Оглавление
Группа авторов. Gastrointestinal Surgical Techniques in Small Animals
Table of Contents
List of Tables
List of Illustrations
Guide
Pages
Gastrointestinal Surgical Techniques in Small Animals
List of Contributors
Preface
About the Companion Website
1 Gastrointestinal Healing
1.1 Anatomy
1.2 Phases of Wound Healing. 1.2.1 Partial Thickness Injury
1.2.2 Full‐Thickness Injury
1.3 Factors Affecting Gastrointestinal Tract Healing. 1.3.1 Ischemia and Tissue Perfusion
1.3.2 Suture Intrinsic Tension
1.3.3 Surgical Technique
1.3.4 Nutrition
1.3.5 Blood Transfusion
1.3.6 Local Infection
1.3.7 Intraperitoneal Infection
1.3.8 Medications
1.3.9 Disease
1.3.10 Large Intestine
References
2 Suture Materials, Staplers, and Tissue Apposition Devices
2.1 Suture Materials
2.1.1 Predictable Absorption Profile
2.1.2 Tensile Strength and Knot Security
2.1.3 Low Capillarity and Bacterial Adhesion
2.1.4 Handling Characteristics
2.1.5 Rate of Strength Gain in GI Surgery
2.1.6 Suture Needles
2.1.7 Directional Barbed Suture
2.1.8 Biofragmentable Anastomosis Ring
2.2 Staplers, Linear, Circular, Skin Staples
References
3 Suture Patterns for Gastrointestinal Surgery
3.1 One‐ or Two‐Layer Closure
3.2 Tissue Inversion, Eversion, or Apposition
3.3 Stapled or Hand‐Sutured Anastomosis
3.4 Appositional Suture Patterns. 3.4.1 Simple Interrupted
3.4.2 Simple Continuous
3.4.3 Patterns to Reduce Excess Mucosal Eversion
3.4.3.1 Gambee
3.4.3.2 Modified Gambee
3.4.3.3 Luminal Interrupted Vertical Mattress Pattern
3.5 Inverting Suture Patterns. 3.5.1 Halsted
3.5.2 Cushing and Connell
3.5.3 Lembert
3.5.4 Parker–Kerr Oversew
3.6 Special Supplementary Patterns: Purse‐String
Bibliography
4 Feeding Tubes
4.1 Nasoesophageal and Nasogastric Tubes
4.1.1 Indications
4.1.2 Materials and Equipment
4.1.3 Surgical Techniques
4.1.4 Utilization
4.1.5 Tips
4.1.6 Complications
4.2 Esophagostomy Tube. 4.2.1 Indications
4.2.2 Materials and Equipment
4.2.3 Surgical Techniques
4.2.4 Tips
4.2.5 Utilization
4.2.6 Complications
4.3 Gastrostomy Tube. 4.3.1 Indications
4.3.2 Materials and Equipment
4.3.3 Technique. 4.3.3.1 Endoscopic Placement
4.3.3.2 Surgical Placement. 4.3.3.2.1 Laparoscopically Assisted
4.3.3.2.2 Laparotomy
4.3.4 Tips
4.3.5 Utilization
4.3.6 Complications
4.4 Jejunostomy Tube. 4.4.1 Indications
4.4.2 Materials and Equipment
4.4.3 Technique. 4.4.3.1 Laparoscopically Assisted
4.4.3.2 Laparotomy
4.4.4 Tips
4.4.5 Utilization
4.4.6 Complications
4.5 Gastrojejunostomy Tube. 4.5.1 Indications
4.5.2 Materials and Equipment
4.5.3 Technique
4.5.4 Tips
References
5 Drainage Techniques for the Peritoneal Space
5.1 Indications
5.2 Techniques
5.2.1 Percutaneous Placement of an Abdominal Drain
5.2.1.1 Passive Drain
5.2.1.2 Closed Suction Drain
5.2.2 Surgical Placement of a Closed Suction Drain
5.2.3 Open Abdomen
5.2.4 Vacuum‐Assisted Drainage of the Abdominal Cavity
5.3 Tips
5.4 Complications and Aftercare
References
6 Maxillectomy and Mandibulectomy
6.1 Indications
6.2 Surgical Techniques
6.2.1 Maxillectomy
6.2.2 Mandible
6.3 Tips
6.4 Complications and Post‐Operative Care
6.4.1 Complications for Maxillectomy
6.4.2 Complications for Mandibulectomy
References
7 Glossectomy
7.1 Indications
7.2 Technique
7.3 Tips
7.4 Complications
References
8 Tonsillectomy
8.1 Indications
8.2 Technique
8.3 Tips
8.4 Complications
References
