Surgical Procedures

Gastric Surgery

• Vagotomy – surgical ligation of the vagus nerve to decrease the secretion of gastric acid

• Pyloroplasty – surgical dilatation of the pyloric sphincter to increase the rate of gastric emptying

• Gastroduodenostomy (Billroth I) – surgical removal of the lower portion of the stomach with anastomosis of the remaining portion of the stomach to the duodenum

• Gastrojejunostomy (Billroth II) – surgical removal of the antrum and distal portion of the stomach and duodenum with anastomosis of the stomach to the jejunum

Gastrostomy

• The creation of an artificial external opening into the stomach for nutritional support or gastrointestinal compression

Gastrectomy• The removal of part or all of the stomach. • There are three main types of

gastrectomy:• partial gastrectomy, removal of the

lower half of the stomach• full gastrectomy, removal of the entire

stomach• sleeve gastrectomy, removal of the left

side of the stomach

Gastrointestinal bypass

• surgical procedure that creates a very small stomach; the rest of the stomach is removed.

GB and Pancreatic Surgeries

• Cholecystostomy – surgical incision into the gallbladder to drain bile

• Choledochotomy – surgical incision into the common bile duct to remove stones

• Choledochostomy – surgical opening of the common bile duct to insert a T-tube or catheter for drainage

• Cholecystectomy – surgical removal of the gallbladder

• Laparoscopic Cholecystectomy – removal of the gallbladder through a small incision in the abdomen and the use of a fiber-optic endoscope

• Pancreatectomy – surgical removal of part or the entire pancreas

Bowel Surgery

• Abdominoperineal resection – removal of the distal sigmoid colon, rectum and anus with the creation of a permanent colostomy

• Colectomy- a surgical procedure to remove all or part of your colon.

• Total colectomy involves removing the entire colon.

• Partial colectomy involves removing part of the colon and may also be called subtotal colectomy.

• Hemicolectomy involves removing the right or left portion of the colon.

• Proctocolectomy involves removing both the colon and rectum.

• Ileostomy – surgical opening of the ileum to the abdominal surface to form a stoma

• Bowel resection- surgical excision of a portion of the bowel

• Colostomy - is a surgical procedure that brings a portion of the large intestine through the abdominal wall to carry feces out of the body.

Hemorrhoidectomy

• Surgical removal of the hemorrhoids

• Incisions are made in the tissue around the hemorrhoid. The swollen vein inside the hemorrhoid is tied off to prevent bleeding, and the hemorrhoid is removed

Preoperative Nursing Responsibilities

* Complete patient and family teaching

* Complete the pre-operative checklist and

obtain a signed informed consent

* Administer preoperative medications as

prescribed

* Document’s the patient history and physical

assessment data

* Administer bowel preparation as prescribed

Postoperative Nursing Responsibilities

* Assess respiratory, cardiac status and fluid

balance

* Administer IV fluids, NG tube feedings and

transfusion as prescribed

* Provide wound care and dressing changes

* Assess for the return of peristalsis

* Monitor and maintain the position and patency of

drainage tubes, NG, IFC, wound drainage

* Assess pain and administer analgesics as

prescribed