By Thomas H. Gouge (auth.), Carol E. H. Scott-Conner MD, PhD, MA (eds.)
Chassin’s Operative techniques in Esophageal surgical procedure bargains the reader a succinct assessment of surgical innovations for issues of the esophagus. Spanning from well-established legacy tactics to the main updated minimally invasive techniques for GERD, this brilliantly illustrated atlas completely offers the theoretical foundation of the operations in addition to the thoughts required to lead away from universal pitfalls. Educed from Chassin’s Operative options in most cases surgical procedure, this quantity contains step by step descriptions of 13 (13) operative systems in esophageal surgery.
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Additional resources for Chassin’s Operative Strategy in Esophageal Surgery
Move to a position on the left side of the patient. Extend the skin incision up from the tip of the scapula in a cephalad direction between the scapula and the spine. With electrocautery divide the rhomboid and trapezium muscles medial to the scapula. Retract the scapula in a cephalad direction and free the erector spinal muscle from the necks of the sixth and ﬁfth ribs. Free a short (1 cm) segment of the sixth (and often of the ﬁfth) rib of its surrounding periosteum and excise it (Fig. 3–23).
Fig. 2–17 Operative Technique 23 Fig. 2–18 Advancement of Stomach into Right Chest Divide the right crux of the diaphragm transversely using electrocautery (Fig. Advance the stomach into the right hemithorax, which should again be exposed by expanding the Finochietto retractor. There must be no constriction of the veins in the vascular pedicle of the stomach at the hiatus. Suture the wall of stomach to the margins of the hiatus by means of interrupted 3-0 silk or Tevdek sutures spaced 2 cm apart to avoid postoperative herniation of bowel into the chest.
As seen in Figure 3–2a, protection from posterior leakage is achieved in the end-to-side cases by the buttress effect of a 6- to 7-cm segment of gastric wall behind the esophagus. In end-to-end Anastomotic Leakage Delicacy and precision of anastomotic technique and adequate exposure are important for preventing anastomotic leaks. If a gastric or lower esophageal lesion has spread up the lower esophagus for a distance of more than 6–8 cm, the esophagogastric anastomosis should not be constructed high up under the aortic arch, as it is a hazardous technique.