9 Palatal and Oronasal Defects
9.1 Indications
9.2 Surgical Techniques
9.2.1 Repair of Congenital Clefts Palates. 9.2.1.1 Primary Cleft Palate Correction Techniques
9.2.1.2 Secondary Cleft Palate Correction Techniques. 9.2.1.2.1 Von Langenbeck Technique
9.2.1.2.2 Overlapping Flap Technique
9.2.1.3 Soft Palate Repair Techniques. 9.2.1.3.1 Bilateral Medially Positioned Flaps
9.2.1.3.2 Overlapping Flap Technique for Repair of the Soft Palate
9.2.2 Repair of Acquired Defects. 9.2.2.1 Vestibular Mucoperiosteal Flaps
9.2.2.2 Palatal Mucoperiosteal Flaps
9.2.2.2.1 Transposition Flap
9.2.2.2.2 Split Palatal U‐Flap
9.2.2.2.3 Rotating Palatal Island Flap
9.2.2.2.4 Palatal Advancement Flaps
9.2.2.3 Miscellaneous Palatal Repair and Salvage Techniques. 9.2.2.3.1 Midline Palatal Fracture or Separation
9.2.2.3.2 Myoperitoneal Microvascular Free Flap
9.2.2.3.3 Angularis Oris Mucosal Flap
9.2.2.3.4 Obturators
9.2.2.3.5 Bone and Cartilage Grafts for the Support of Pedicle Grafts
9.3 Tips
9.4 Complications
References
10 Salivary Gland Surgery
10.1 Indications
10.2 Techniques. 10.2.1 Anatomical Considerations
10.2.2 Removal of Sialoliths
10.2.3 Cervical, Pharyngeal, Ranula Mucoceles (Mandibular and Sublingual Sialadenectomy)
10.2.3.1 Approaches to the Mandibular/Sublingual Salivary Complex
10.2.3.1.1 Lateral (or Horizontal) Approach
10.2.3.1.2 Ventral Approach
10.2.3.1.3 Marsupialization of Pharyngeal Mucoceles and Ranulas
10.2.4 Zygomatic Salivary Mucocele
10.2.4.1 Surgical Exposure (Approaches) for Zygomatic Sialadenectomy
10.2.4.1.1 Zygomatic Arch Partial Excision (Limited Approach)
10.2.4.1.2 Zygomatic Arch Osteotomy (for Maximum Exposure and Complete Periorbital Exploration)
10.2.4.1.3 Gland Excision Technique
10.2.5 Parotid Mucocele (Parotid Sialadenectomy)
10.3 Tips
10.4 Complications and Outcome
Bibliography
11 Esophagotomy
11.1 Indications
11.2 Technique. 11.2.1 Surgical Approach of the Esophagus
11.2.2 Esophagotomy
11.2.3 Patch
11.3 Tips
11.4 Complications
References
12 Esophagectomy and Reconstruction
12.1 Indications
12.2 Technique
12.2.1 Esophagectomy
12.2.2 Dilation and Diverticulum of the Esophagus
12.2.2.1 Severe Dilation of the Esophagus Due to a Persistent Aortic Arch
12.2.2.2 Pulsion Diverticulum
12.2.3 Substitution
12.3 Tips
12.4 Complications
References
13 Cricopharyngeal Myotomy and Heller Myotomy
13.1 Indications
13.2 Technique. 13.2.1 Cricopharyngeal Myotomy
13.2.2 Heller's Myotomy
13.3 Tips. 13.3.1 Cricopharyngeal Myotomy
13.3.2 Heller's Myotomy
13.4 Complications
References
14 Vascular Ring Anomaly
14.1 Indications
14.2 Techniques
14.2.1 Intercostal Thoracotomy
14.2.1.1 Ligamentum Arteriosum
14.2.1.2 Double Aortic Arch
14.2.2 Thoracoscopy
14.3 Tips
14.4 Complications and Aftercare
References
15 Hiatal Hernia
15.1 Indications
15.2 Techniques
15.2.1 Laparotomy
15.2.2 Laparoscopy
15.3 Tips
15.4 Complications and Post‐Operative Cares
References
16 Anatomy and Physiology of the Stomach
16.1 Anatomy. 16.1.1 Divisions
16.1.2 Morphology and Glandular Organization
16.1.3 Blood Supply
16.1.4 Innervation
16.2 Physiology. 16.2.1 Gastrin
16.2.2 Somatostatin
16.2.3 Histamine
16.2.4 Ghrelin and Leptin
16.2.5 Other Gastric Secretory Products
16.2.6 Acid Secretion
16.3 Acid Secretion and Gastrectomy
16.4 Stomach Motility and Gastrectomy
References
17 Gastrotomy
17.1 Indications
