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Home , Buccopharyngeal fascia, Interfoveolar ligament, Lacunar ligament, Muscular triangle, Submandibular triangle, Submental triangle

Index

Abdomen anal fi stulectomy, 478 abdominal aorta, anatomy, 631–632 fi stulous tract, probe and abdominal aortic aneurysm repair incision, 481 elective infrarenal, 641–644 Goodsall-Salmon’s rule of abdominal hysterectomy fi stulas, 482–483 bilateral salpingo- seton procedure, 481 oophorectomy, 658 anorectal landmarks, 476 incision, surgical technique, band ligation 655–662 anus examination and prolapse abdominal incisions, 148 reduction, 490–493 midline, thoracic extension McGivney and McGowan band of, 150 ligator, 489 anterior , 113–115 digital examination, 477–478 blood supply of, 131–132 external thrombosed fossae of, 117–118 hemorrhoids, incision hernias, see Hernia and drainage of, 489 layers of, 117 hemorrhoidectomy supply of, 132–134 external hemorrhoid, 483 Adrenal glands ischiorectal abscess, 478, 480 adrenalectomies, 607–618 pilonidal cyst, excision of, laparoscopic adrenalectomy, 493–495 619–630 sigmoidoscopic examination, relations of, 603–604 475–476, 479 right and left, 604 stapled hemorrhoidectomy vascular system of, 605–606 open-sided retractor, 486–487 and perianal regions, sigmoidoscopy, 487–489 surgical procedures Anterior iliopubic tract repair, anal fi ssure, 483 condon procedure, 175

668585 686 Index

Anus and vascular system of lymph drainage of, 437 arterial supply, 96 pelvic splanchnic nerves, venous drainage, 100 436–437 Buccopharyngeal , 28 conjoined area, 121–122 Carotid endarterectomy, 631, , 127 635–640 inguinal , 119 anatomy for, 631 lacunar and , 120 , 23 Carpal tunnel appendectomy, 406–411 canals within, 669 laparoscopic appendectomy, distal, central and upper proximal 412–413 zone divisions, 672 relations and positions of, 403 median nerve vascular system of, 403 anatomical variations of, 674 blood and venous supply, 404 motor branches topography lymphatic drainage, 404–405 of, 668 Arteria thyroidea ima, 35 palmar cutaneous Auriculotemporal nerve, 46 branches of, 671 Axilla, 95 presentation of surgical anatomy lymph nodes of, 101 and, 665–667 topography of, 96 proximal surgical and distal surgical zone, 670 Biliary tract anatomy, 533 surgical treatment of, 673 Body wall lower anterior, 117–118 volar carpal ligament, division posterior (lumbar), 145–146 of, 676 Bogros, space deep inguinal Cavitron ultrasonic aspirator vasculature, 138 (CUSA), 524 Branchial cleft sinuses and cysts Cecopexy, colon, 438–439 excision of, 76–78 Cecostomy, colon, 438 remnants anatomy Choledochal cystectomy, 565–566 cysts, 49–51 Choledochoduodenostomy, 560–564 fi stulas, 47–48 Circle of death, 145 sinuses, 48–49 Colles fascia, 118, 122 Breast Colon anatomy , 415 axilla, 95 ileocecal folds, 416 deep pectoral fascia, 93–95 colon proper muscles and nerves, 95 Jackson’s veil, 416, 418 sagittal section, 99 mesocolon, 416 lymphatic drainage, 100–102 mobile cecum, 417 and mastectomy, 97–100 right colon, attachment degrees, morphology of, 95–96 417 Index 687

