Advanced Surgical Techniques for Rural Surgeons 1st edition by Amy Halverson, David Borgstrom – Ebook PDF Instant Download/Delivery: 1493914951, 9781493914951
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ISBN 10: 1493914951
ISBN 13: 9781493914951
Author: Amy Halverson, David Borgstrom
This unique reference fulfills the unmet need of a textbook that addresses the scope of practice for surgeons practicing in rural regions. The text provides up-to-date content covering a wide breadth of topics relevant to surgical care in rural areas, with focus on the surgical diseases that are often treated by surgical subspecialists in the urban setting. Written by experts in each subspecialty, the text focuses on procedural aspects of surgical patient care. The first section discusses practice issues unique to rural surgery and provides an overview of applying principles of quality improvement to surgical practice. Subsequent chapters cover specific surgical procedures. Each chapter includes a brief discussion of indications and contraindications for surgery. The surgical technique is described with attention to important anatomic details. Key portions of the procedure are highlighted including potential complications and how to avoid them. Procedure specific perioperative care is also discussed. Supported with ample illustrations and images, Advanced Surgical Techniques for Rural Surgeons is a valuable resource for surgeons currently in practice or preparing to practice in a rural area, as well as surgical technicians, surgical nurse practitioners and physician’s assistants.
Advanced Surgical Techniques for Rural Surgeons 1st Table of contents:
Part I: Gastrointestinal
1: Endoscopic Control of Upper GI Bleeding
Indications
Preoperative Preparation
Operative Strategy
Treatment of Specific Causes of UGIB
Peptic Ulcer Disease and Stigmata of Hemorrhage
Esophageal Varices Associated with Portal Hypertension (Fig. 1.2)
Mallory–Weiss Tears (Fig. 1.3)
Dieulafoy’s Lesion
Congestive Gastropathy
Vascular Conditions
Aorto-Enteric Fistula
Neoplasms
Anastomotic Ulcers (Fig. 1.8)
Operative Technique
Therapeutic Endoscopic Techniques
Injection Therapy
Saline With/Without Epinephrine
Sclerosants
Ablative Therapy
Mechanical Therapy
Combination Therapy
Insertion of Sengstaken–Blakemore Tube
Potential Pitfalls
When to Transfer
Suggested Reading
2: Endoscopic and Laparoscopic Techniques for Enteral Access
Indications
Preoperative Preparation
Potential Pitfalls
Operative Strategy
Operative Technique
Endoscopic Techniques
PEG
PEG-J
DPEJ
Laparoscopic Approaches
Laparoscopic-Assisted PEG
Laparoscopic Gastrostomy Tube Placement
Laparoscopic GJ Tube
J-Tube
Postoperative Care
Common Complications
Suggested Reading
3: Endomucosal Resection of Colon Polyps and Control of Postpolypectomy Bleeding
Indications
Preoperative Preparation
Operative Strategy
Operative Technique
Potential Pitfalls
Common Complications
When to Transfer
References
Suggested Reading
4: Laparoscopic Common Bile Duct Exploration
Indications
Preoperative Preparation
Operative Strategy
Operative Technique
Trocar Placement and Initial Dissection
Intraoperative Cholangiogram
Attempt Flushing
Determination of LCBDE Approach
Transcystic LCBDE
Guide Wire Access
Cystic Duct Dilation
Choledochoscope Setup and Insertion
Stone Capture and Extraction
Completion Cholangiogram and Cystic Duct Ligation
Transcholedochal LCBDE
Common Duct Dissection and Choledochotomy
Choledochoscope Insertion and Stone Capture and Extraction
Choledochotomy Closure (With or Without T-Tube Insertion)
Completion Cholangiogram and Cystic Duct Ligation
Potential Pitfalls
Postoperative Care
Common Complications
When to Transfer
Suggested Reading
5: Partial Cholecystectomy
Indications
Preoperative Preparation
Operative Strategy
Operative Technique
Potential Pitfalls
Postoperative Care
Common Complications
When to Transfer
Suggested Reading
6: Percutaneous Cholecystostomy
Indications
Preoperative Preparation
Operative Strategy
Operative Technique
Equipment Needed
Potential Pitfalls
Postoperative Care
Common Complications
When to Transfer
Suggested Reading
Part II: Abdominal Wall
7: Laparoscopic Repair of Abdominal Wall Hernias
Introduction
Indications
Preoperative Preparation
Operative Strategy
Operative Technique
Potential Pitfalls
Postoperative Care
Common Complications
When to Transfer
Suggested Reading
8: Closure Repair of Complex Ventral Hernias: Open with Separation of Parts
Indications
Preoperative Preparation
Anatomy
Operative Strategy
Operative Technique
Mesh
Technical Repair: Positioning and Marking
Initial Operative Hernia Management
Incision
