Добавил:

Sekretar kiopkiopkiop18@yandex.ru t.me/Prokururor I Вовсе не секретарь, но почту проверяю Опубликованный материал нарушает ваши авторские права? Сообщите нам.

Вуз:

Ростовский Государственный Медицинский Университет

Предмет:

Медицина общая

Файл:

Книга_938_Библиотеки_им_академика_М_И_Перельмана

.pdf

Скачиваний:

Добавлен:

31.08.2026

Размер:

30 Мб

Скачать

☆

<<< < Предыдущая 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 3536 / 3636

Index

https://t.me/med1917

347

skin preparation, 9 smoking cessation, 3–4 stoma siting, 5–6 surgery procedures, 8 surgical checklist, 7 surgical site infection prevention, 7

venous thromboembolic prophylaxis, 11–12 Preperitoneal mesh placement, 182 Pre-peritoneal oblique incision, 89 Pressure ulcers, 67, 70 Primitive esophagoscopies, 189 Pringle maneuver, 128 Prociency-based training, FRS, 222 ProGrip™, 176 Prone position, operative room, 74, 76 Proprietary knots, 50 PROUD trial, 49 Pulmonary hilum control, 283, 285 Pulmonary segmentectomy, 112 Purse-string suture, 61, 154

Quill SRS™, 49 Quill™ Knotless Tissue-Closure Device, 49

Rack-and-pinion retractor, 278 Rake retractor, 27 Rapid ve-step technique, 327 Reanastomosis, 140 Rectal anatomy, 112 Reef knot, 52 Renal injuries, 263, 264 Resident success, 317, 319 Resuscitative endovascular balloon occlusion of the aorta

(REBOA), 286 Retention sutures, 92 Retractors, 25, 95

dissection techniques, 111 effective recruitment of the operative assistant, 97 handheld retractors, 98, 102–103 laparoscopic fan-style retractor, 102 laparoscopic procedures, 99 laparoscopic retractors, 99, 104 large-scale eld exposure, 97 moment-by-moment adjustments, 97 open procedures, 99 self-retaining retractors, 98–99, 103 Senn retractor, 103 types of, 97–102

wound protector, 102 Retroexion, 168, 171 Retrohepatic injury, 261 Retromuscular repairs, 182 Retroperitoneal hematoma, 257 Retroperitoneal incision, 89 Retrorectus repair, 182 Reverse cutting needle, 45

Rhabdomyolysis, 70 Richardson retractor, 27, 100 Richardson-Eastman retractor, 27, 100 Robotic arm docking sequence, 218 Robotic skill acquisition, 221 Robotic surgery

automatic detection of errors, 217 intraoperative phase

instrument insertion, 220 surgeon console, 220 surgical cart, 218 trocar placement, 217

laparoscopic surgery

advatages, 216 camera platform, 216 degrees of freedom, 216 ergonomic equipment, 216 instrument handling, 216 learning curve, 215 motion amplication adjustments, 216 motion reversal elimination, 216 surgeon’s hand motions, 216 three-dimensional anatomy, 215

tremor elimination, 216 operating room setup for, 22 postoperative phase, 221 preoperative phase, 217 safety mechanisms, 217 simulation tasks, 224 surgeon competancy, 221 team communication issues, 217 telepresence, 215

Robotic trocars, 218 Rumel tourniquet, 128 Running whipstitch, 60 Russian staplers, 137 Russian tissue forceps, 25, 26 Ryder needle driver, 26

Sacrum position, 74 Safety precaution

dissection techniques, 109–114 patient positioning, operating room, 70

Scalpel, 23 Scissors, 23 Seldinger technique, 145 Self-retaining retractors, 98–99, 103 Senn retractor, 27, 100, 103 Sequential compression devices (SCD), 198 Sewing, 50 Sharp dissection, 86, 109 Short bite technique, 209 Short stitch technique for laparotomy closure, 211 Short-term effects of smoking, 3 Silo technique, 267 Simple knot, 52 Simulation-based curriculum, robotic surgery, 221, 224 Single-incision laparoscopic surgery (SILS), 198–200

348

https://t.me/med1917

Index

Single-layer hand-sewn gastrojejunostomy, 232 Skin layers, 84, 85 Skin closure, 83, 91, 93

concepts, 83–85

suture options for, 92 Skin hooks, 100, 112 Skin preparation, 76–77

antiseptic agent, 78

antiseptic-related res, 79

hair trimming, 77

preoperative home showering, 77

preoperative preparation, 9

sterilization process, 80

surgical site, 77–78 Slip knot, 52 Smoking cessation, 3 Society of American Gastrointestinal and Endoscopic