17.2 Techniques
17.3 Tips
17.4 Complications and Post‐Operative Cares
18 Gastrectomy
18.1 Indications
18.2 Technique
18.2.1 Local Gastrectomy for Resection of Neoplasia or Ulcer
18.2.2 Local Gastrectomy During a Gastric Dilatation‐Volvulus
18.2.3 Segmental Gastrectomy
18.3 Tips
18.4 Complications and Post‐Operative Cares
References
19 Billroth I
19.1 Indications
19.2 Technique
19.3 Tips
19.4 Complications
References
20 Billroth II
20.1 Indications
20.2 Technique
20.2.1 Gastrectomy
20.2.2 Dissection of the Duodenum
20.2.3 Gastrojejunostomy
20.2.4 Cholecystoduodenostomy
20.2.5 Feeding Tube
20.3 Tips
20.4 Complications and Post‐Operative Care
20.4.1 Dumping Syndrome
20.4.2 Afferent Loop Syndrome
20.4.3 Gastritis and Esophagitis
References
21 Pyloroplasty
21.1 Indications
21.2 Technique. 21.2.1 Y‐U Pyloroplasty
21.2.2 Other Pyloroplasty
21.2.3 Pyloromyotomy
21.3 Tips
21.4 Complications
References
22 Roux‐en‐Y
22.1 Indications
22.2 Technique. 22.2.1 Roux‐en‐Y for Upper GI Reconstruction
22.2.2 Roux‐en‐Y for Biliary Diversion
22.2.3 Roux‐en‐Y for Upper GI Diversion
22.3 Tips
22.4 Complications
References
23 Gastropexy
23.1 Indications
23.2 Surgical Procedures. 23.2.1 Tube Gastropexy
23.2.2 Incisional Gastropexy. 23.2.2.1 Standard Incisional Gastropexy
23.2.2.2 Modified Incisional Gastropexy
23.2.3 Belt‐Loop Gastropexy
23.2.4 Circumcostal Gastropexy
23.2.5 Gastrocolopexy
23.2.6 Incorporating Gastropexy
23.2.7 Endoscopically Assisted Gastropexy
23.2.8 Laparoscopic‐Assisted Gastropexy
23.2.9 Laparoscopic Gastropexy. 23.2.9.1 Stapled Technique
23.2.9.2 Intracorporeal Suturing Techniques
23.2.9.3 Three Port Technique
23.2.9.4 Single‐Access Port Technique
23.3 Tips
23.4 Post‐Operative Care and Complications
References
24 Enterotomy
24.1 Indications
24.2 Surgical Techniques. 24.2.1 Intestinal Biopsy. 24.2.1.1 Punch Technique
24.2.1.2 Incision Techniques. 24.2.1.2.1 Longitudinal Incision Technique
24.2.1.2.2 Transverse Incision Technique
24.2.2 Enterotomy
24.3 Tips. 24.3.1 Leak Test
24.3.2 Reinforcement of an Enterotomy
24.4 Post‐Operative Complications and Outcome
References
25 Enterectomy
25.1 Indications
25.2 Surgical Techniques
25.2.1 Hand‐Sewn Anastomosis
25.2.2 Anastomosis Using a Skin Stapler
25.2.3 Functional End‐to‐End Anastomosis (FEEA) with Stapling Equipment: Open Technique
25.2.4 One‐Stage FEEA
25.3 Tips. 25.3.1 Anatomical Considerations. 25.3.1.1 Duodenum
25.3.1.2 Vasculature of the Intestine
25.3.2 Handling of Tissue
25.3.3 Utilization of Linear Stapler/Staple Size
25.3.4 Suture Line Reinforcement
25.3.4.1 Omentalization
25.3.4.2 Serosal Patch
25.3.4.2.1 Serosal Patching Over Enterotomy Closure or Defect
25.3.4.2.2 Serosal Patching for Bowel Anastomosis
25.4 Post‐Operative Complications and Outcome
References
26 Enteroplication/Enteropexy for Prevention of Intussusception
26.1 Indications
26.2 Surgical Procedures. 26.2.1 Complete (Global) Enteroplication
26.2.2 Limited Enteroplication
26.2.3 Enteropexy
26.3 Tips
26.4 Post‐Operative Considerations and Prognosis
Bibliography
27 Colectomy and Subtotal Colectomy
27.1 Indications
27.2 Surgical Techniques. 27.2.1 Preoperative Considerations
27.2.2 Surgical Procedures
27.2.2.1 Colonic Anastomosis Closure Methods. 27.2.2.1.1 Suture
27.2.2.1.2 Linear Stapler
27.2.2.1.3 EEA Stapler
27.2.2.1.4 Biofragmentable Ring