Addressing Foreign Bodies and Adhesions
Retrorectus Dissection
Reconstruction of Posterior Layer
Mesh Placement
Anterior Component Separation
Posterior Component Separation: TAR
Reconstruction of the Anterior Layers
Potential Pitfalls
Postoperative Care
Common Complications
When to Transfer
Suggested Reading
Part III: Surgical Oncology
9: Surgical Management of Skin Neoplasias of the Face
Introduction
General Principles
Preoperative Preparation
Operative Strategy
Operative Technique
Potential Pitfalls
Postoperative Care
Common Complications
When to Transfer
Suggested Reading
10: Defect Closure After Lesion Excision of the Face
Indications
Preoperative Preparation
Operative Strategy
Operative Technique
Potential Pitfalls
Postoperative Care
Common Complications
When to Transfer
Suggested Reading
11: Surgical Management of Melanoma of the Trunk and Extremities
Indications
Preoperative Preparation
Operative Strategy
Operative Technique
Potential Pitfalls
Postoperative Care
Common Complications
When to Transfer
Suggested Reading
12: Post-excisional Wound Closure Chapter for Rural Surgeons
Introduction
Indications
Preoperative Preparation
Pitfalls and Danger Points
Operative Strategy
Operative Technique
Primary Closure
Postoperative Care
Skin Grafting
Important Facts About Skin Grafts
Contracture
Skin Graft Physiology
Preoperative Preparation
Operative Technique
Recipient Site Preparation
Full-Thickness Skin Grafts
Split-Thickness Skin Grafts
Postoperative Care
Donor Sites
Recipient Site
Local Flap Closure
Rotation Flap
Transposition Flap
Advancement Flap
Postoperative Care
Complications
When to Transfer
Suggested Reading
13: Breast Ultrasound in Rural Surgical Practice
Indications
Preoperative Preparation
Surgeon
Patient
Operative Strategy
Operative Procedure
Diagnostic Breast US
Margin Analysis
Echogenicity
Acoustic Shadow
Growth Pattern
Compressibility
Lymph Nodes
US Images
Breast Intervention
Aspiration
Core Biopsy
Wire Localization
Intraoperative or Post-lumpectomy Balloon Catheter Placement for APBI
Intraoperative Placement of CED
Postoperative Placement of Balloon Catheter
Potential Pitfalls
Post-procedure Care
Common Complications
14: Oncoplastic Techniques for Breast Conservation
Indications
Preoperative Preparation
Operative Strategy
Basic Principles
Operative Techniques
Potential Pitfalls
Postoperative Care
Common Complications
When to Transfer
Suggested Reading
15: Skin-Sparing Mastectomy
Indications
Preoperative Preparation
Preoperative Imaging and Laboratory Testing
Tissue Diagnosis and Multidisciplinary Discussions
Ductal Carcinoma In Situ and Invasive Ductal Carcinoma
Considerations for SSM and TSSM
Operative Strategy
Operative Technique
Determine the Best Skin Incision
Sentinel Lymph Node Biopsy
Creating the Skin Flaps
Breast Excision
Potential Pitfalls
Postoperative Care
Common Complications
When to Transfer
Suggested Reading
Part IV: Head and Neck
16: Epistaxis
Indications
Preoperative Preparation
Management Strategy
Operative Techniques
Anterior–Posterior Packing
Potential Pitfalls
Postoperative Care
Common Complications
When to Transfer
Suggested Reading
17: Thyroid Surgery
Introduction
Indications
Operative Technique
Potential Pitfalls
Postoperative Care
Common Complications
When to Transfer
Suggested Reading
18: Parathyroidectomy
Developments in Laboratory Diagnosis
History
Presenting Signs and Symptoms
Surgical Approach
Nuclear Medicine Parathyroid Scans
Patient #1: History of Hypercalcemia
Patient #2: History of High Calcium
Operative Procedure
Surgical Pathology
Conclusion
Caution to Surgeons
References
Part V: Vascular
19: Central Venous Access for Rural Surgeons
Introduction
Indications
Preoperative Preparation
Operative Strategy
Central Venous Access by Anatomic Landmarks vs. Ultrasound-Guided Central Venous Access
Operative Technique
Techniques for Insertion of Implanted Ports
Venous Access in the Morbidly Obese Patient
Potential Pitfalls
Malpositioned Catheter Tip
Organizations’ Positions on Catheter Tip Location
References
Suggested Reading
20: Pacemakers
Indications
Preoperative Preparation
Pitfalls and Danger Points
Operative Strategy
Operative Technique
Incision
Venous Access
Lead Placement
Pulse Generator Placement
Potential Pitfalls
Postoperative Care
Common Complications
When to Transfer
Suggested Reading
21: The Vein Stripping Ablation and Phlebectomy
Indications (Fig. 21.1)
Preoperative Preparation
Operative Strategy
Operative Technique (Fig. 21.2)
Postoperative Care
Potential Pitfalls
Common Complications
When to Transfer
Suggested Reading
Part VI: Trauma
22: Decompressive Craniotomy in Trauma
Indications
Acute Epidural Hematomas
