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Appendicectomy
An appendectomy, also termed appendicectomy, is a surgical operation in which the vermiform appendix (a portion of the intestine) is removed. Appendectomy is normally performed as an urgent or emergency procedure to treat complicated acute appendicitis. Appendectomy may be performed laparoscopically (as minimally invasive surgery) or as an open operation. Over the 2010s, surgical practice has increasingly moved towards routinely offering laparoscopic appendicectomy; for example in the United Kingdom over 95% of adult appendicectomies are planned as laparoscopic procedures. Laparoscopy is often used if the diagnosis is in doubt, or in order to leave a less visible surgical scar. Recovery may be slightly faster after laparoscopic surgery, although the laparoscopic procedure itself is more expensive and resource-intensive than open surgery and generally takes longer. Advanced pelvic sepsis occasionally requires a lower midline laparotomy. Complicated (perforated) appendicitis shoul ...
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Appendicitis
Appendicitis is inflammation of the appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, and decreased appetite. However, approximately 40% of people do not have these typical symptoms. Severe complications of a ruptured appendix include widespread, painful inflammation of the inner lining of the abdominal wall and sepsis. Appendicitis is caused by a blockage of the hollow portion of the appendix. This is most commonly due to a calcified "stone" made of feces. Inflamed lymphoid tissue from a viral infection, parasites, gallstone, or tumors may also cause the blockage. This blockage leads to increased pressures in the appendix, decreased blood flow to the tissues of the appendix, and bacterial growth inside the appendix causing inflammation. The combination of inflammation, reduced blood flow to the appendix and distention of the appendix causes tissue injury and tissue death. If this process is left untreated, the appendix may burst, releasing ba ...
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Appendicitis
Appendicitis is inflammation of the appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, and decreased appetite. However, approximately 40% of people do not have these typical symptoms. Severe complications of a ruptured appendix include widespread, painful inflammation of the inner lining of the abdominal wall and sepsis. Appendicitis is caused by a blockage of the hollow portion of the appendix. This is most commonly due to a calcified "stone" made of feces. Inflamed lymphoid tissue from a viral infection, parasites, gallstone, or tumors may also cause the blockage. This blockage leads to increased pressures in the appendix, decreased blood flow to the tissues of the appendix, and bacterial growth inside the appendix causing inflammation. The combination of inflammation, reduced blood flow to the appendix and distention of the appendix causes tissue injury and tissue death. If this process is left untreated, the appendix may burst, releasing ba ...
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General Surgery
General surgery is a surgical specialty that focuses on alimentary canal and abdominal contents including the esophagus, stomach, small intestine, large intestine, liver, pancreas, gallbladder, appendix and bile ducts, and often the thyroid gland. They also deal with diseases involving the skin, breast, soft tissue, trauma, peripheral artery disease and hernias and perform endoscopic procedures such as gastroscopy and colonoscopy. Scope General surgeons may sub-specialize into one or more of the following disciplines: Trauma surgery In many parts of the world including North America, Australia and the United Kingdom, the overall responsibility for trauma care falls under the auspices of general surgery. Some general surgeons obtain advanced training in this field (most commonly surgical critical care) and specialty certification surgical critical care. General surgeons must be able to deal initially with almost any surgical emergency. Often, they are the first port of c ...
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Caecum
The cecum or caecum is a pouch within the peritoneum that is considered to be the beginning of the large intestine. It is typically located on the right side of the body (the same side of the body as the appendix, to which it is joined). The word cecum (, plural ceca ) stems from the Latin '' caecus'' meaning blind. It receives chyme from the ileum, and connects to the ascending colon of the large intestine. It is separated from the ileum by the ileocecal valve (ICV) or Bauhin's valve. It is also separated from the colon by the cecocolic junction. While the cecum is usually intraperitoneal, the ascending colon is retroperitoneal. In herbivores, the cecum stores food material where bacteria are able to break down the cellulose. In humans, the cecum is involved in absorption of salts and electrolytes and lubricates the solid waste that passes into the large intestine. Structure Development The cecum and appendix are formed by the enlargement of the postarterial segment of ...
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Ligature (medicine)
In surgery or medical procedure, a ligature consists of a piece of thread ( suture) tied around an anatomical structure, usually a blood vessel or another hollow structure (e.g. urethra) to shut it off. History The principle of ligation is attributed to Hippocrates and Galen. In ancient Rome, ligatures were used to treat hemorrhoids. The concept of a ligature was reintroduced some 1,500 years later by Ambroise Paré, and finally it found its modern use in 1870–80, made popular by Jules-Émile Péan. Procedure With a blood vessel the surgeon will clamp the vessel perpendicular to the axis of the artery or vein with a hemostat, then secure it by ligating it; i.e. using a piece of suture around it before dividing the structure and releasing the hemostat. It is different from a tourniquet in that the tourniquet will not be secured by knots and it can therefore be released/tightened at will. Ligature is one of the remedies to treat skin tag, or acrochorda. It is done by tying str ...
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Peritoneum
The peritoneum is the serous membrane forming the lining of the abdominal cavity or coelom in amniotes and some invertebrates, such as annelids. It covers most of the intra-abdominal (or coelomic) organs, and is composed of a layer of mesothelium supported by a thin layer of connective tissue. This peritoneal lining of the cavity supports many of the abdominal organs and serves as a conduit for their blood vessels, lymphatic vessels, and nerves. The abdominal cavity (the space bounded by the vertebrae, abdominal muscles, diaphragm, and pelvic floor) is different from the intraperitoneal space (located within the abdominal cavity but wrapped in peritoneum). The structures within the intraperitoneal space are called "intraperitoneal" (e.g., the stomach and intestines), the structures in the abdominal cavity that are located behind the intraperitoneal space are called "retroperitoneal" (e.g., the kidneys), and those structures below the intraperitoneal space are called "subp ...
