Thursday, December 4, 2014

Hepatic Resection


Hepatic Resection
Objective
In case of tumor to remove:
•   Small wedge biopsy
•   Local excision of tumors
•   A major lobectomy.
Position
Supine.
Anesthesia
General.
Procedure
1.  Abdominal or thoracic abdominal incisions.
2.  If a thoracoabdominal incision, the abdominal portion is incised first.
3.  Hepatic artery, portal vein, major biliary ducts are controlled by vascular forceps.
4.  The liver parenchyma ligate major vascular and biliary channels.
5.  Careful technique is necessary when approaching the posterior surface where the hepatic veins enter the inferior vena cava.
6.  After hemostatsis and the bile ducts are ligated the exposed pnarenchyma covered by greater omentum.
7.  The area is drained.
8.  The abdomen is closed in layers.
Instruments
•   General set
•   Deep instruments set
•   Gastrointestinal set
•   Biliary tract set
•   Thoracotomy set (for thoracoabdominal approach)
•   Hemoclip appliers (various sizes and lengths) (Fig. 17.25)
•   A CUSA may be required (Chapter 2 Fig. 2.7).
Any questions be sent to drmmkapur@gmail.com
All older posts are stored in archives for access and review.
Visitors that follow may post contributions to the site,please write to address above.
To create consumer/provider engagement visit www.surginstuatlas.blogspot.com

No comments:

Post a Comment