, PRESENTATION, AND CLASSIFICATION
- OPEN VERSUS ENDOVASCULAR THERAPY
- PERIOPERATIVE MEDICAL THERAPY FOR ACUTE LIMB ISCHEMIA
- SURGICAL TECHNIQUES
- Embolectomy Catheter Basics
- Surgical Technique for Embolectomy
- Surgical Technique for Fasciotomy
- Postoperative Care and Complications
- CHAPTER 248: Mastery Keys: Anatomy of Fascial Compartments of Lower Extremity
- THIGH
- Anterior Compartment
- Medial (Adductor) Compartment
- Posterior Compartment
- Leg
- ANTERIOR COMPARTMENT
- LATERAL COMPARTMENT
- POSTERIOR COMPARTMENT
- Superficial Posterior Compartment
- Deep Posterior Compartment
- Part E: Mesenteric and Renal Artery Disease
- CHAPTER 249: Renal Artery Occlusive Disease: Open and Endovascular Management
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY: RENOVASCULAR HYPERTENSION
- PATHOPHYSIOLOGY: ISCHEMIC NEPHROPATHY
- CLINICAL PRESENTATION
- Epidemiology
- History and Physical Examination
- Initial Laboratory Findings
- Natural History
- PREOPERATIVE PLANNING
- Diagnostic Evaluation: Functional Studies
- Diagnostic Evaluation: Noninvasive Imaging
- Diagnostic Evaluation: Invasive Imaging
- SURGICAL TECHNIQUE
- Endovascular Repair
- Open Repair
- RESULTS OF RENAL ARTERY INTERVENTION AND OUTCOMES
- CHAPTER 250: Acute Mesenteric Artery Ischemia: Open and Endovascular
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS AND CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE—OPEN
- SURGICAL TECHNIQUE—ENDOVASCULAR
- Endovascular Access
- Endovascular Diagnostic and Revascularization Techniques
- Acute Embolus
- Acute Thrombosis in the Setting of Chronic Occlusive Disease
- Retrograde Open Mesenteric Stenting
- POSTOPERATIVE CARE
- COMPLICATIONS AND THEIR MANAGEMENT
- OUTCOMES
- CHAPTER 251: Mastery Keys: Anatomy of Mesenteric Arteries
- CELIAC ARTERY (Fig. 251.1)
- SUPERIOR MESENTERIC ARTERY (FIGS. 251.1 to 251.3)
- INFERIOR MESENTERIC ARTERY (FIGS. 251.1 and 251.4)
- CHAPTER 252: Open and Endovascular Revascularization for Chronic Mesenteric Ischemia
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- CLINICAL PRESENTATION AND DIAGNOSIS
- TREATMENT STRATEGIES AND PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE: OPEN REVASCULARIZATION
- Outcomes, Complications, and Management
- SURGICAL TECHNIQUE: ENDOVASCULAR REVASCULARIZATION
- SURGICAL TECHNIQUE: HYBRID REVASCULARIZATION
- Outcomes, Complications, and Management
- SUMMARY
- Part F: Venous Disorders
- CHAPTER 253: Contemporary Operative Venous Thrombectomy
- INTRODUCTION
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- The Technique of Operative Venous Thrombectomy
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 254: Chronic Deep Vein Thrombosis/Postthrombotic Syndrome: Open and Endovascular Treatment
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- MEDICAL THERAPY
- INDICATIONS FOR ENDOVASCULAR SURGERY
- ENDOVASCULAR SURGERY TECHNIQUES AND OPTIONS
- IVC FILTER-INDUCED VENOCAVAL OBSTRUCTIVE DISEASE
- Surgical Technique
- Extra-Abdominal Reconstructions
- Intra-Abdominal Reconstructions
- Endophlebectomy
- Adjunctive Procedures
- Postoperative Care
- Complications/Management
- Outcomes
- ACKNOWLEDGMENT
- CHAPTER 255: Vena Cava Filter Placement and Removal
- INTRODUCTION
- INDICATIONS/CONTRAINDICATIONS
- Filter Placement
- Types of Available Vena Cava Filters
- PREOPERATIVE PLANNING
- Anatomic Considerations
- Duplication of the IVC
- Isolated Left-Sided IVC
- Circumaortic and Retroaortic Left Renal Veins
- Megacava
- SURGICAL TECHNIQUE
- Standard Fluoroscopy-Guided IVC Filter Placement
- Ultrasound-Guided IVC Filter Placement
- IVC Filter Retrieval
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- Early Complications
- Late Complications
- OUTCOMES
- The Prepic Trials
- ACKNOWLEDGMENT
- CHAPTER 256: Venous Insufficiency Treatments, Including Medical Management
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- Medical Management/Conservative Measures
- INDICATIONS/CONTRAINDICATIONS
- Intervention
- Preoperative Planning
- SURGICAL TECHNIQUE
- Treatment of Truncal Veins
- Thermal Ablation (Radiofrequency and Laser)
- Nontumescent/Nonthermal Ablation
- Surgical Therapies
