CP

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Author:
jessiekate22
ID:
170198
Filename:
CP
Updated:
2012-09-11 07:21:38
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Surgical techniques
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VIVA
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  1. what is a roof top?
    - lie where the diaphragm sits
  2. What is a subcostal insicion?
    - incision below the rib
  3. Surgical techniques
  4. What is a oesophagectomy?
    • - removal of part of the upper GI tract
    • - done when pt have Ca, ulceration
    • - either a laparotomy or thoracotomy
    • - very long surgical time 
    • - removae oseophagus, pyloroplasty- stomach in thorax
  5. What is the post op care for upper GI tract- oesophagectomy?
    • - usually intubated and ventilated in ICU for up to 7 days
    • - very high risk of complications
    • - gastrpgraffin swallow post op to check leaks
  6. What are the main physiotherapy key points for an upper GI tract oesophagectomy?
    • - unless consult with the surgeon
    • - do not tip as they have no syphincter
    • - do not suction- can go to stomach
    • - do not apply positive airway pressure eg CPAP- can go into stomach
  7. What is an upper GIT gastrectomy?
    • - laparotomy 
    • - removal of stomach- all or part
    • - anastomose remains of stomach to SI
    • - done when pt has Ca or ulcers
  8. What is the post op care of upper GIT gastrectomy?
    • - usually high dependency
    • - NGT
  9. What is the main physiotherapy key point for a pt with upper GIT- gastrectomy?
    - do not tip unless ok with surgeon
  10. What is the surgeory of the UGIT- fundoplication?
    • - often a laparoscopic
    • - fundus wrapped around sphincter to reduce reflux
    • - done when pt has reflux and with hiatus hernia
  11. What is the post op care and the main physio points after and UGIT- fundoplication?
    • - general ward
    • - may not need physio if laparoscopic and no risk factors
    • - do not tip unless ok with surgeon
  12. Small intestine op
    • - resection  of small bowel (duodenectomy etc)
    • - done when pt has Ca, usually obstruction- fibrosis/ ulcer
    • - surgical procedure- laparotomy
    • - post op- general ward 
    • - physio- no specific
  13. What are the types of large intestine surgeries?
    • - colectomy
    • - hemicolectomy
    • - anterior resection
    • - hartmans
    • - proctocolectomy
    • - abdominal peritoneal resection
  14. What are the surgical processes of a colectomy (hemicoectomy, proctocolectomy)?
    • It is done through laparotomy, resection of part of colon and re- anastomosis of remians
    • - done when pt has Ca, ulceration and diverticulitis
    • - there isa right and left hemicolectomy
    • - after surgeory- a stoma may be require: ileostomy, colostomy, may be temporary or permanent
    • - post op care- general ward unless high risk
    • physio- no specific
  15. WHat process is used for a hepatectomy?
    • - surgical procedure- high laparotomy- roof top- mercedes bens
    • - indications- liver Ca, cysts, other liver patholgy
    • - post op-high dependency
    • - physio- high risk factor for resp complications due to high incision, often R LL
  16. Cholecystectomy 
    • - indications- cholecystitis, cholelithiasis
    • - surgical proedure- lateral subcostal incision, often laproscopic, combines with cholangiogram
    • - on gall bladder
    • - post op- general ward
    • - physio key points- lap chole- generally no physio intervention unless signif factors
  17. What is the whipples surgery include?
    • includes- pancreaticoduodenectomy, cholecystectomy, choledochojejunostomy, pancreaticojejunostomy, gastrojejunosteomy
    • - done when cancer of head of pancreas
    • - surgical procedure- high laparotomy- roof top
    • - post op care- high dependency
    • - physio key points- high risk resp complications, usually (R) LL
  18. What is an AAA repair?
    - abdominal aortic aneurysm repair
  19. what is the surgical procedure of AAA repair?
    • - long midline incision
    • - sometimes endoluminal
    • - aorta clamped off
  20. Post op care of AAA?
    • - if open- ICU and I&V
    • - usually HDU
    • - phsyiotherapy- no specific
  21. What is the carotid endarterectomy?
    • - removal of obstruction from carotid artery
    • - usually no requirement for physio
    • - high dependency due to stroke
  22. Vascular bipass surgery
    • - bypass of stenosis in artery 
    • - PVD with ischemia
    • -fempop
    • - ilofemoral
    • - physio depends on- type of surgery, risk factors, mobility requirements
  23. What is a nephrectomy?
    -renal surgery
  24. WHat is the surgical procedure of nephrectomy?
    • - lateral laparotomy
    • - indications- renal Ca, other renal disease
    • - post op- general or renal ward
    • - physio key points- non
  25. what is the most common organ transplant?
    • - renal transplant
    • - indications- chronic renal disease eg polycystic kidneys
    • - surgical procedure- lateral or sub costal, transplant attached on iliac artery, cadaver or living donor
    • - post op care- reverse barrier nursing, often not allowed to sit up in the early post op period ceck before you change the pt position
    • - phsyio- check with unit protocol prior treatment
  26. Cystectomy- urological
    • - indications- TCC bladder
    • - surgical procedure- midline laporotomy, bladder removed, ileum formed into conduit for urine to skin surface
    • - post care- general or renal ward
    • - physio- nil specific
  27. urological- radical prostatectomy 
    • - indications- Ca prostate or enlargement
    • - surgical procedure- midline mapartomy, usually done transurethral- TURP
    • - postop care- renal or general surgical ward
  28. gynaecolgical- major pelvis
    • - indications- various eg eterine Ca, prolapse
    • - surglica- midline laparotomy, may be LAS
    • - post op- gynae or general surgical ward
    • - physio- nil specific, no nee to see unless major abd or risk facotr
  29. head and neck surgery
    • - variety of surgical techniques
    • - indications- usually Ca of head and neck- eg larynx, pharynx
    • - surgical procedure- resection and reconstruction as appropriate, may or may not have tracheostomy, often very long surgery, pt often have respiratory co-morbits
    • - post op care- specialist ward or high dependency
    • - physio key points-may need suctioning if trache, otherwise treat as usual

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