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General Surgery (Laparoscopic Port (Advantages of MAS (Smaller Incisions,…

- - - - ↓ risk of infection
      - ↓ friction in tissues
    - - Harder to handle: stiff and has more memory
      - Knots may slip
      - Less tensile strength
  - - - Easier to handle: less memory
      - Knots slip less
      - Greater tensile strength
    - - ↑ risk of infection
      - ↑ friction in tissues
  - - - Catgut / Chromic
    - - Silk: braided suture that may be used to secure drains
  - - - Fine: GI and vascular surgery
      - Medium: general closure
      - Heavy: hernia repair
- - - - Rectal bleeding
      - Colonic Neoplasia
      - IBD
  - - - Mechanical: pushing against bowel wall
      - Pneumatic: over-inflation
  - - - Perianal: haemorrhoids, fissure
      - Diverticular disease
      - Malignancy
    - - IBD
      - Infection
      - Upper GI bleed
      - Angiodysplasia
- - - - Drainage of established collections
      - Drain a viscus: e.g. bladder
      - Collect blood for autotransfusion
  - - - Active: driven by suction
        e.g. Redivac drain
      - Passive: no suction, driven by pressure differential e.g. Robinson drain
    - - Open
        
        e.g. corrugated rubber or plastic sheets
        
        Fluid collects into dressing or stoma bag
      - Closed
        
        e.g. chest drains, Robinson or Redivac
        
        Tube attached to a container
    - - Type: closed, passive
      - Use: abdominal surgery
        
        Risk of infection
        
        Contamination: faeces or pus
    - - Type: closed, active
      - Use
        
        Breast surgery: prevent seroma or haematoma
        
        Thyroid surgery: risk of haematoma
    - - Type: closed, passive
      - Use
        
        NGT
        
        T-tube
    - - Type: open, passive
      - Use: abdominal surgery
    - - Type: open, passive
      - Use: large cavities
- - - - Gastrectomy
  - - - Fill pelvic cavity with saline
      - Insufflate rectum c¯ air and look for bubbles in the saline.
    - - Water-soluble contrast enema
- - - - Pain if injected below dentate line
      - Damage to nearby structures
      - Primary haemorrhage
    - - Prostatitis
      - Impotence