Saturday, February 18, 2012

GASTRO JEJUNOSTOMY PROCEDURE 2


When is gastrojejunostomy carried out?
· Gastrojejunostomy is carried out in cases of obstruction of stomach outlet.
· This can result because of cancer or an ulcer of the stomach.
· To establish alternative connection between stomach and small intestine.
· To follow vagotomy.
Position of the patient
Supine.
Anaesthesia given during this procedure
General.
Procedure
· A midline or paramedian incision is made, next an opening is made in transverse mesocolon.
· Stomach antrum is isolated and tissue forceps is applied at lesser and greater curvature of the stomach.
· The jejunum is also held by tissue forceps loop 10 – 20 cm from duodenojejunal junction.
· Next non-crushing occlusion clamp is applied.
- Two-layer anastomosis with 2/0 chromic is now carried out. The outer is continuous (in the seromuscular layer) and the inner continuous to all layers.
- Also anastomosis is brought above the mesocolon tethered.
- Wound is closed in layers.
Instruments
General set, 1
Laparotomy set, 1
Fine artery forceps, 5

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