- Treatment of Tributary Veins
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- Deep Venous Insufficiency
- OUTCOMES
- Part G: Dialysis Access
- CHAPTER 257: Autogenous and Prosthetic Arteriovenous Hemodialysis Access
- INTRODUCTION
- “Life-Plan”
- CLINICAL PRESENTATION AND GENERAL PRINCIPLES
- SURGICAL TECHNIQUES
- Anesthetic Choice and General Principles
- Autogenous Radio-Cephalic Access
- Autogenous Radio-Basilic Access
- Autogenous Brachio-Cephalic Access
- Autogenous Brachio-Basilic Access (Single- and Two-Stage Procedures)
- Forearm Loop Prosthetic Access
- Brachial Artery or Axillary Artery-to-Axillary Vein Graft
- POSTOPERATIVE CARE
- COMPLICATIONS AND MANAGEMENT
- Hematoma
- Thrombosis
- Infection
- Edema and CVOD
- (Pseudo)Aneurysm
- Neuropathic Pain Syndromes, IMN, ARHI
- OUTCOMES
- CHAPTER 258: Mastery Keys: Vascular Anatomy of Upper Extremity
- RADIAL ARTERY
- BRACHIAL ARTERY
- ARTERIOVENOUS FISTULA
- Part H: Thoracic
- CHAPTER 259: Thoracic Outlet Syndrome
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- Neurogenic TOS
- Arterial TOS
- Venous TOS—Paget–Schroetter Syndrome
- MULTIMODAL THERAPY
- Neurogenic TOS
- Arterial TOS
- Venous TOS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Supra/Infraclavicular
- Transaxillary
- POSTOPERATIVE MANAGEMENT
- COMPLICATIONS
- Neuropraxia and Brachial Plexus Injury
- Lymphatic Leak
- Bleeding
- Pneumothorax
- OUTCOMES
- CHAPTER 260: Mastery Keys: Anatomy of the Thoracic Outlet
- CHAPTER 261: Blunt Thoracic Aortic Injury (BTAI)
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS AND CLINICAL PRESENTATION
- BTAI CLASSIFICATION
- INITIAL MANAGEMENT
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- Part I: Trauma
- CHAPTER 262: Vascular Injuries to the Neck, Including the Subclavian Vessels
- INTRODUCTION
- HISTORICAL PERSPECTIVE
- GENERAL APPROACH—ANATOMIC ZONES
- ETIOLOGY/EPIDEMIOLOGY
- MANAGEMENT
- Operating Room Setup/Hybrid Setup
- ZONE I
- ZONE II
- ZONE III
- Blunt Vascular Injury
- VERTEBRAL ARTERY TRAUMA
- SUMMARY
- CHAPTER 263: Injury to the Abdomen: Open and Endovascular
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- Mechanism
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Open Surgical Management
- Injuries in the Porta Hepatis
- Endovascular
- Angioembolization
- Stent-Grafting
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT/OUTCOMES
- CHAPTER 264: Injury to the Extremities: Open and Endovascular Management
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- EPIDEMIOLOGY, AMPUTATION, AND MORTALITY
- Civilian
- Military
- PEDIATRIC INJURY
- INDICATIONS FOR INTERVENTION
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- General Operative Topics
- TEMPORARY VASCULAR SHUNTING (TVS)
- Conduit Selection
- Arterial Repair
- Vein Repair
- Fasciotomy
- Wound Management
- Upper Extremity
- Lower Extremity
- Endovascular Treatment
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- Long-Term Follow-Up
- SECTION XIII: Trauma, Burn, and Acute Care Surgery
- CHAPTER 265: Initial Assessment and Airway Management
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- INITIAL ASSESSMENT
- Trauma Team
- Prehospital Handoff
- Primary Survey
- Airway
- Breathing
- Circulation
- Disability
- Exposure
- Monitoring
- Primary Survey Adjuncts
- Secondary Survey
- Additional Diagnostic Studies
- Resuscitative Emergency Department Thoracotomy
- AIRWAY MANAGEMENT
- Airway Anatomy
- Airway Assessment
- Definitive Airway Measures
- Emergency Surgical Airway
- OUTCOMES
- CHAPTER 266: Focused Assessment with Sonography in Trauma (FAST)
- INTRODUCTION
- HISTORICAL PERSPECTIVES
- TECHNICAL CONSIDERATIONS
- Physics of Ultrasound
- Transducer Types
- COMPLETING THE EXAM
- Right Upper Quadrant View
- Pericardial View
- Left Upper Quadrant View
- Pelvic
- Incorporation of Extended FAST
- CLINICAL APPLICATION
- ADDITIONAL CONSIDERATIONS, PEARLS, AND PITFALLS
- FUTURE DIRECTIONS
- OUTCOMES
- CHAPTER 267: Management of Neck Injuries
- INTRODUCTION
- ANATOMY
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- ETIOLOGY/PATHOPHYSIOLOGY
- INJURY GRADING
- MANAGEMENT
- DIAGNOSIS/CLINICAL PRESENTATION