sigmoid mesocolon, average Copious lymphorrhea, 32 measurements, 419 Cysts, 49 transverse, 418 incomplete closure of 2nd fascial relations and tissue branchial cleft/ pouch, 50 spaces, 425 layers of wall Direct inguinal hernia anal canal, 421, 423 condon repair of, 175 anus and rectum, spaces of, 422 nyhus procedure, 188–189 epiploic appendages, 420 repair of, 174 loops, 423 Douglas linea semicircularis, 115 rectum, 421 sphincteric elements, 422 Epigastric artery, 131 , 421 , 132 lymphatic drainage of Epigastric hernia, 160–162. See also divisions, 431–432 pelvic diaphragm and continence External supravesical hernias, 179 fasciae of, 426 possible pathways of, 136 muscles, 425 Extrahepatic biliary tract rectum and anal canal, 418 cholecystectomy, 545–548 resection choledochal cystectomy, 565–566 abdominoperineal, 463–465 choledochoduodenostomy, left colectomy, 453 560–564 preoperative preparation, 447 common bile duct, 536–538 right colectomy, steps, exploration, 551–560 447–452 cystic duct, 535 triple-staple procedure, low gallbladder, 535–536 anterior, 453–459 hepatocystic triangle and triangle surgery, decalogue, 438 of calot, 538–541 vascular system operative cholangiogram, marginal and inferior 549–551 mesenteric artery, 428 sphincteroplasty, 560 middle colic artery, 428 vascular system of, 541–542 right colon, arteries variations, 429 venous and lymphatic drainage, superior mesenteric artery, 543–544 427–428 Extraperitoneal laparoscopic inguinal Colostomy herniorrhaphy end colostomy, 442, 464 operating room set-up, 198 loop colostomy, 439–447 Prasad end loop colostomy, 444 , 20 Condon repairs, 175 trunk, 46–47 Conjoined area, 121 Falx inguinalis, 117, 122 Cooper ligament repair Femoral artery relaxing incision, 178–179 superfi cial branches of, 131 688 Index

Femoral canal, 130–131 Lichtenstein repair, 201–202 , 179–181 Nyhus procedure, 186–189 abdominal wall and hernias, preperitoneal approach, 186–187 184–185 superfi cial fascia, 118–119 Nyhus procedure for, 188–189 repair above , Harmonic Scalpel, 468 181–182 Henle ligament, 117, 122 repair below inguinal ligament, Hepatic duct and subvesicular bile 183–185 ducts, 533–535 Femoral sheath, 137 Hernias. See also hernias. Femoropopliteal bypass, 644–651 anterior abdominal wall Fistulas, 47 incisions of, 148–154 congenital cervicoaural, 48 Bard plug and patch repair, 204–207 track of 2nd-pouch and-cleft, 49 Body wall, lower anterior, Flexor retinaculum 117–118 division of, 676 Bogros space of, 123–124 postage stamp size, 668 direct inguinal superfi cial relations of, 669 Condon repair of, 175 Fossae of the abdominal wall repair of, 174 lateral, medial, 118 epigastric hernia, 160, 162 supravesical, 118–119 external supravesical hernia, 179 Frey’s syndrome, 46 femoral hermia. See Femoral Fruchaud’s myopectineal orifi ce Hernia. Gillert sutureless anterior view, 129 mesh-plug repair, 202–203 posterior view of, 139 groin, Cooper ligament repair, and mesh coverage, 195 168–172 Full-thickness skin graft, 11 incisional hernia smaill defects, 156–157 Gel Port, 470–471, 473–474 indirect inguinal Giant prosthetic reinforcement of Condon repair of, 175 visceral sac (GPRVS) Cooper ligament repair, (GPRVS), Stoppa procedure, 193 168–172 Gilbert sutureless, mesh-plug repair, Shouldice technique in, 202–203 176–178 Gimbernat. See inguinal, iliopubic tract repair Great auricular nerve, 46 and, 187 Groin hernias, 168–172. See also Kugel repair, 157–160 Hernias. Shouldice technique, 176–178 anatomy of, 118–131 sliding indirect inguinal repair of, ihopulric tract repair of, 127 172–174 indirect inguinal hernia spigelian, 163–166 Cooper ligament repair of, repair of, 167 168–172 umbilical laparoscopic approach, 194–200 Hesselbach triangle, 126 Index 689