27.2.2.2 Surgical Techniques. 27.2.2.2.1 Segmental Colectomy
27.2.2.2.2 Colectomy and Subtotal Colectomy for Megacolon
Subtotal Colectomy – Colocolic Anastomosis (Preservation of the Ileocecocolic Junction)
Subtotal Colectomy – Ileocolic Anastomosis
27.3 Tips
27.4 Post‐Operative Considerations and Prognosis
References
28 Colotomy
28.1 Indications
28.2 Surgical Technique. 28.2.1 Preoperative Considerations
28.2.2 Surgical Procedure
28.3 Post‐Operative Considerations and Prognosis
References
29 Typhlectomy and Ileocecocolic Resection
29.1 Indications
29.2 Surgical Techniques. 29.2.1 Simple Typhlectomy
29.2.2 Colotomy and Typhlectomy Technique
29.2.3 Ileocolic Resection and Anastomosis
29.3 Tips
29.4 Post‐Operative Considerations and Prognosis
References
30 Colostomy and Jejunostomy
30.1 Indications
30.2 Surgical Technique
30.2.1 Flank Diverting Loop Rod‐Supported Colostomy. 30.2.1.1 Creation of the Loop Colostomy
30.2.1.2 Reversal of the Loop Colostomy
30.2.2 End‐on Colostomy
30.2.3 Laparoscopic‐Assisted End‐on Jejunostomy. 30.2.3.1 Creation of the Jejunostomy
30.2.3.2 End‐on Jejunostomy Reversal
30.3 Tips
30.4 Post‐Operative Considerations and Prognosis
References
31 Colopexy
31.1 Indications
31.2 Surgical Techniques
31.2.1 Standard Ventral Midline Approach
31.2.2 Paramedian Incorporating
31.2.3 Laparoscopic Colopexy
31.2.4 Laparoscopic‐Assisted Colopexy
31.3 Tips
31.4 Post‐Operative Care, Complications
References
32 Approaches to the Rectum and Pelvic Canal
32.1 Indications
32.2 Surgical Approaches to the Rectum. 32.2.1 Dorsal Approach
32.2.2 Lateral Approach
32.2.3 Ventral Approach with Pubic Osteotomy
32.3 Post‐Operative Care and Complications
References
33 Surgery of the Rectum
33.1 Indications
33.2 Surgical Techniques. 33.2.1 Transanal Techniques
33.2.1.1 Transanal Endoscopic Mass Excision
33.2.1.2 Transanal Approach with a Rigid Endoscope and a Single‐Port Access System
33.2.1.3 Transanal Prolapse and Mass Excision; Intraluminal Closure of a Distal Rectal Perforation
33.2.1.4 Excision of a Rectal Prolapse
33.2.1.5 Transanal Rectal Pull‐Through Technique and Hand Suture
33.2.1.6 Transanal Pull‐Through Technique with Circular Stapler
33.2.2 Combined Transanal and Abdominal Techniques
33.2.2.1 Combined Transabdominal‐Transanal Pull‐Through Technique, Hand‐Sutured
33.2.2.2 Rectal Resection with Transanal Circular Stapled Anastomosis Technique via Pubic Osteotomy Approach
33.3 Tips
33.4 Post‐Operative Care and Complications
References
34 Anal Sac Resection
34.1 Indications
34.2 Surgical Techniques
34.2.1 Preparation and Positioning of the Patient
34.2.2 Open Technique. 34.2.2.1 Standard Open Technique
34.2.2.2 Modified Open
34.2.3 Closed Technique for Benign Anal Sac Disease
34.2.3.1 Closed Technique Without Filling the Anal Sac
34.2.3.2 Foley Catheter Closed Technique
34.2.4 Closed Technique for Anal Sac Neoplasia
34.3 Tips
34.4 Post‐Operative Care and Complications
Bibliography
35 Liver Lobectomy
35.1 Indications
35.2 Technique. 35.2.1 Liver Biopsy
35.2.1.1 Laparotomy
35.2.1.2 Laparoscopy
35.2.2 Partial Liver Lobectomy
35.2.3 Complete Liver Lobectomy
35.2.3.1 Liver Lobectomy with Sutures
35.2.3.1.1 Lobectomy of the Left Lateral Liver Lobe, Left Medial Liver Lobe, and Quadrate Liver Lobe
35.2.3.1.2 Lobectomy of the Right Medial and Lateral Liver Lobes
35.2.3.2 Liver Lobectomy with Staples
