WikiAnesthesia - User contributions [en]

Esophagastric fundoplication

2024-02-15T13:44:14Z

Ttrypho:

{{Infobox surgical procedure
| anesthesia_type = General
| airway = ETT (DLT if thoracic approach)
| lines_access = Large bore PIV
| monitors = Standard
| considerations_preoperative = Patients often Obese
| considerations_intraoperative = Severe GERD - consider RSI
| considerations_postoperative =
}}

Provide a brief summary of this surgical procedure and its indications here.

== Overview ==

=== Indications ===

* Usually for symptomatic reflux refractory to medical management

=== Surgical procedure ===

* The fundus of stomach is wrapped around the lower oesophagus

== Preoperative management ==

=== Patient evaluation ===
{| class="wikitable"
|+
!System
!Considerations
|-
|Airway
|
|-
|Neurologic
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|-
|Cardiovascular
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|-
|Pulmonary
|
|-
|Gastrointestinal
|
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|
|-
|Other
|
|}

=== Labs and studies ===

=== Operating room setup ===

=== Patient preparation and premedication ===

* Aspiration precautions if severe GERD

=== Regional and neuraxial techniques ===

* N/A if laparoscopic approach

== Intraoperative management ==

=== Monitoring and access ===

* Standard monitors unless indicated by patient comorbidities
* Large bore PIV generally sufficient.

=== Induction and airway management ===

* Consider RSI
* If laparoscopic abdominal approach: ETT

=== Positioning ===

* Supine

=== Maintenance and surgical considerations ===

* Laproscopic approach: ~5 porst in upper abdomen.

=== Emergence ===

* Routine. Ensure well suctioned of any gastric contents.

== Postoperative management ==

=== Disposition ===

=== Pain management ===

* Prn multimodals

=== Potential complications ===

* Complications are rare
* Atelectasis
* Esophageal or gastric perforation
* Hemorrhage
* Pneumothorax
* Capnomediastinum

== Procedure variants ==

{| class="wikitable wikitable-horizontal-scroll"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
|
|
|-
|Position
|
|
|-
|Surgical time
|
|
|-
|EBL
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|-
|Postoperative disposition
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|Pain management
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|-
|Potential complications
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|}

== References ==

[[Category:Surgical procedures]]

Sentinel lymph node biopsy

2024-02-15T13:32:17Z

Ttrypho:

{{Infobox surgical procedure
| anesthesia_type = GA, local with sedation
| airway = LMA
| lines_access = PIV sufficient
| monitors = standard
| considerations_preoperative = Cancer considerations.
Radioisotope tagging beforehand means that cancelling "elective" cases is discouraged once they have been tagged.
| considerations_intraoperative = avoid BP cuff on ipsilateral arm.
| considerations_postoperative = PONV (breast surgery). With local infilitration, pain is usually minimal.
}}

Provide a brief summary here.

== Overview ==

=== Indications ===

* The sentinel lymph node is the first node or group of lymph nodes that drains from the primary cancer. Thus, it is used to check for metastastic breast cancer.

=== Surgical procedure ===

* Carried out in conjunction with radioisotope tagging beforehand. The nodes with the highest degree of activity are removed.
* Involves incision in axilla to excise corresponding nodes.

== Preoperative management ==

=== Patient evaluation ===
{| class="wikitable"
|+
!System
!Considerations
|-
|Airway
|
|-
|Neurologic
|
|-
|Cardiovascular
|
|-
|Pulmonary
|
|-
|Gastrointestinal
|
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|
|-
|Other
|
|}

=== Labs and studies ===

=== Operating room setup ===

=== Patient preparation and premedication ===

=== Regional and neuraxial techniques ===

== Intraoperative management ==

=== Monitoring and access ===

* Standard monitors
* PIV sufficient

=== Induction and airway management ===

* If GA - standard induction. Usually a fairly healthy population.
* If MAC - propofol infusion +/- narcotic prn

=== Positioning ===

* Supine. Arms out

=== Maintenance and surgical considerations ===

=== Emergence ===

== Postoperative management ==

=== Disposition ===

* Day procedure

=== Pain management ===

* Usually small incision. Local infilitration +/- prn narcotic, multimodals sufficient.

=== Potential complications ===

== Procedure variants ==

{| class="wikitable wikitable-horizontal-scroll"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
|
|
|-
|Indications
|
|
|-
|Position
|
|
|-
|Surgical time
|
|
|-
|EBL
|
|
|-
|Postoperative disposition
|
|
|-
|Pain management
|
|
|-
|Potential complications
|
|
|}

== References ==

[[Category:Surgical procedures]]

Lobectomy

2024-02-08T15:30:45Z

Ttrypho: summary chart

{{Infobox surgical procedure
| anesthesia_type = General
| airway = DLT, ETT with bronchial blocker
| lines_access = PIV, large bore IV, arterial line on dependent side in lateral position,
| monitors = Standard, 5-lead,
| considerations_preoperative = Chronic respirtory disease, chronic smokers and sequelae, coexisting cardiovascular disease.
</br> "three legged stool" to estimate postoperative lung function - most commonly: PFT's to estimate ppoDLCO & ppoFEV1, functional status / echo
| considerations_intraoperative = One lung ventilation, protective lung ventilation, managing hypoxia on one lung ventilation, thoracotomy vs minimally invasive approach
| considerations_postoperative = analgesia: if VATS, regional block or PCA sufficient; if thoracotomy, epidural or PVB preferred
}}

Provide a brief summary of this surgical procedure and its indications here.

== Preoperative management ==

=== Patient evaluation ===
{| class="wikitable"
|+
!System
!Considerations
|-
|Neurologic
|
|-
|Cardiovascular
|
|-
|Pulmonary
|
|-
|Gastrointestinal
|
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|
|-
|Other
|
|}

=== Labs and studies ===

=== Operating room setup ===

=== Patient preparation and premedication ===

=== Regional and neuraxial techniques ===

== Intraoperative management ==

=== Monitoring and access ===

=== Induction and airway management ===

=== Positioning ===

=== Maintenance and surgical considerations ===

=== Emergence ===

== Postoperative management ==

=== Disposition ===

=== Pain management ===

=== Potential complications ===

== Procedure variants ==

{| class="wikitable wikitable-horizontal-scroll"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
|
|
|-
|Position
|
|
|-
|Surgical time
|
|
|-
|EBL
|
|
|-
|Postoperative disposition
|
|
|-
|Pain management
|
|
|-
|Potential complications
|
|
|}

== References ==

[[Category:Surgical procedures]]