Horner’s syndrome, 41 , 122 Hydrocele Internal thoracic artery, 99 adult noncommunicating repair of, 208–209 Kugel hernia repair, 189–193 (XII), 21 Lacunar ligament, 120 Ileoanal anastomosis/restorative Laparoscopic adrenalectomy, proctocolectomy and 619–630 GIA insertion, 460, 462 Laparoscopic appendectomy, J-pouch construction, 461 appendix, 412–413 pouch apex, anastomosed, 462 Laparoscopic cadaveric typical proctocolectomy, panorama, 135–145 460–461 Laparoscopic cholecystectomy, , 125 566–572 Iliopubic tract, 122–123 Laparoscopic colectomy diagrammatic presentation hand-assisted, 465–466 of, 142 left, 470–473 Incisional hernias, 155–160 right, 473–475 Incisions sigmoid, 467–470 dehiscence of, 154 total abdominal, 475 lower midline incision, 151 Laparoscopic Nissen fundoplication, pararectus incision, 152 238–243 surgical anatomy of, 148–149 Laparoscopic splenectomy, 593–601 upper midline, 149–150 Left colectomy, 463–465 Indirect inguinal hernia left ureter, identifi cation, 454 Condon repair of, 175 ligament division, 453 Nyhus procedure, 188–189 muscles, 425–426 Inguinal canal puborectalis, 427 anterior, inferior and posterior Lichtenstein herniorrhaphy, 201–202 wall, 127 Linea alba, 115, 160–162 in female, 127–128 incisions of, 149–150 in male, 126–127 Liver wall, posterior “strong,” “weak,” excisional biopsy, 517, 518 128 hepatic artery, 505–508 Inguinal hernia. See Groin hernias. hepatic resections, 519–520 Inguinal ligament, 119 hepatic veins, 510–511 Inguinal region intrahepatic duct system, 502–504 deep inguinal vasculature, 138 left hepatic lobectomy, 521–524 laparoscopic topographic anatomy left lateral segmentectomy, 522 of, 136 falciform ligament, 525 Inguinal ring left lobe, diminished size, 504 superior and inferior crura form, lobectomy and segmentectomy, 126 planes of transection, 521 Innominate fascia, 117 lymphatic drainage, 511–512 690 Index

morphology, 501–502 gland, 27 true lobulation and fasciae, superfi cial and deep, segmentation, 501 25–28 needle biopsy, 517 lymphatics of, 28–30 perihepatic spaces, 513–516 lymph nodes and lymphatic peritoneal refl ections and drainage of head and , , 498–500 29–30 portal vein, 508–509 nonthyroid neck masses resection and trauma, 527–531 rule of 80 and 7, 52 right hepatic lobectomy, posterior cervical triangle, 525–529 23–24 topographic anatomy, 497–499 radical , 78 Loop colostomy, 439–447 anatomy, 80–88 Lower extremity bypass anatomy, synopsis of, 79 631–634 spaces in, 28 Lumbar hernia (Dowd-Ponka) repair, sternocleidomastoid muscle, 26 209–211 Nyhus hernia repairs, 188–189 Lumpectomy, 111–112 Lymphadenectomy, 10 Oblique incision, 153

Mastectomy Palmar cutaneous nerve, 675 excisional biopsy, 104–105 Panoramic laparoscopic modifi ed radical, 105–111 anatomy of inguinal area, surgical anatomy of, 102–103 135–145 McBurney incision, 154 Pararectus incision, 152 McBurney’s point, 406 Parathyroid glands Medial umbilical ligament (MUL), arterial supply, 34–35 116 blood supply, 41 Microsurgery, 677–684 reoperation, 71–72 , 23 venous drainage, 35–36 Musculocutaneous nerves, 132 Mylohyoid and muscles anatomy, 43–46 exposure, 21 parotidectomy, 52–56 radical, 57 Nail anatomy, 6 , 423, 425 Neck Pectineal ligament, 120 anterior cervical triangle Peritoneum, 424 carotid triangle, 23 Petit triangle, inferior hernia, 147 muscular triangle, 23 Pfannenstiel transverse abdominal , 17–22 incision, 152–153 , 22 Postage-stamp graft, 11 cross section through neck Posterior body wall lumbar area below , 26 of, 145–146 Index 691