35.3 Tips
35.4 Complications
References
36 Surgery of the Gallbladder
36.1 Indications
36.2 Techniques. 36.2.1 Cholecystostomy
36.2.2 Cholecystotomy
36.2.3 Cholecystectomy. 36.2.3.1 Laparotomy
36.2.3.2 Laparoscopy
36.3 Tips
36.4 Complications and Post‐Operative Care
References
37 Biliary Diversion
37.1 Indications
37.2 Surgical Techniques. 37.2.1 Temporary Biliary Diversion
37.2.1.1 Temporary Cholecystostomy Tube During Laparotomy
37.2.1.2 Temporary Cholecystostomy Tube with Laparoscopy
37.2.2 Permanent Biliary Diversion
37.2.2.1 Cholecystoduodenostomy
37.2.2.2 Roux‐en‐Y Diversion
37.2.2.2.1 Cholecystojejunoduodenostomy
37.2.2.2.2 Cholecystojejunojejunostomy
37.2.2.3 Cholecystojejunostomy
37.2.2.4 Choledochoduodenostomy or Choledochojejunostomy
37.3 Tips
37.4 Complications
References
38 Surgery of the Bile Duct
38.1 Indications
38.2 Techniques. 38.2.1 Choledochotomy
38.2.2 Resection Anastomosis of the Common Bile Duct
38.2.3 Choledochoduodenostomy or Choledochojejunostomy
38.3 Tips
38.4 Complications
References
39 Biliary Stenting
39.1 Indications
39.2 Technique
39.2.1 Short‐Term Temporary Stenting
39.2.2 Long‐Term Temporary Stenting
39.2.3 Permanent Stenting
39.3 Tips
39.4 Complications and Post‐Operative Care
References
40 Arterio‐Venous Fistula
40.1 Indications
40.2 Technique
40.2.1 Laparotomy
40.2.2 Interventional Radiology
40.3 Tips
40.4 Complications
References
41 Portosystemic Shunt
41.1 Indications
41.2 Technique
41.2.1 Identification and Dissection. 41.2.1.1 Extrahepatic PSS
41.2.1.1.1 Identification. 41.2.1.1.1.1 Porto‐Caval Shunt
41.2.1.1.1.2 Porto‐Azygous Shunt
41.2.1.1.2 Dissection
41.2.1.2 Intrahepatic PSS. 41.2.1.2.1 Identification
41.2.1.2.2 Dissection. 41.2.1.2.2.1 Extravascular Approach of the Hepatic Veins
41.2.1.2.2.2 Extravascular Approach of the Portal Vein
41.2.2 Techniques for Ligation or Progressive Occlusion of the Shunt
41.2.2.1 Techniques Resulting in Fixed Attenuation of a Shunt. 41.2.2.1.1 Attenuation with Sutures
41.2.2.1.2 Attenuation with Mattress Sutures
41.2.2.1.3 Intravascular Approach of the Hepatic Vein or the Portal Vein
41.2.2.1.4 Percutaneous Transjugular Coil Embolization of Shunt with Interventional Radiology
41.2.2.2 Techniques Resulting in Slow Progressive and Complete Occlusion of a PSS. 41.2.2.2.1 Ameroid Constrictor
41.2.2.2.2 Cellophane Banding
41.2.2.2.3 Silicon‐Polyacrylic Acid Gradual Venous Occlusion Device
41.2.2.2.4 Hydraulic Occluder
41.3 Tips
41.4 Complications. 41.4.1 Post‐Operative Complications and Short‐Term Outcome. 41.4.1.1 Portal Hypertension
41.4.1.2 Gastrointestinal Bleeding
41.4.1.3 Hypoglycemia
41.4.1.4 Hemorrhage
41.4.1.5 Neurological Complications
41.4.1.6 Short‐Term Outcome and Prognostic Indicators
41.4.2 Long‐Term Complications and Outcome. 41.4.2.1 Portal Hypertension
41.4.2.2 Persistence of Shunting
41.4.2.3 Long‐Term Outcome and Prognostic Indicators
References
42 Surgery of the Pancreas
42.1 Indications
42.2 Surgical Procedures
42.2.1 Pancreatic Biopsy
42.2.1.1 Suture Fracture Technique
42.2.1.2 Laparoscopic Pancreatic Biopsy
42.2.2 Nodulectomy (Enucleation) Via Blunt Dissection
42.2.3 Partial Pancreatectomy
42.2.4 Total Pancreatectomy
42.2.5 Pancreatic Drainage
42.3 Tips
42.4 Post‐Operative Care and Complications
References
Index
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