- MANAGEMENT
- DIAGNOSIS/CLINICAL PRESENTATION
- MANAGEMENT
- INTRODUCTION
- The “No-Zone” Approach
- DIAGNOSIS/CLINICAL PRESENTATION
- Airway and Breathing
- Circulation
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Management of Zone I Injury
- Management of Vascular Injury
- Management of Penetrating Laryngotracheal Injuries
- Management of Penetrating Pharyngoesophageal Injury
- SUMMARY
- CHAPTER 268: Mastery Keys: Surgical Anatomy of Lateral Neck Exploration for Trauma
- EXPOSURE
- EXPLORATION OF VASCULAR STRUCTURES
- EXPLORATION OF MIDLINE STRUCTURES
- ADDITIONAL EXPOSURE OF THORACIC INLET
- CHAPTER 269: Neurosurgical Emergencies
- INTRODUCTION
- Etiology and Pathophysiology
- DEFINITION
- PATHOGENESIS AND PATHOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- IMAGING STUDIES
- COMPLICATIONS/MANAGEMENT
- Primary and Secondary Survey
- Patients with GCS Score 3–8
- Intracranial Pressure, Cerebral Perfusion Pressure, and Pressure Reactivity Index
- Patients with Diffuse Axonal Injury
- Patients with Brain Contusion
- Craniotomy or Decompressive Craniectomies for Hematomas or Diffuse Axonal Injuries
- Acute on Chronic SDH
- Surgical Management of CSF Fistulas
- OUTCOMES
- Patients With Penetrating Brain Injury
- INTRODUCTION
- PATHOGENESIS AND PATHOLOGY
- DIAGNOSIS, CLINICAL PRESENTATION
- IMAGING STUDIES
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- Prognosis
- CHAPTER 270: Thoracic Trauma and Injury to the Diaphragm
- INTRODUCTION
- INITIAL EVALUATION
- RESUSCITATIVE THORACOTOMY
- Indications/Contraindications
- Surgical Technique
- SECONDARY EVALUATION, DIAGNOSIS, AND CLINICAL PRESENTATION
- Indications for Urgent Intervention in Thoracic Trauma
- Surgical Technique: Incisions and Approaches
- RIB FRACTURES
- Clinical Presentation and Diagnosis
- Treatment
- STERNAL FRACTURES
- PULMONARY INJURIES
- LACERATIONS
- Operative Indications and Approach
- Treatment
- CONTUSIONS
- Clinical Presentation and Diagnosis
- Treatment
- CLINICAL PRESENTATION OF PENETRATING AND BLUNT CARDIAC INJURY
- OPERATIVE APPROACHES
- TREATMENT
- MYOCARDIAL CONTUSION: DIAGNOSIS AND TREATMENT
- CLINICAL PRESENTATION AND DIAGNOSIS
- OPERATIVE PLANNING, APPROACHES, AND TREATMENT
- CLINICAL PRESENTATION AND DIAGNOSIS
- Operative Approach
- Treatment
- CLINICAL PRESENTATION AND DIAGNOSIS
- OPERATIVE APPROACH
- TREATMENT
- CLINICAL PRESENTATION AND DIAGNOSIS
- TREATMENT
- POSTOPERATIVE MANAGEMENT
- ANATOMY
- ETIOLOGY AND PATHOPHYSIOLOGY
- CLINICAL PRESENTATION AND DIAGNOSIS
- OPERATIVE INDICATIONS, PLANNING, AND TREATMENT
- OPERATIVE TREATMENT
- Laparotomy
- Laparoscopy
- Thoracoscopy (VATS)
- Thoracotomy
- POSTOPERATIVE CARE AND COMPLICATIONS
- CONCLUSION
- CHAPTER 271: Retained Hemothorax, Pleural Effusion and Traumatic Empyema
- DEFINITION
- DIAGNOSIS/CLINICAL PRESENTATION
- Plain Radiography
- Computed Tomography
- Ultrasonography
- MULTIMODAL THERAPY
- Standardized Approach
- DIAGNOSIS/CLINICAL PRESENTATION
- Plain Radiography
- Ultrasonography
- Computed Tomography
- MULTIMODAL THERAPY
- Antibiotic Therapy
- Pleural Drainage
- Fibrinolytics
- PERIPROCEDURAL MANAGEMENT AND TECHNIQUE
- POSTOPERATIVE CONSIDERATIONS
- COMPLICATIONS
- Inadequate Drainage or Recurrence
- Persistent Air Leak
- Trapped Lung
- CONCLUSION
- CHAPTER 272: Management of Cardiac Injuries
- INTRODUCTION
- ETIOLOGY
- DIAGNOSIS AND CLINICAL PRESENTATION
- OPERATIVE MANAGEMENT AND NONOPERATIVE THERAPY
- Preoperative Planning
- SURGICAL TECHNIQUES
- Pericardial Window
- Positive Pericardial Window and Management with Pericardial Drain Only
- Decision on Incision—Thoracotomy versus Sternotomy
- VENTRICULAR INJURIES
- ATRIAL INJURIES
- CORONARY ARTERIES
- INTRA- AND POSTOPERATIVE CARE
- Resuscitation
- Postoperative Management
- Complications
- Outcomes
- CHAPTER 273: Mastery Keys: Surgical Anatomy of Median Sternotomy and Heart
- MEDIAN STERNOTOMY
- HEART
- External Anatomy (Figs. 273.1 to 273.4)
- Blood Supply (Figs. 273.3A, 273.4 to 273.6)
- CHAPTER 274: Damage Control Laparotomy
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSTICS/CLINICAL PRESENTATION
