Surgical Procedure Overview: Appendectomy and Thyroidectomy
Learn about appendectomy and thyroidectomy surgical procedures, including definitions, indications, types, anesthesia, positions, procedures, and potential complications. Appendectomy involves removing the appendix, while thyroidectomy involves removing all or part of the thyroid gland. Explore the details and considerations for each surgery in this informative content.
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Presentation Transcript
Common Surgical Operation Haitham R. Elmehdawi
APPENDECTOMY DEFINATION INDICATIONS TYPES ANAESTHESIA POSITION EXPOSURE AND PROCEDURE COMPLICATIONS
APPENDECTOMY DEFINITION An appendectomy is the surgical removal of the appendix.
APPENDECTOMY INDICATIONS Acute appendicitis As Interval appendectomy after drainage of abscess Appendicular mass Carcinoid tumour : at the tip. <2cm Mucocele of the appendix As part of other operation On table colonic lavage.
APPENDECTOMY TYPES OPEN LAPAROSCOPIC
APPENDECTOMY ANAESTHESIA General anesthesia with endotracheal intubation and muscle relaxation Spinal or Local anesthesia may be indicated in the very ill patient.
APPENDECTOMY POSITION Patient is placed in supine position. Routine scrubbing and gowning The skin is cleaned from the nipple line to the mid thigh and draped exposing the operation field.
APPENDECTOMY PROCEDURE INCISION Mc Burney s/Grid iron Lanz Rutherford Morison s
APPENDECTOMY POST-OP COMPLICATION Wound infection Most common 5-10% of patient 4-5th day Intra- abdominal abscess -8% Ileus Portal pyemia Faecal fistula Adhesive intestinal obstruction Generalised peritonitis Hemorrhage Respiratory infections UTI Venous thrombosis and embolism
THYROIDECTOMY DEFINATION INDICATIONS TYPES ANAESTHESIA POSITION EXPOSURE AND PROCEDURE COMPLICATIONS
THYROIDECTOMY DEFINITION Thyroidectomy is the surgical removal of all or part of the thyroid gland.
THYROIDECTOMY INDICATIONS Toxic multinodular goiter; does not respond well to drugs. Toxic solitary nodule; it may be neoplastic. Malignant goiter Presence of pressure symptoms Failure of patient to take drugs regularly or follow-up Complications during drug therapy Relapse after previous drug therapy Exophthalmus Cosmetic
THYROIDECTOMY TYPES OF THYROIDECTOMY Hemithyroidectomy Subtotal thyroidectomy Near total thyroidectomy Total thyroidectomy
THYROIDECTOMY Hemithyroidectomy
THYROIDECTOMY Subtotal thyroidectomy
THYROIDECTOMY Near total thyroidectomy
THYROIDECTOMY Total thyroidectomy
THYROIDECTOMY ANAESTHESIA Anaesthesia is general
THYROIDECTOMY POSITION patient is placed in a supine position initially with the neck extended by placing a ring beneath the head and a sandbag roll beneath the shoulder. The table is tilted 20 30 degrees head up to aid in emptying the neck veins. The skin is prepped from the chin to the upper thorax
THYROIDECTOMY PROCEDURE INCISION Kocher s low collar incision
THYROIDECTOMY POST-OP COMPLICATION EARLY Haemorrhage hypoparathyroidism Recurrent laryngeal nerve palsy 95% neurapraxia and resolves If bilateral, cord adduct to midline so needs immediate reintubation Thyroid crisis LATE Hypothroidism Recurrence Keloid
Cholecystectomy DEFINATION INDICATIONS TYPES ANAESTHESIA POSITION EXPOSURE AND PROCEDURE COMPLICATIONS
Cholecystectomy DEFINITION It is the surgical removal of the gall bladder .
Cholecystectomy INDICATIONS Cholelithiasis Acute cholecystitis Chronic cholecystitis Acalculous cholecystitis Gallstone pancreatitis Gallbladder polyps Porcelain gallbladder
Cholecystectomy TYPES OPEN LAPAROSCOPIC
Cholecystectomy LAPAROSCOPIC CHOLECYSTECTOMY STANDARD MODIFIED Reduce port size Reduce port number NOTES
Cholecystectomy LAPAROSCOPIC CHOLECYSTECTOMY NOTES
Cholecystectomy ANAESTHESIA General anesthesia with endotracheal intubation and muscle relaxation.
Cholecystectomy POSITION Patient is placed in supine position. Routine scrubbing and gowning The skin is cleaned from the nipple line to the mid thigh and draped exposing the operation field.
Cholecystectomy PROCEDURE INCISION 4 small incisions
Cholecystectomy POST-OP COMPLICATION Haemorrhage Bile leak Bile duct injury Wound infection Intra- abdominal abscess Ileus Adhesive intestinal obstruction Generalised peritonitis
