SOLVED389

PREOPERATIVE DIAGNOSIS: Gastroesophageal reflux disease with unsatisfactory medical management POSTOPERATIVE DIAGNOSIS: Same OPERATION PERFORMED: Nissen Fundoplication DESCRIPTION OF OPERATION: The patient is brought to the operating room and placed under general endotracheal anesthesia. The patient was prepped and draped in standard fashion. We made a periumbilical incision, passed the Veress needle, insufflated with carbon dioxide passed the trocars. I made two counter incisions in the left upper quadrant and one in the right upper quadrant. We grasped the stomach with the grasper, folded it posteriorly and made a circumferential 360-degree wrap around the gastroesophageal junction, tacking it from the left fundus to the esophagus to the right fundus. We used three sutures like this and then we used two EndoStitches to tack the stomach to the left diaphragm and then to the right diaphragm to minimize the chance of gastric torsion or herniation. This fundoplication was performed over the bougie and we were very satisfied with the result. We ensured that hemostasis was adequate and removed the trocars. We used deep fascial sutures and the subcuticular stitch for the skin. The patient was taken to PACU in good condition. 1.1. What is the intent of this procedure? 1.2. Which root
SCIENCE
HEALTH SCIENCE
NURSING

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