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE OF DAMAGE CONTROL LAPAROTOMY
- Resuscitation in the ICU
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 275: Treatment of Major Hepatic and Splenic Trauma
- INTRODUCTION
- OPERATIVE ANATOMY
- Liver and Biliary Tree
- Spleen
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- NONOPERATIVE MANAGEMENT OF IPSO INJURIES
- OPERATIVE MANAGEMENT OF IPSO INJURIES
- Operative Preparations
- DEFINITIVE OPERATIVE TECHNIQUES
- Liver
- Hemostasis of Hepatic Injuries
- Spleen
- ENDOVASCULAR MANAGEMENT OF IPSO INJURIES
- Spleen
- COMPLICATIONS AND MANAGEMENT
- Hemorrhage
- Abscess
- Splenic Necrosis
- Hepatic Necrosis
- Hemobilia
- Biloma, Biliary Fistula, Bile Leak, Bile Peritonitis
- Hepatic Arteriovenous Fistula Formation
- POSTOPERATIVE CARE AND FOLLOW-UP
- CHAPTER 276: Abdominal Vascular Injury and Use of REBOA
- INTRODUCTION
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- PREOPERATIVE PLANNING
- INDICATIONS AND CONTRAINDICATIONS FOR REBOA USE
- Zone 1 REBOA
- Zone 3 REBOA
- Zone 2 REBOA
- SURGICAL TECHNIQUE
- First Step: Get Access
- Open Cut-Down Technique
- Placement of Balloon
- Determining Definitive Control of Hemorrhage
- Deflation of Balloon Occlusion
- Partial REBOA
- POSTOPERATIVE CARE
- COMPLICATIONS
- OUTCOMES AFTER REBOA
- CONCLUSIONS
- CHAPTER 277: Duodenal and Pancreatic Trauma
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- Classification of Injury—American Association for the Surgery of Trauma (AAST) Duodenum Organ Injury Scale (OIS)
- SURGICAL TECHNIQUE
- Exposure of the Duodenum
- Factors in Repair
- Nonoperative Management of Organ Injury Scale Grade I Duodenal Hematoma
- Management of Organ Injury Scale Grades II, III, and Selected Grade IV Injuries (Table 277.2)
- Adjunctive Procedures for Selected Patients Undergoing Duodenal Repair
- Management of Organ Injury Scale Grade IV Injury Involving the Ampulla or Distal Common Bile Duct and Grade V Injury (Table 277.2)
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTINODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- Classification of Injury—American Association for the Surgery of Trauma Pancreas Organ Injury Scale
- SURGICAL TECHNIQUE
- Exposure of the Pancreas
- Factors in Repair
- Nonoperative Management of Organ Injury Scale Grade I, II, and Select Grade III Injuries
- Management of Organ Injury Scale Grades I and II Injuries Found Incidentally at Laparotomy (Table 277.5)
- Management of Organ Injury Scale Grade III Injury (Table 277.5)
- Management of Organ Injury Scale Grade IV Injury (Table 277.5)
- Management of Organ Injury Scale Grade V Injury (Table 277.5)
- SUMMARY OF OPERATIVE MANAGEMENT FOR PANCREATIC INJURIES
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- COMBINED PANCREATODUODENAL INJURIES
- Complications/Mortality
- CHAPTER 278: Abdominal Compartment Syndrome and Management of the Open Abdomen
- INTRODUCTION
- ETIOLOGY AND DIAGNOSIS
- MANAGEMENT
- INDICATIONS
- TEMPORARY ABDOMINAL CLOSURE
- POSTOPERATIVE CARE IN THE OPEN ABDOMEN
- CLOSURE TECHNIQUES
- STAGE 1: ATTEMPTED DELAYED PRIMARY CLOSURE
- STAGE 2: STAGED SPLIT-THICKNESS SKIN GRAFTING
- COMPLICATIONS (OPEN ABDOMEN)
- STAGE 3: DEFINITIVE ABDOMINAL WALL RECONSTRUCTION
- OPERATIVE TECHNIQUE: MODIFIED COMPONENTS SEPARATION
- Step 1: Skin Graft Removal
- Step 2: Full-Thickness Skin-Flap Creation
- Step 3: External Oblique Component of Anterior Rectus Fascia Release
- Step 4: Posterior Rectus-Sheath Dissection
- Step 5: The Memphis Modification—Internal Oblique Component of Anterior Rectus-Fascia Release
- Step 6: Anterior Fascia and Muscle Translocation
- Step 7: Midline Closure
- POSTOPERATIVE CARE (ABDOMINAL WALL RECONSTRUCTION)
- COMPLICATIONS (ABDOMINAL WALL RECONSTRUCTION)
- OUTCOMES
- SUMMARY
- CHAPTER 279: Pelvic Fractures and Retroperitoneal Hematoma
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- Anatomy
- Injury Classification
- DIAGNOSIS/CLINICAL PRESENTATION
- Primary and Secondary Survey
- Imaging Adjuncts
- Management of Concomitant Injuries
- Additional Considerations in Special Populations
- MULTIMODAL THERAPY
- Temporary Hemostasis
- Definitive Hemostasis
