Endoscopic surgery connecting the stomach – ileum is an open laparoscopic method; at the same time, during the laparoscopy will combine micro-duodenal surgery, through the thick skin and the head of the corolla.
1. When is the endoscopic surgery in order to connect the stomach – the duodenum?
Surgery is performed when the path down to the duodenum is clogged with a lump, or a narrow ulcer,… or do not pass food through the duodenum may be caused by a rupture of the duodenum,…
The patient will be prescribed laparoscopic surgery to connect the stomach – ileum when the patient has the following symptoms:
- Food does not go down the road to the duodenum due to obstruction due to the patient having tumors in the burrow, duodenum, Vater ball, pancreas.
- The path down the duodenum is poorly circulating because the patient has had a full X nerve cut, an orthage shape.
- The patient's body actively prevents food from passing through the duodenum, closing the taste.
- Or the duodenal extra bag is large so it cannot be removed.
2. Contraintent to laparoscopic surgery connecting the stomach – duodenal support?
General contrain specify:
- Patients suffer from many diseases, are severely malnourished, the body is in poor health.
- There are tumors that invade the stomach area.
- The tumor has been migrating in many places.
- Patients with cardiovascular and respiratory diseases at the same time, can not inflate the abdominal area.
- Patients have had abdominal surgery many times.
3. Preparation before conducting laparoscopic surgery connecting the stomach – duodenal support
Implementer: Includes a team of nursing staff specializing in digestion with long experience in laparoscopic surgery, an anesthesiist. Patients will receive in-administration anesthesia
Media: Laparoscopic Surgery Set
Patients: Required to do pre-endoscopic tests to ensure safety
Perform basic tests: Blood formula test, bio-biomedification, blood clots, cardicardimonary imaging, electrocardiary heart usually,…
- Gastroscopy is aimed at accurately diagnosing the cause of the blockage.
- Photocular gastric imaging: To assess the patient's stomach shape and diagnose the degree of amenity stenosis.
- Do additional abdominal CT-Scan to assess the lesion.
- Pre-screening anesthesia
- Wash the stomach before surgery.
Medical records: In accordance with the regulations of the hospital, patients complete administrative procedures before surgery including: medical records, minutes of consultation, examination before anesthesia, written commitment to agree to surgery.
- Position: Lying head high, legs low. The screen and devices are positioned across the patient's left shoulder. The patient is located in a high head position, low legs at an angle of 150 – 300 (Trendelenburg position), two legs in the form of an angle of 900. The home screen and devices are positioned across the patient's left shoulder. The implementer stands to the right of the patient
- Oral articomy: The doctor perform the mouth connecting the front of the mescosa of the horizontal colon, connecting the colon to the front of the 2-layer cave. The length of the mouth is about 6cm, about 4cm from the taste – the lowest support part of the stomach. Open the stomach, open the intestine to hemage well open (by stitching, electric burning …), technicians clean the stomach before connecting. Stitch the edge muscle after the gastric opening (except for the back sewing mucosa) with the muscle bar behind the intestinal opening with a separate nose or squeezed nose. Perform layer stitches in the back that take only the mucous membranes or the whole with a separate nose or squeezed nose, closed stitches.
After performing laparoscopic surgery connecting the stomach – duodenal support, the patient continues to need further monitoring and treatment:
- Fasting, intravenous nourishment.
- Use of antibiotics for treatment within 5 days.
- Gastric cathetro can be in order to withdraw early within 24-48 hours after surgery.
- Nourish the body through the gastrointestinal tract early after gastric re withdrawal.
- Abdominal drainage can be performed if it can be withdrawn within 48 hours if the patient's abdominal condition is stable.
Performing endoscopy connecting the stomach – duodenal support is a method of laparoscopic surgery that requires skilled practitioners and modern equipment because of the complex endoscopic method. Patients should choose large and highly reputable hospitals to ensure safety as well as the best level of success.
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