My surgeons have thrown a curve ball at me and I desperately need some help! I am used to doing heart, lungs and vascular so this looks like Greek to me!
Please see below for the part of the op note I am struggling with:
The patient's abdomen was prepped and draped in standard fashion, and an open laparotomy was performed. Palpatation of the peritoneum for metastases was performed, and there were no metastases over the liver or any evidence of pleural studding. The patient's lesser sac was entered, and a harmonic scalpel was used to take down the short gastric all the way to the level of the spleen. Complete dissection of the esophagus at the level of the diaphragmatic hiatus was performed. There was evidence of dense fibrosis on the left lateral surface of the esophagus at the level of hiatus. This was dissected bluntly. A portion of the crus on the left side was taken down as an en bloc resection of this densely fibrotic area. There was evidence of perforation during this mobilization; intraoperative antibiotics were given. The lesser curvature was then mobilized and was dissected free. At this point, the left gastric artery was identified and a vascular load ethicon stapler was used to mobilize and transect this artery. The pylorus was then identified, and a pyloroplasty was performed in order to defunctionalize the patient's pylorus and prevent obstruction. A Kocher maneuver was performed to mobilize as much duodenum as possible.
Please help!
Please see below for the part of the op note I am struggling with:
The patient's abdomen was prepped and draped in standard fashion, and an open laparotomy was performed. Palpatation of the peritoneum for metastases was performed, and there were no metastases over the liver or any evidence of pleural studding. The patient's lesser sac was entered, and a harmonic scalpel was used to take down the short gastric all the way to the level of the spleen. Complete dissection of the esophagus at the level of the diaphragmatic hiatus was performed. There was evidence of dense fibrosis on the left lateral surface of the esophagus at the level of hiatus. This was dissected bluntly. A portion of the crus on the left side was taken down as an en bloc resection of this densely fibrotic area. There was evidence of perforation during this mobilization; intraoperative antibiotics were given. The lesser curvature was then mobilized and was dissected free. At this point, the left gastric artery was identified and a vascular load ethicon stapler was used to mobilize and transect this artery. The pylorus was then identified, and a pyloroplasty was performed in order to defunctionalize the patient's pylorus and prevent obstruction. A Kocher maneuver was performed to mobilize as much duodenum as possible.
Please help!