- SURGICAL TECHNIQUE
- Preperitoneal Packing
- Open Vascular Control
- External Fixation
- Approach to Retroperitoneal Injuries
- Management of Urologic Injuries
- Definitive Pelvic Fixation
- Anterior–Posterior Compression Injuries
- Lateral Compression Injuries
- Open Pelvic Fractures
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- Pelvic Sepsis
- Venous Thromboembolism
- Fat Embolism Syndrome
- OUTCOMES
- CHAPTER 280: Genitourinary Tract Trauma
- INTRODUCTION
- RENAL TRAUMA
- Staging of Renal Injuries
- Radiographic Staging
- INDICATIONS FOR SURGICAL EXPLORATION
- PARENCHYMAL INJURY
- VASCULAR INJURY
- RENAL EXPLORATION AND RECONSTRUCTION
- Proximal Vascular Control
- Principles of Reconstruction
- Specific Techniques
- VASCULAR INJURY AND REPAIR
- POSTOPERATIVE CARE AND COMPLICATIONS
- USE OF INTERVENTIONAL RADIOLOGY TECHNIQUES IN RENAL TRAUMA
- Angioembolization
- Endovascular Stents
- COMPLICATIONS OF RENAL INJURIES
- URETERAL INJURY
- Staging
- Principles of Reconstruction
- Techniques of Reconstruction
- Bladder Trauma
- Principles of Reconstruction
- Urethral Trauma
- Anterior Urethral (Straddle) Injuries
- Posterior Urethral Injuries
- External Genital Trauma
- Testicular Trauma
- PENILE TRAUMA
- Penile Fracture
- Penile Amputation
- Penetrating Penile Injury
- Skin Loss to Genitals
- Genital Burn Injuries
- CONCLUSIONS
- CHAPTER 281: Mastery Keys: Surgical Anatomy of Urogenital System
- KIDNEYS
- Fasciae (Fig. 281.2)
- Location and Parts
- Blood Supply
- Lymphatic Drainage (Fig. 281.8A)
- Innervation (Fig. 281.8C)
- URETERS
- Vasculature (Fig. 281.7A)
- INNERVATION (Fig. 281.8C)
- URINARY BLADDER
- Parts
- Vasculature
- Innervation
- Urethra
- CHAPTER 282: Burn and Inhalation Injury
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- Risk Factor
- Burn Wound Evaluation
- Diagnosis of Inhalation Injury and Respiratory Poisoning
- Other Concomitant Injuries
- Prognosis
- MULTIMODAL THERAPY
- Triage
- Initial Medical Treatment
- IMMEDIATE SURGICAL TREATMENT: ESCHAROTOMY AND FASCIOTOMY
- Escharotomy
- Fasciotomy
- INDICATION FOR SURGICAL TREATMENT
- Specific Considerations:
- PREOPERATIVE PLANNING: TIMING AND WOUND COVERAGE STRATEGY
- Surgical Timing
- Wound Coverage Strategy
- Definitive Coverage
- SURGICAL TECHNIQUE
- Wound Care
- Excision
- Autologous Skin Graft
- Expansion
- Alexander Technique
- Allo- and Xenograft as Temporary Coverage
- Dermal Regenerative Template
- Cultured Epithelial Autograft
- POSTOPERATIVE CARE
- OUTCOMES
- Acute Complications
- Long-Term Results
- CONCLUSION
- CHAPTER 283: Management of the Acute Abdomen
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- SURGICAL TECHNIQUE
- Laparoscopy
- Open laparotomy
- Damage Control in Emergency General Surgery
- SPECIAL PATIENT POPULATIONS AND CONSIDERATIONS
- Transplant Patients
- COVID-19
- Postoperative/Postprocedural Patients
- Abdominal Pain in Pregnancy
- Acute Abdomen in the Medical Intensive Care Unit
- Acute Abdomen after Bariatric Surgery
- COMPLICATIONS/OUTCOMES
- SUMMARY
- CHAPTER 284: Gastrointestinal Bleeding
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- Upper Gastrointestinal Bleeding:
- Lower Gastrointestinal Bleeding
- Occult GI Bleeding
- Obscure Gastrointestinal Bleeding
- Common Etiologies of Upper GI Bleeding
- Common Etiologies of Lower GI Bleeding
- DIAGNOSIS/CLINICAL PRESENTATION
- Bleeding Localization
- MULTIMODAL THERAPY
- Upper GI Bleeding Procedures and Interventions
- Lower GI Procedures and Interventions
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- Long-Term Followup
- CHAPTER 285: Gastric and Duodenal Perforations
- INTRODUCTION
- CLINICAL PRESENTATION/DIAGNOSIS
- Laboratory Studies
- Imaging Studies
- MANAGEMENT PRINCIPLES
- Principles of Nonoperative Management
- Principles of Operative Management
- SURGICAL TECHNIQUES
- Patient Positioning and Operative Equipment
- Incision
- Irrigation
- Role of Intraoperative Biopsy
- Gastric Perforations
- Duodenal Perforations
- COMPLICATIONS/MANAGEMENT
- Postoperative Management
- Postoperative Care/Complications
- CHAPTER 286: Acute Biliary Tract Disease
- INTRODUCTION
- SURGICAL ANATOMY
