Belsey Mark fundoplication - Revision history

Tony.Wang at 20:59, 15 September 2022

2022-09-15T20:59:08Z

← Older revision		Revision as of 13:59, 15 September 2022
Line 2:		Line 2:
	\| anesthesia_type = GA		\| anesthesia_type = GA
	\| airway = DLT		\| airway = DLT
	\| lines_access = ~~Large~~ bore PIV~~, arterial line~~		\| lines_access = 1-2 large bore PIV
	\| monitors = Standard ASA~~, arterial monitor~~		\| monitors = Standard ASA
			EKG
	\| considerations_preoperative = Consider RSI for reflux		\| considerations_preoperative = Consider RSI for reflux
	\| considerations_intraoperative = ~~DLT~~ for L thoracotomy		\| considerations_intraoperative = One lung ventilation for L thoracotomy
	\| considerations_postoperative = Consider thoracic epidural		\| considerations_postoperative = Consider thoracic epidural
	}}		}}
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	=== Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. --> ===		=== Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. --> ===

			* One lung ventilation (e.g. DLT or bronchial blocker)
			* Fiberoptic scope

	=== Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. --> ===		=== Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. --> ===

	=== Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> ===		=== Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> ===
			Consider thoracic epidural or serratus block for postop pain management

	== Intraoperative management ==		== Intraoperative management ==
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	=== Disposition<!-- List and/or describe the postoperative disposition and any special considerations for transport of patients for this case. --> ===		=== Disposition<!-- List and/or describe the postoperative disposition and any special considerations for transport of patients for this case. --> ===
			Typically floor/IMC is adequate

	=== Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. --> ===		=== Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. --> ===
			Thoracic epidural PCEA or serratus block

	=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> ===		=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> ===
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	\|+		\|+
	!		!
	!~~Variant 1~~		!Belsey Mark
	~~!Variant 2~~
	\|-		\|-
	\|Unique considerations		\|Unique considerations
	\|
	\|		\|
	\|-		\|-
	\|Indications		\|Indications
	\|
	\|		\|
	\|-		\|-
	\|Position		\|Position
	\|
	\|		\|
	\|-		\|-
	\|Surgical time		\|Surgical time
	\|
	\|		\|
	\|-		\|-
	\|EBL		\|EBL
	\|		\|200-300 mL
	\|
	\|-		\|-
	\|Postoperative disposition		\|Postoperative disposition
	\|
	\|		\|
	\|-		\|-
	\|Pain management		\|Pain management
	\|
	\|		\|
	\|-		\|-
	\|Potential complications		\|Potential complications
	\|
	\|		\|
	\|}		\|}

Tony.Wang: indications

2022-09-15T20:55:59Z

indications

← Older revision		Revision as of 13:55, 15 September 2022
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	=== Indications<!-- List and/or describe the indications for this surgical procedure. --> ===		=== Indications<!-- List and/or describe the indications for this surgical procedure. --> ===
	~~GERD~~		Paraesophageal hernias that are not good candidates for a Nissen fundoplication such as:

			* hostile abdomen from many prior abdominal procedures
			* concern for pericardial adhesions in a longstanding paraesophageal hernia

	=== Surgical procedure<!-- Briefly describe the major steps of this surgical procedure. --> ===		=== Surgical procedure<!-- Briefly describe the major steps of this surgical procedure. --> ===

Tony.Wang at 19:48, 14 September 2022

2022-09-14T19:48:24Z

← Older revision		Revision as of 12:48, 14 September 2022
Line 68:		Line 68:

	=== Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> ===		=== Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> ===
			One lung ventilation is needed for surgical exposure of esophagus, using either double lumen tube (DLT) or bronchial blocker.

	=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===		=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===
			R lateral decubitus

	=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===		=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===

Tony.Wang: Created page

2022-09-14T19:45:55Z

Created page

New page

{{Infobox surgical procedure
| anesthesia_type = GA
| airway = DLT
| lines_access = Large bore PIV, arterial line
| monitors = Standard ASA, arterial monitor
| considerations_preoperative = Consider RSI for reflux
| considerations_intraoperative = DLT for L thoracotomy
| considerations_postoperative = Consider thoracic epidural
}}

The Belsey Mark IV fundoplication was a technique developed by Dr. Ronald Belsey whereby the distal esophagus is moved below the diaphragm, and an incomplete (240 degree) fundal wrap is performed. This restores the gastoesophageal junction (GEJ).

== Overview ==

=== Indications ===
GERD

=== Surgical procedure ===
The incision is typically left thoracotomy along 6th rib

== Preoperative management ==

=== Patient evaluation ===
{| class="wikitable"
|+
!System
!Considerations
|-
|Airway
|
|-
|Neurologic
|
|-
|Cardiovascular
|
|-
|Pulmonary
|
|-
|Gastrointestinal
|
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|
|-
|Other
|
|}

=== Labs and studies ===

=== Operating room setup ===

=== Patient preparation and premedication ===

=== Regional and neuraxial techniques ===

== Intraoperative management ==

=== Monitoring and access ===

=== Induction and airway management ===

=== Positioning ===

=== Maintenance and surgical considerations ===

=== Emergence ===

== Postoperative management ==

=== Disposition ===

=== Pain management ===

=== Potential complications ===

== Procedure variants ==

{| class="wikitable wikitable-horizontal-scroll"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
|
|
|-
|Indications
|
|
|-
|Position
|
|
|-
|Surgical time
|
|
|-
|EBL
|
|
|-
|Postoperative disposition
|
|
|-
|Pain management
|
|
|-
|Potential complications
|
|
|}

== References ==

[[Category:Surgical procedures]]