Posterior cervical triangle, 23 Spigelian (lateral ventral) hernia, Pudendal artery, 131–132 163–167 Spleen Ramus colli mandibularis, 19 accessory spleens, 579–582 Rectum and anal canal, 418 anatomy, 573 arteries of, 428, 430 laparoscopic splenectomy, line of peritoneal 593–601 refl ection, 420 major ligaments, 573–574 lymphatic drainage of minor ligaments, 574–578 , 436 segmental anatomy, 579 watershed, 432 splenic artery occlusion, 591–593 Rectus (Paramedian) incision, 151 splenectomy, 583–591 Rectus sheath vascular system of, 578–579 anterior lamina of, 178–179 Split-thickness graft, 11 Recurrent hernia, 189 Sternal splitting, 150 Recurrent laryngeal nerve, 35–39 Stoppa procedure, 193 Refl ected inguinal ligament, 122 Subcostal incision, 153–154 Relaxing incision, 178–179 Sublingual artery, 21 Riedel’s lobe, liver, 504–505 Submandibular triangle Right colectomy, 448–452 contents of, 20 Round ligament (RL), 116 fl oor and basement, 21 lymphatic drainage of, 22 Scalp, 2–3 neural hammocks, 19 nerves, 5–6 roof of, 17–18 surgery, excision of Submaxillary gland resection, 57–60 benign lesion, 11–12 Submental triangle, 22 malignant lesion, 12 Superior laryngeal nerve vascular system and carotid arteries, branching, 39 arterial supply, 3 internal and external branches, lymphatic drainage, 3–4 relations of, 40 venous drainage, 3–4 Superior , 146 Sentinel biopsy, 10 Superior triangle comparision, Sinuses, 48 146–147 Sistrunk procedure, 41 Surgical ellipse Skin posterior wall and, 129–130 benign skin lesions, 7–8 grafts, 10–11 Temporal artery biopsy, 12–13 malignant skin lesions, 8–9 Thoracic duct, 31 melanoma, 9–10 Thoracic extension, 150 and subcutaneous tissue, 1–2 Thoracoabdominal Incisions, 154 Sliding indirect inguinal hernia Thyroglossal duct, 41 repair of, 172–174 cystectomy, 72–76 Sphincteroplasty, 560 cysts, 73 692 Index

Thyroid gland Triple-staple procedure, low anterior anatomy, 32 resection, 453–459 capsule of, 33–34 inferior mesentric artery, ligate, development, 33 venous drainage, 35–41 Umbilical fascia, 115 arterial supply, 34 Umbilical hernias recurrent laryngeal nerve and large, 163 , small, 162–163 crossing, 35 Umbilical ligaments, variations in, reoperation, 70–71 116 thyroidectomy, 60–70 venous drainage of, 35–36 variations anatomy of, Toe nail ingrown 115–116 conservative treatment, 14 Umbilical ring (UR), 115–116 matrix Urachus (U), 116 partial excision and, 14 Uterus, tubes, and ovaries radical excision, 14–16 bilateral salpingo-oophorectomy, total excision (avulsion) of, 14 655–662 vascular and nervous relations and, 653 system, 42 vascular system of, 654 Tracheostomy, 88–91 , 123, 125, 137 Vagus nerves, 290, 292, 293, 330, incisions of, 149–150 332 Transverse incisions, 152 Vertical incisions, 149–150 Transversus abdominis arch, 122 Triangle of doom and triangle of Wharton’s duct, 21 pain, 144 excision of stone from, 60