- CLINICAL PRESENTATION
- DIAGNOSIS AND TREATMENT
- INDICATIONS
- Cholecystostomy
- Open Cholecystectomy
- Operative Cholangiogram
- Operative Ultrasonography
- Subtotal Cholecystectomy
- Common Bile Duct Exploration
- Other Maneuvers
- POSTOPERATIVE MANAGEMENT
- CHAPTER 287: Small Bowel Obstruction
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- Indications for Surgery
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- Long-Term Follow-Up
- CHAPTER 288: Appendicitis
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- THERAPY
- Nonoperative Management
- Complicated Appendicitis
- OPERATIVE MANAGEMENT
- Indications/Contraindications
- Preoperative Planning
- SURGICAL TECHNIQUE
- Open Appendectomy
- LAPAROSCOPIC APPENDECTOMY
- ROBOTIC-ASSISTED APPENDECTOMY
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- SPECIAL CONSIDERATIONS
- Appendicitis in Pregnancy
- Appendiceal Diverticulitis
- Appendicitis in Elderly
- Periappendicitis
- Incidental Appendectomy
- CHAPTER 289: Management of Toxic Megacolon and C. difficile Colitis
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Exploration and Planning
- Diversion Procedure (Ileostomy–Colostomy)
- Colonic Lavage Through Diverting Loop Ileostomy
- Subtotal or Total Colectomy
- Proctocolectomy with End Ileostomy/Re-Establishment of Intestinal Continuity
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- Wound Infection/Fascial Dehiscence
- Intra-Abdominal/Pelvic Abscesses
- Stomas
- Hemorrhage
- Antibiotics
- OUTCOMES
- CHAPTER 290: Complication of Bariatric Surgery
- INTRODUCTION
- EARLY COMPLICATIONS
- Leak
- Bleeding
- Thromboembolic Complications
- Cardiopulmonary Complications
- Early Bowel Obstruction
- LATE COMPLICATIONS
- Strictures and Stenosis
- Marginal Ulcer
- Gastrogastric Fistula
- Bowel Obstruction
- Gastroesophageal Reflux Disease
- COMPLICATIONS ASSOCIATED WITH OTHER BARIATRIC PROCEDURES
- Adjustable Gastric Band Complications
- Duodenal Switch/Biliopancreatic Diversion, and Single Anastomotic Procedures
- OTHER CONSIDERATIONS
- Biliary Disease
- Nutritional Deficiencies
- Weight Recidivism
- Psychiatric Considerations
- CONCLUSION
- CHAPTER 291: Surgical Infections of Skin and Soft Tissue
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS AND CLINICAL PRESENTATION
- INDICATIONS AND CONTRAINDICATIONS FOR SURGERY
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- NSTI
- Prognosis and Futility for NSTI
- CHAPTER 292: Management of Incarcerated Hernias
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- Inguinal Hernia
- Ventral Hernia
- Parastomal Hernia
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Inguinal Hernia
- Ventral Hernia
- Other Hernias
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CONCLUSION
- SECTION XIV: Pediatric Surgery
- CHAPTER 293: Congenital Neck Masses
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- PREOPERATIVE PLANNING
- INDICATIONS/CONTRAINDICATIONS
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE, COMPLICATIONS, AND OUTCOMES
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS, CLINICAL PRESENTATION, AND PREOPERATIVE PLANNING
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- SURGICAL TECHNIQUE
- Open Excision: General Concepts
- First Branchial Cleft Anomalies
- Second, Third, and Fourth Branchial Cleft Anomalies
- Endoscopic Obliteration
- POSTOPERATIVE CARE, COMPLICATIONS, AND OUTCOMES
- ETIOLOGY AND PATHOPHYSIOLOGY
- Infectious Etiologies
- Neoplastic Etiologies
- Inflammatory and Miscellaneous Etiologies
- DIAGNOSIS AND CLINICAL PRESENTATION
- Infectious Lymphadenopathy
- Neoplastic Lymphadenopathy
- PREOPERATIVE PLANNING AND INDICATIONS
- Laboratory Evaluation
- Imaging
- Biopsy
- SURGICAL TECHNIQUE
- Excisional Lymph Node Biopsy
- POSTOPERATIVE CARE, COMPLICATIONS, AND OUTCOMES
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS, CLINICAL PRESENTATION, INDICATIONS FOR SURGERY, AND PREOPERATIVE PLANNING
- Subglottic Hemangiomas
- Lymphatic Malformations
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE, COMPLICATIONS, OUTCOMES, AND MULTIMODAL CARE
- CHAPTER 294: Esophageal Atresia and Tracheoesophageal Fistula
