SurgLEC FE: GIT - Surgery of the Esophagus

Esophagotomy

is an incision into the esophageal lumen

Esophagectomy

partial resection of the esophagus

Esophagostomy

creation of an opening in the esophagus for placement of feeding tubes.

Regurgitation

passive expulsion of undigested food or fluid from the pharynx or esophagus

Vomiting

centrally mediated reflex

healing of esophageal surgery

is challenged by serosa, no omentum, segmented blood supply constant motion bolus, distention and intolerance of longitudinal stretching.

Suction

lumen should be ___ prior to incising

longitudinal

Make ___ esophagotomy incisions

contralateral perforations

Inspect for ____ or necrosis

3-5 cm

Resect only __ during esophagectomy

submucosa

Incorporate ___ with all sutures

One layer closure

keep knots extraluminal

Two-layer closure

inner layer intraluminal knots, outer layer extraluminal knots

Tension

relieving technique: circumferential myotomy, gastric advancement, phrenic nerve interruption, pexy sutures

muscle flaps

Seal and support with a harvested omental flaps or ___

esophagitis

Treat ___ with proton pump inhibitors and or gastric prokinetics

cervical

For Approach to the ___ esophagus, Position the patient in dorsal recumbency with the neck resting on a rolled towel.

trachea

Incise the skin from the larynx to the manubrium and separate the sternohyoid muscles to expose the ___.

esophagus

Retract the trachea to the right to expose the ___, thyroid, carotid sheath, and recurrent laryngeal nerve.

Cranial Thoracic

For Approach to the ___ Esophagus, Position the patient in right lateral recumbency over a rolled towel placed perpendicular to the long axis of the body

latissimus dorsi

Identify and dissect the ___ muscle

serratus ventralis

Identify and transect or retract the ___

intercostal muscle

Expose and incise the ____

rib retractors

Position ___ and identify the thoracic viscera