Essay 12- Basic surgical procedures- -tomy and -stomy

What is a surgical procedure?

A procedure that involves cutting or incising structures in order to facilitate a certain operation

Examples of surgical procedures

• -tomia

• Stomia

• Incisio

• Excisio

• Trepanatio- drilling into bones (skull)

• By-pass (CABG)

• Resectio (stomach, liver, pancreas, parotid gland)

• Ectomia (removal)

• Amputatio

• Breast reduction

• Breast augmentation

-tomy

comes from the Greek word tomos, meaning "cutting"

• refers to any surgical incision made into the body or a structure

• to facilitate a procedure or operation.

• Incision size and location depend on the extent of exposure needed.

• Use of scalpel and other cutting instruments is essential.

• Langer’s Lines are natural lines in the skin, oriented along the collagen fibers.

  • Best incisions should run parallel to these lines

  • to reduce scarring

  • promote better healing.

Incision Types and Uses:

• Wilde’s incision

• thoracotomy

• laparotomy

• laparoscopic port sites

• medial sternotomy

Wilde’s Incision:

Used for drainage of mastoiditis, made behind the ear.

Thoracotomy:

Surgical opening of the chest,

usually performed for procedures involving the lungs or heart

(e.g., lung resection, heart surgery).

Laparotomy

A midline incision along the linea alba

used in abdominal surgeries,

like exploratory surgeries or removing organs

• Pfannenstiel Incision: Transverse incision below the umbilicus (commonly used for C-sections).

• McBurney Incision: Oblique incision in the lower right quadrant (used in appendectomy).

• Kocher Incision: Subcostal incision, used for gall bladder surgery or biliary tree pathologies.

Laparoscopic Port Sites:

Small incisions made for laparoscopy,

• where instruments are passed into the abdominal cavity.

Medial sternotomy

for cardiac procedures

Incision used in cardiac surgery, extending from the sternal notch to the xiphoid process.

Managing Bleeding Post-Incision:

• Fine surgery: Blood may be drained, especially in extremity surgery.

• Local anesthesia: Weak adrenaline solutions can constrict vessels.

• Pressure: Applied directly to the cut edge to control small vessel bleeding.

• Hemostatic Forceps: Used to clamp and seal bleeding vessels.

stomy

from greek word stomia which means mouth

• the creation of a surgical opening

• in a body part or between two body parts

• to allow for the diversion of fluids

• or the insertion of medical devices.

Common Types of -Stomy Procedures:

• Tracheostomy- opening on cricothyroid membrane for a direct airway through an incision for tracheal tube

• Gastrostomy- opening made in stomach to insert a feeding tube

  • Gastrostomy can be done if the opening between the stomach and small intestine is eliminated

• Colostomy- opening in healthy part of LI and suturing it to abdominal wall and attaching stoma appliance

• Nephrostomy- opening created in skin and kidney which allows urine diversion from renal pelvis

• Laparostomy- surgical opening of the abdomen which is left open for a few days

  • Also called open abdomen

• Ileostomy- surgically created opening between the ileum and anterior abdominal wall

• Gastroileostomy- surgical connection between stomach and small intestine’

• Gastroduodenostomy- surgical connection between the stomach and duodenum

  • Required in the event of serious peptic ulcer disease