Zollinger's Atlas of Surgical Operations, Tenth Edition
Format: PDF / Kindle (mobi) / ePub
The classic surgical atlas, more comprehensive than ever!
For more than half-a-century, Zollinger’s Atlas of Surgical Operations has been the gold-standard reference for learning howto perform the most common surgical procedures using safe, well-established techniques. The tenth edition continues this tradition of excellence. The atlas covers gastrointestinal, hepatobiliary, pancreatic, vascular, gynecologic, and additional procedures, including hernia repair, vascular access, breast procedures, sentinel lymph node biopsy,thyroidectomy, and many more. The illustrations in this atlas have withstood the test of time. They allow you to visualize both the anatomy and the operation, making the book useful as a refresher or for learning the steps of a particular procedure.
The tenth edition of Zollinger’s Atlas of Surgical Operations expands the content to include 19 new operations. Each chapter contains beautifully rendered line drawings with color highlights that depict every important action you must consider while performing the operation. Each chapter also includes consistently formatted coverage of indications,preoperative preparation, anesthesia, position, operative preparation, incision and exposure, procedure, closure, and postoperative care.
junction should now be divided. The remaining vasculature to the colon can be divided close to the bowel. The superior hemorrhoidal vessels and presacral space should not be violated. When a second procedure (either ileorectal anastomosis or proctectomy and ileoanal pouch reconstruction) is contemplated, these planes should be left as virgin territory to facilitate that subsequent procedure. TOTAL PROCTOCOLECTOMY The remaining description applies to the completion of a single-stage total
The patient is placed in a semilithotomy position using Allen stirrups and in a modest Trendelenburg position to enhance exposure of the deep pelvis and permit the introduction of the stapling instrument via the anus. OPERATIVE PREPARATION Not only the abdominal wall from the xiphoid to the pubis, but the skin over the perineum, groin, and especially the anal region are prepared since the instrument will be introduced through the anus. INCISION AND EXPOSURE A long midline incision
The neck of the sac can sometimes be identified as a slightly thickened white ring. The sac should be ligated proximal to this ring. After the purse-string suture is tied, the excess sac is amputated with scissors (FIGURE 12). If desired, the ligated sac may be anchored to the overlying muscle. In this instance the long ends of the suture used to close the neck of the sac are rethreaded. The needle is inserted beneath the transversalis fascia and brought up in the edge of the internal oblique
index finger beneath the triangular ligament to define its limits and to protect the underlying structures, the triangular ligament is divided with long, curved scissors. The assistant stands on the patient’s left side and can usually do this more easily than the surgeon (FIGURE 3). It should be unnecessary to tie any bleeding points; however, occasionally the tip of the left lobe may require several ties to control slight oozing on the liver side. The left lobe of the liver is then folded either
The child is taken to the x-ray department, and here hydrostatic reduction by barium enema is attempted, utilizing a pressure of no more than 3 ft. As much as 1 hour may be spent in this procedure as long as manipulation of the abdomen is avoided and the exposure to fluoroscopy limited as much as possible. If the intussusception is going to reduce, it will progressively do so. If this method fails, surgery follows immediately. If a mass lesion or cancer is suspected in an elderly patient, then a