Acute Subdural Hematomas
Other Injuries
Preoperative Preparation
Operative Strategy
Operative Technique
Potential Pitfalls
Postoperative Care
Common Complications
When to Transfer
Suggested Reading
23: Tracheostomy and Cricothyroidotomy
Indications
Operative Strategy
Tracheostomy
Operative Technique
Pitfalls of Tracheostomy
Cricothyroidotomy
Operative Technique
Pitfalls of Cricothyroidotomy
Suggested Reading
24: Repair of Soft Tissue Facial Injuries
General Principles
Preoperative Preparation
Operative Strategy
Operative Technique
Potential Pitfalls
Postoperative Care
Common Complications
When to Transfer
Suggested Reading
25: Repair of Fingertip Amputations
Indications
Anatomy
Patient Evaluation
Injury Patterns and Classification
Preoperative Preparation
Debridement and Closure
Operative Strategy
Operative Technique
Potential Pitfalls
Postoperative Care
Common Complications
Skin Grafting
Operative Strategy
Operative Technique
Potential Pitfalls
Postoperative Care
Common Complications
V to Y Advancement
Operative Strategy
Operative Technique
Potential Pitfalls
Postoperative Care
Common Complications
Lateral Kutler Flap
Operative Strategy
Operative Technique
Potential Pitfalls
Postoperative Care
Common Complications
Revision Amputation
Operative Strategy
Operative Technique
Potential Pitfalls
Postoperative Care
Common Complications
When to Transfer
Suggested Reading
26: Damage Control Laparotomy
Introduction
Preparation
Damage Control for Trauma
Indications
Pitfalls and Danger Points
Operative Strategy
Temporary Abdominal Closure
Damage Control for Intraabdominal Sepsis
Damage Control for an Intraoperative Consultation
Conclusion
Reference
Part VII: Obstetric Gynecology
27: Cesarean Section in a Rural Setting
Indications
Preoperative Preparation
Operative Strategy
Operative Technique
Anesthesia
Skin Incision
The Pfannenstiel Incision (Fig. 27.1)
The Joel-Cohen Incision (Fig. 27.1)
Uterine Incisions
Transverse Incision
Vertical Incision
Fetal Extraction
Cephalic
Breech
Frank Breech Extraction
Complete or Footling Breech Extraction
Placental Delivery
Uterine Repair
Abdominal Closure
Pitfalls and Danger Points
Intrapartum Complications
Postpartum Hemorrhage
Uterine Atony
Medical Management of Uterine Atony
Surgical Management of Uterine Atony
Placenta Accreta
Surgical Management of Placenta Accreta
Postoperative Care
Postoperative Complications
References
Suggested Reading
28: Surgical Management of Ectopic Pregnancy
General Indications for Surgery
Preoperative Preparation
Operative Strategy
Potential Pitfalls
Postoperative Care
Common Complications
When to Transfer
Salpingectomy (Figs. 28.2, 28.3, and 28.4)
Indications
Operative Strategy
Operative Technique
Partial Salpingectomy
Indications
Operative Strategy
Operative Technique
Pitfalls
Salpingostomy
Indications
Preoperative Preparation
Operative Strategy
Operative Technique
Potential Pitfalls
Postoperative Care
Cornual Resection for Cornual Ectopic (Fig. 28.6)
Preoperative Preparation
Operative Strategy
Operative Technique
Potential Pitfalls
Postoperative Care
Common Complications
When to Transfer
Suggested Reading
29: Ovarian Torsion
Indications
Preoperative Preparation
Operative Strategy
Operative Technique
Incisions
Exposure
Evaluation for Underlying Ovarian Pathology
Oophoropexy
Oophorectomy
Potential Pitfalls
Postoperative Care
Common Complications
When to Transfer
Suggested Reading
Part VIII: Urology
30: Percutaneous Suprapubic Catheter Placement
Indications
Preoperative Preparation
Operative Technique
Potential Complications
When to Transfer
31: Preoperative Ureteral Catheter Placement to Prevent Ureteral Injuries
Indications
Preoperative Preparation
Ureteral Catheter Placement
Operative Technique
Potential Pitfalls
Common Complications
32: Surgical Management of Testicular Torsion
Indications
Preoperative Preparation
Operative Strategy
Operative Technique
Postoperative Care
Potential Problems
33: Vasectomy
Indications
Preoperative Preparation
Operative Strategy
Operative Technique
Potential Pitfalls
Postoperative Care
Complications
When to Transfer
Suggested Reading
Part IX: Pediatric Surgery
34: Perioperative Management in Infants and Children
Introduction
Vital Signs
Airway and Breathing
Circulation
Preoperative Care
Intraoperative Care
Postoperative Care
Suggested Reading
35: Hypertrophic Pyloric Stenosis (HPS) in Infancy
Indications
Preoperative Preparation
Operative Technique
Potential Pitfalls
Postoperative Care
Common Complications
When to Transfer
Suggested Reading
Index
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Tags: Amy Halverson, David Borgstrom, Advanced Surgical, Rural Surgeons