Surgeons (SAGES), 164, 166, 293 Spinous process, 74 Splenectomy, 262 Splitting technique, 109 Square knot, 51, 52 S-retractor, 27 Stapled enteroenterostomy, 233 Stapled ileocolonic anastomoses, 227, 228 Stapled tractotomy technique, 283, 284 Stapling device

application of, 138, 139 complication, 140 history of, 137 linear vs. circular, 139

mechanics of, 138–139 Sterile eld, 18 Sterile members of OR team, 17 Sterilization process, 80 Sterilizing agents, 81 Stoma siting, 5 Straight Crile, 29 Straight Kelly clamp, 30 Stratax™, 49 Stratum basale, 84 Stratum lucidum, 84 Subcutaneous tissue, 84 Suction cannulae, 37 Suction devices, 27, 37 Sump drain, 149–151 Supine position, operative room, 70, 71 Supraceliac control, 127 Supradiaphragmatic occlusion, 128 Suprarenal aortic injuries, 264 Surgeon’s knot, 52 Surgeon’s overall effort, 312 Surgical checklist, preoperative preparation, 7 Surgical effort, 312 Surgical knots, 52 Surgical site infection (SSI), 7, 49, 76, 77, 91 Surgical site preparation, 78 Surgical training

accreditation process, 290

care complexity, 291, 292 communities online forums, 291 formal programs, 291 intraoperative assistance, 291 mentorship, 291 metrics, 291 operative and clinical performance

assessments, 290 preoperative planning, 291 re-operative surgery, 291 seeking out opinions, 291 social media outlets, 291 success, 291 surgical complications, 292–293 transition, 290 volume, 291

Sutures, 50–51

absorbable suture, 42 approximating skin and soft tissues, 58 baseball stitch, 60 bite size, 56 body positioning, 55–56 continuous running locking stitch, 60 continuous subcuticular stitch, 59–60 current controversies/future directions, 49–50 Gambee stitch, 62 gastrointestinal anastomosis, 61 goals of, 58 history, 39–40 inverted u-stitch, 60 knotless, 62–63 Lembert suture, 61 ligatures, 60 materials, 41–44 multilament/braided, 41 natural materials, 41 needle curves and uses, 47 needle driver, 53–55 needle holder and correct needle positioning, 53 non-absorbable suture, 41, 43 package, anatomy/dissecting, 40–41 pressure and, 126 purse-string suture, 61 simple interrupted, 58–59 size, 41 synthetic materials, 41 tail control, 56 technical/practical considerations/safety precautions,

47–49 USP sizes, 44 vessels and, 121

Swaged sutures, 45 Sweetheart retractor, 27 Synthetic meshes, 175, 182

bioabsorbable, 177 expanded polytetrauoroethylene, 177 polyester, 176 polypropylene, 177 polyvinylidene uoride, 177

Index

https://t.me/med1917

349

Tachycardia

causes, 324 clinical evaluation, 324 diagnosis, 324

treatment, 324, 325 Tapered needles, 44, 49 Telepresence surgery, 215 Temporary abdominal wall closure, 258

clinical scenarios, 265

damage control, 265, 271

indications, 266

noncommercial methods, 268

NPTS

applications, 267 sponge-based, 268–270 towel-based, 268, 269

visceral protection, 269 patch technique, 267, 268 practical/safety precautions

early complications, 270

enterocutaneous stulas, 271

late complications, 271

postoperative care, 270–271 silo technique, 267 skin-only closures, 266 by vascular surgeons, 265

Ten Commandments, 308, 309 Tenotomy scissor, 24 Tensile strength loss, 44 Tension pneumothorax, 155 The Joint Commission on Accreditation of Healthcare

Organizations, 91

Thopaz

digital chest drainage system, 156 Thoracoabdominal incision, 89 Thyroid incisions, 89 Tissue plane, dissection techniques, 112 Tobramycin, 11 Tracheal hook, 330 Tracheostomy, 89, 331 Traction

dissection techniques, 111

prevention, 75 Transportation process, 259 Transverse incision, abdomen, 88 Trauma laparotomy, see Exploratory laparotomy, trauma Trauma thoracotomy, 275 Trendelenburg position, 72, 96, 107 Triclosan, 49 Triple-channel Davol drain, 150–152 Trocars, 37 Trousseau dilator, 331 T-tube, 148, 149

Ulnar neuropathy, 66, 67 Ultrasonic energy devices, 133 Ultrasound dissection, 111

United States Surgical Corporation, 137 US Army retractors, 100

Vacuum-assisted closure (VAC) therapy, 158–160 Vancomycin, 8, 11 Vascular anastomosis

anastomotic narrowing, 248 anatomy, 243 anticoagulation, 242 arteriotomy and venotomy, 242 atherosclerotic calcication, vessel, 240 autologous vein graft, 242 complications, 247, 248 conduit, target vessel preparation, 242 double-barreled, monolament suture, 246 emergency maneuvers, vascular control, 248 exposure of vessels, 239, 240 four-quadrant repair, 246 hybrid graft, 249 iatrogenic/traumatic defect, 246 instruments, 239, 240 intraluminal insertion, 249 parachute technique, 247 patch repair, 245, 246 physiology, 245 postoperative bleeding, 248 proximal and distal vascular control, 240, 241 PTFE graft, 241 quadrant repair technique, 247 single, continuous, monolament suture, 246 suturing, 247, 249 traumatic/iatrogenic vascular injury, 248

Vascular control

clamp-tie-divide-tie method, 123 with division between clamps, 122

with suture ligature, 124 Vascular injuries, 264 Vascular repair and anastomotic creation, 239 Vascular shunts

anastomotic creation, 243

distal perfusion, 244

forward ow preservation, 244

hemostasis and suture repair, 244

reperfusion, 243, 244

vascular clamps, 244 Vascular surgery

instruments, 249

vascular clamps, 249