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Open
- Thoracoscopic
- Magnets
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- Anastomotic Leak
- Anastomotic Stricture
- Recurrent Tracheoesophageal Fistula
- Tracheobronchomalacia
- Gastroesophageal Reflux Disease and Esophageal Dysmotility
- Long Gap Esophageal Atresia
- H-Type Tracheoesophageal Fistula
- OUTCOMES
- CHAPTER 295: Mastery Keys: Embryology of the Development of the Esophagus and Trachea
- CHAPTER 296: Congenital Diaphragmatic Hernia
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- CLINICAL PRESENTATION
- Fetal Presentation/Risk Prediction
- Postnatal Presentation/Risk Prediction
- MULTIMODAL THERAPY AND PREOPERATIVE PLANNING
- Neonatal Management
- Extracorporeal Life Support
- PREOPERATIVE PREPARATION
- SURGICAL TECHNIQUE
- Open Repair via Left Subcostal Approach
- Nuances for Operating on ECLS
- Nuances for Approaching Right CDH
- Minimally Invasive Surgical (MIS) Repair via Thoracoscopic Approach
- COMPLICATIONS
- OUTCOMES
- CHAPTER 297: Chest Wall Deformities
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS AND CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- Pain
- Metal Allergy Screening
- Constipation
- SURGICAL TECHNIQUE
- Choice of Operation
- Anesthetic Considerations
- Minimally Invasive Repair of Pectus Excavatum (Modified Nuss Procedure)
- Procedure
- Open Pectus Repair
- Positioning
- POSTOPERATIVE CARE
- Activity Restriction
- Bar Removal
- COMPLICATIONS AND THEIR MANAGEMENT
- Pneumothorax
- Bar Rotation
- Infection
- Metal Allergy
- Pleural Effusion
- Bleeding at Bar Removal
- Recurrence
- OUTCOMES
- CHAPTER 298: Gastroesophageal Reflux Disease in Infants and Children
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Gastrostomy/Gastrojejunostomy
- Nissen Fundoplication
- Open Nissen Fundoplication
- Gastro-Esophageal Disassociation/Disconnection
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- Gastrojejunostomy
- Fundoplication
- OUTCOMES
- Long-Term Follow-Up
- CHAPTER 299: Hypertrophic Pyloric Stenosis and Congenital Duodenal Obstruction
- INTRODUCTION
- Hypertrophic Pyloric Stenosis
- Congenital Duodenal Obstruction
- EPIDEMIOLOGY
- Hypertrophic Pyloric Stenosis
- ETIOLOGY AND PATHOPHYSIOLOGY
- Hypertrophic Pyloric Stenosis
- Congenital Duodenal Obstruction
- DIAGNOSIS AND CLINICAL PRESENTATION
- Hypertrophic Pyloric Stenosis
- Congenital Duodenal Obstruction
- MULTIMODAL THERAPY
- Hypertrophic Pyloric Stenosis
- Congenital Duodenal Obstruction
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- Hypertrophic Pyloric Stenosis
- Congenital Duodenal Obstruction
- SURGICAL TECHNIQUE
- Hypertrophic Pyloric Stenosis
- Congenital Duodenal Obstruction
- POSTOPERATIVE CARE
- Hypertrophic Pyloric Stenosis
- Congenital Duodenal Obstruction
- COMPLICATIONS/MANAGEMENT
- Hypertrophic Pyloric Stenosis
- Congenital Duodenal Obstruction
- OUTCOMES
- Hypertrophic Pyloric Stenosis
- Congenital Duodenal Obstruction
- CHAPTER 300: Malrotation
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- Ultrasonography
- Upper Gastrointestinal Study
- Other Imaging Modalities
- Considerations in Patients with Congenital Heart Disease
- SURGICAL TECHNIQUE
- Open Ladd procedure
- Laparoscopic Ladd Procedure
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- ACKNOWLEDGMENT
- CHAPTER 301: Mastery Keys: Embryology of Gastrointestinal Tract
- CHAPTER 302: Biliary Atresia and Choledochal Cysts–Obstructive Jaundice in the Pediatric Population
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- Anatomic Classification
- CLINICAL PRESENTATION
- INDICATIONS AND PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Initial Fibrous Remnant Dissection
- Extended Lateral Dissection
- Enteric Drainage
- Laparoscopic Portoenterostomy
- POSTOPERATIVE CARE
- COMPLICATIONS AND MANAGEMENT
- OUTCOMES
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- CLINICAL PRESENTATION
- INDICATIONS AND PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- COMPLICATIONS AND OUTCOMES
- CHAPTER 303: Intussusception
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- Resuscitation
- Radiographic Management
