Friday, July 11, 2014

SURGICAL PROCEDURE 2 Gastro-jejunostomy



2.  Gastrojejunostomy
Objective
In cases of obstruction of stomach outlet:
•   To establish alternative connection between stomach and small intestine.
•   To follow Vagotomy.
Position
Supine.
Anesthesia
General.
Procedure
•   Midline or Paramedian incision
•   Opening made in transverse mesocolon
•   Stomach antrum isolated tissue forceps at lesser and greater curvature
•   Jejunum also held in tissue forceps loop 10 to 20 cm form duodenojejunal junction
•   Non-crushing occlusion clamp applied
•   Two layers anastomosis 2/0 chromic
•   Outer continuous seromuscular
•   Inner continuous all layers
•   Anastomosis brought above the mesocolon tethered
•   Wound closed in layers.
Instruments
•   General set, 1
•           Gastrointestinal set, 1


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