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what is a roof top?
- lie where the diaphragm sits
What is a subcostal insicion?
- incision below the rib
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
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
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
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
What is the post op care of upper GIT gastrectomy?
- - usually high dependency
- - NGT
What is the main physiotherapy key point for a pt with upper GIT- gastrectomy?
- do not tip unless ok with surgeon
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
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
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
What are the types of large intestine surgeries?
- - colectomy
- - hemicolectomy
- - anterior resection
- - hartmans
- - proctocolectomy
- - abdominal peritoneal resection
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
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
- - 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
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
What is an AAA repair?
- abdominal aortic aneurysm repair
what is the surgical procedure of AAA repair?
- - long midline incision
- - sometimes endoluminal
- - aorta clamped off
Post op care of AAA?
- - if open- ICU and I&V
- - usually HDU
- - phsyiotherapy- no specific
What is the carotid endarterectomy?
- - removal of obstruction from carotid artery
- - usually no requirement for physio
- - high dependency due to stroke
Vascular bipass surgery
- - bypass of stenosis in artery
- - PVD with ischemia
- - ilofemoral
- - physio depends on- type of surgery, risk factors, mobility requirements
What is a nephrectomy?
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
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
- - 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
urological- radical prostatectomy
- - indications- Ca prostate or enlargement
- - surgical procedure- midline mapartomy, usually done transurethral- TURP
- - postop care- renal or general surgical ward
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
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