- Surgical Management
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 304: Congenital Abdominal Wall Defects
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- PREOPERATIVE PLANNING
- INDICATIONS AND CONTRAINDICATIONS
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- COMPLICATIONS AND MANAGEMENT
- OUTCOMES
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- INDICATIONS/CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- Staged Neonatal Closure
- Scarification Treatment
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- Ruptured Omphalocele
- OUTCOMES
- CHAPTER 305: Mastery Keys: Embryology of Formation of Thoracic and Abdominal Wall and Cavities
- DEVELOPMENT AND DIFFERENTIATION OF SOMITES
- DEVELOPMENT OF BODY CAVITIES
- CHAPTER 306: Neonatal Necrotizing Enterocolitis and Short Bowel Syndrome
- INTRODUCTION
- NEONATAL NECROTIZING ENTEROCOLITIS
- ETIOLOGY AND PATHOPHYSIOLOGY
- CLINICAL PRESENTATION AND DIAGNOSIS
- TREATMENT
- INDICATIONS FOR SURGERY
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- COMPLICATIONS
- ETIOLOGY, PATHOPHYSIOLOGY, AND CLINICAL PRESENTATION
- TREATMENT
- COMPLICATIONS OF SHORT BOWEL SYNDROME AND INDICATIONS FOR SURGERY
- SURGICAL TECHNIQUES
- POSTOPERATIVE CARE
- COMPLICATIONS OF INTESTINAL LENGTHENING
- INTESTINAL TRANSPLANT
- ACKNOWLEDGEMENT
- CHAPTER 307: Neonatal Bowel Obstruction
- INTRODUCTION
- PRENATAL HISTORY
- PERINATAL MANAGEMENT
- DIAGNOSTIC ALGORITHM
- SURGICAL MANAGEMENT OF SPECIFIC NEONATAL BOWEL OBSTRUCTIONS
- ETIOLOGY AND PATHOPHYSIOLOGY
- Medical Therapy and Perinatal Management
- INDICATIONS AND CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- OUTCOMES AND COMPLICATIONS
- ETIOLOGY AND PATHOPHYSIOLOGY
- CLINICAL PRESENTATION
- MEDICAL THERAPY
- INDICATIONS AND CONTRAINDICATIONS
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- OUTCOMES AND COMPLICATIONS
- CHAPTER 308: Hirschsprung Disease
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- Radiographic Evaluation
- Rectal Biopsy
- Anorectal Manometry
- PREOPERATIVE PLANNING
- SURGICAL TECHNIQUES
- Leveling Colostomy or Ileostomy
- Pull-Through for Recto Sigmoid HD
- Soave Pull-Through
- Duhamel
- Pull-Through With Intestinal Derotation
- Pull-Through for Total Colonic HD
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- Obstruction
- Enterocolitis
- Soiling
- OUTCOMES
- CHAPTER 309: Anorectal Malformations
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- PREOPERATIVE PLANNING
- Staged Reconstruction
- SURGICAL TECHNIQUES
- Neonatal Surgical Management
- Cloacal Malformation
- Imperforate Anus in Setting of OEIS
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- CHAPTER 310: Cryptorchidism
- INTRODUCTION
- ETIOLOGY AND PATHOPHYSIOLOGY
- DIAGNOSIS/CLINICAL PRESENTATION
- MULTIMODAL THERAPY
- INDICATIONS/CONTRAINDICATIONS
- SURGICAL TECHNIQUE
- Palpable Testis
- Nonpalpable Testis
- Fowler–Stephens Orchidopexy
- POSTOPERATIVE CARE
- COMPLICATIONS/MANAGEMENT
- OUTCOMES
- Malignancy
- CHAPTER 311: Mastery Keys: Descent of Testis
- APPENDIX: Figure Credits: Anatomy Chapters
- Index
About The Author(s)
- E. Christopher Ellison
- Gilbert R. Upchurch MD
Chief of Vascular and Endovascular Surgery, William H. Muller, Jr. Professor, University of Virginia, Charlottesville, VA
- Philip Alexander Efron
- Steven D. Wexner
- Nancy D. Perrier MD, FACS
- V. Suzanne Klimberg MD
- Muriel Balsam Kohn Chair in Breast Surgical Oncology, University of Arkansas for Medical Sciences, Little Rock, AR
- John H. Stewart MD, MBA
- Valerie W. Rusch MD
- Chief of Thoracic Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY; Professor of Surgery, Weill Medical College of Cornell University, New York, NY
- JON C. GOULD
- SUSAN GALANDIUK
- TIMOTHY M. PAWLIK MD, MPH, MTS, PhD
- William C. Chapman MD
- Benjamin Kuttikatt Poulose MD, MPH
- Peter K. Henke MD
- Assistant Professor, Vascular Surgery Section, University of Michigan Healthcare System, Ann Arbor, MI
- Alicia Mohr MD
- Mirza Saleem Islam MD, MPH
- Anne M. R. Agur BSc (OT), MSc, PhD, FAAA
- CAROL E. H. SCOTT-CONNER
- David Renton






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