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Incisional Hernia
An incisional hernia is a type of hernia caused by an incompletely-healed surgical wound. Since median incisions in the abdomen are frequent for abdominal exploratory surgery, ventral incisional hernias are often also classified as ventral hernias due to their location. Not all ventral hernias are from incisions, as some may be caused by other trauma or congenital problems. Signs and symptoms Clinically, incisional hernias present as a bulge or protrusion at or near the area of a surgical incision. Virtually any prior abdominal operation can develop an incisional hernia at the scar area (provided adequate healing does not occur due to infection), including large abdominal procedures such as intestinal or vascular surgery, and small incisions, such as ( appendix removal or abdominal exploratory surgery). While incisional hernias can occur at any incision, they tend to occur more commonly along a straight line from the xiphoid process of the sternum straight down to the pubis, ...
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Internal Oblique
The abdominal internal oblique muscle, also internal oblique muscle or interior oblique, is an abdominal muscle in the abdominal wall that lies below the external oblique muscle and just above the transverse abdominal muscle. Structure Its fibers run perpendicular to the external oblique muscle, beginning in the thoracolumbar fascia of the lower back, the anterior 2/3 of the iliac crest (upper part of hip bone) and the lateral half of the inguinal ligament. The muscle fibers run from these points superomedially (up and towards midline) to the muscle's insertions on the inferior borders of the 10th through 12th ribs and the linea alba. In males, the cremaster muscle is also attached to the internal oblique. Nerve supply The internal oblique is supplied by the lower intercostal nerves, as well as the iliohypogastric nerve and the ilioinguinal nerve. Function The internal oblique performs two major functions. Firstly as an accessory muscle of respiration, it acts as an antagoni ...
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Aponeurosis
An aponeurosis (; plural: ''aponeuroses'') is a type or a variant of the deep fascia, in the form of a sheet of pearly-white fibrous tissue that attaches sheet-like muscles needing a wide area of attachment. Their primary function is to join muscles and the body parts they act upon, whether bone or other muscles. They have a shiny, whitish-silvery color, are histologically similar to tendons, and are very sparingly supplied with blood vessels and nerves. When dissected, aponeuroses are papery and peel off by sections. The primary regions with thick aponeuroses are in the ventral abdominal region, the dorsal lumbar region, the ventriculus in birds, and the palmar (palms) and plantar (soles) regions. Anatomy Anterior abdominal aponeuroses The anterior abdominal aponeuroses are located just superficial to the rectus abdominis muscle. It has for its borders the external oblique, pectoralis muscles, and the latissimus dorsi. Posterior lumbar aponeuroses The posterior lumbar apo ...
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External Oblique
The abdominal external oblique muscle (also external oblique muscle, or exterior oblique) is the largest and outermost of the three flat abdominal muscles of the lateral anterior abdomen. Structure The external oblique is situated on the lateral and anterior parts of the abdomen. It is broad, thin, and irregularly quadrilateral, its muscular portion occupying the side, its aponeurosis the anterior wall of the abdomen. In most humans (especially females), the oblique is not visible, due to subcutaneous fat deposits and the small size of the muscle. It arises from eight fleshy digitations, each from the external surfaces and inferior borders of the fifth to twelfth ribs (lower eight ribs). These digitations are arranged in an oblique line which runs inferiorly and anteriorly, with the upper digitations being attached close to the cartilages of the corresponding ribs, the lowest to the apex of the cartilage of the last rib, the intermediate ones to the ribs at some distance from th ...
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Abdominal Wall
In anatomy, the abdominal wall represents the boundaries of the abdominal cavity. The abdominal wall is split into the anterolateral and posterior walls. There is a common set of layers covering and forming all the walls: the deepest being the visceral peritoneum, which covers many of the abdominal organs (most of the large and small intestines, for example), and the parietal peritoneum- which covers the visceral peritoneum below it, the extraperitoneal fat, the transversalis fascia, the internal and external oblique and transversus abdominis aponeurosis, and a layer of fascia, which has different names according to what it covers (e.g., transversalis, psoas fascia). In medical vernacular, the term 'abdominal wall' most commonly refers to the layers composing the anterior abdominal wall which, in addition to the layers mentioned above, includes the three layers of muscle: the transversus abdominis (transverse abdominal muscle), the internal (obliquus internus) and the external o ...
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Navel
The navel (clinically known as the umbilicus, commonly known as the belly button or tummy button) is a protruding, flat, or hollowed area on the abdomen at the attachment site of the umbilical cord. All placental mammals have a navel, although it is generally more conspicuous in humans. Structure The umbilicus is used to visually separate the abdomen into quadrants. The umbilicus is a prominent scar on the abdomen, with its position being relatively consistent among humans. The skin around the waist at the level of the umbilicus is supplied by the tenth thoracic spinal nerve (T10 dermatome). The umbilicus itself typically lies at a vertical level corresponding to the junction between the L3 and L4 vertebrae, with a normal variation among people between the L3 and L5 vertebrae. Parts of the adult navel include the "umbilical cord remnant" or "umbilical tip", which is the often protruding scar left by the detachment of the umbilical cord. This is located in the center of the ...
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