LAR stands for?
lateral Anterior Resection
long Anterior Resection
low Anterior Resection
The removal of the lower sigmoid and rectosigmoid portions of the rectum is kmow as?
medial Anterior Resection
anterior Resection
LAR
GI resection
What best describes the purpose of a LAR procedure?
treat lesions in the bladder
treat hernias in the colon
treat lesions in the small intestine and rectum
treat lesions in the sigmoid and rectum
In a LAR procedure it is vital to maintain a portion of the colon to keep the function of?
maintain water absorption
maintain hemostasis
maintain circulatory system
maintain fecal function
LAR procedures are done in what patient position on the O.R. bed?
supine
lateral
prone
lithomtomy
J-Pouch is known as?
Low Anterior Resection
colon resection
Ileoanal endorectal pull through
lateral endorectal pull through
Ileoanal Endorectal Pull-Through is the removal of?
colon and proximal 2/3 of rectum
small intestine and part of rectum
small intestine and 2/3 of rectum
colon and 1/3 of rectum
What procedure peels away the inner lining of the rectum?
gastroectomy
mucosalectomy
colongealectomy
mucosectomy
What procedure relieves symptoms of ulcerative colitis and polyosis?
low anterior resection
ileonal endorectal pull-through
cholangiocarcinoma
What procedure is known as a anal sphincter saving operation?
gastrointestinal resection
abdominal perineal resection
ileoanal endorectal pull-through
What procedure leaves the patient with a permanent colostomy?
Lower anterior resection
colonectomy
What procedure leaves the anal opening closed for life?
appendectomy
Which of the following procedures can be done to help an adult patient with stomach ulcers and a newborn with a distal stomach sphincter stenosis?
Pyloroplasty
Billroth I
J-pouch
In a LAR what is the diagnostic instrument used to inflate the colon?
Asepto
Sigmoidoscope
Stentascope
Stethoscope
What medication is injected at the "Dentate" intraoperatively to help separate the layers on a J-Pouch procedure?
thrombin
dexamethazone
kantrex
saline with epinephrine
What is removed on the J-Pouch procedure?
distal stomach and 1/2 of duodenum
distal colon, rectum and anus
entire colon and proximal 2/3 of the rectum
proximal colon and cecum
Gastrostomy is the
removal of a bezoar (intestinal stones)
repair of a stomach ulcer
resection of a portion of the stomach
creation of an opening from the stomach to the skin
Which instrument set/s would be needed for either Billroth procedure?
large self-retaining retractor set
Major Lap
GI clamps set
all of the above
Which stapler is used (if possible) at the end of the J-Pouch procedure to complete the anastomosis with the rectum?
LDS
TA
GIA
EEA
During the LAR procedure, how does the surgeon avoid damaging the ureters during the dissection process of the procedure?
the assistant will place their hands over the ureters for protection
dye is injected to help make the ureters show up.
Stents are placed to help identify the ureters
X-rays are taken during the procedure
What is the position that the patient will be in for the LAR procedure?
Low Lithotomy
Left Lateral
Supine
Prone
What is the determining factor when a surgeon decides between an Abdominal Perineal or a Low Anterior Resection?
availability of the instruments
level of the patient's lesion
skill level of the surgeon
insurance carrier
A mucosectomy is best described as:
peeling away the mucosal lining, leaving the underlying muscle layer
wrapping the proximal stomach around the esophagus
the permanent closing of the rectum
partial closing of the rectum
What is the size of the stomach pouch after the bariatric surgery?
1 liter
100 ml
15-20 ml
50-75 cc
The term "Dumping Syndrome" relates to which procedure.
Abdominal Perineal Resection
Roux-en-y
Which of the Billroth procedures uses TA-30 staplers times 3 for the anastomosis?
I
both
II
neither
What patient position is used to displace the abdominal contents to enhance the surgeon's view of the lower abdominal/pelvic region?
Fowler's
Trendelenburg
reverse Trendelenburg
The identification and resection of two nerves that will interrupt the parasympathetic nerves and reduce gastric acid secretions is called what?
Vagotomy
Billroth II
Why is the psychological aspect of the Bariatric patient important to consider before the procedure can be performed?
Obesity can be related to psychological problems
Changes in diet are drastic
Reasons for their desired weight loss
All of the above are possible
What is the condition the Billroth patient most likely has?
stomach ulcers or cancer
rectal polyps
colon cancer
esophageal atresia
At the completion of the LAR, air is instilled into the colon and the abdominal cavity is filled with irrigation solution. This is done for what purpose?
To look for bleeding within the bowel
To seal the anastomosis
To reduce the chance for gas production after surgery
To check for leaks in the anastomosis
What stapler is the most important in the creation of the actual J-Pouch (not the anastomosis)?
The three portions of the small intestine are the
cecum, mesentery, and ileum
mesentery, duodenum, and appendix
ilium, sigmoid, and jejunum
duodenum, ileum, and jejunum
What is the purpose of the J-Pouch?
provide a place for the colostomy to expel waste
provide a holding chamber for fecal matter to solidify
to give the patient time for water absorption
both b & c
Which surgical procedure relieves symptoms of ulcerative colitis and familial polyposis
Ileoanal Endorectal Pull Through
What does Bariatric Surgery (Roux-en-y) treat?
Polyps
Ulcers
Obesity
Colitis
Another name for the Billroth I & II is?
J-Pouch
Gastrectomy
What suture is used to close the anus at the start (not the end) on the Abdominal Perineal Resection?
3-0 plain ties
4-0 chromic on a general closure
2-0 silk on a curved cutting
0 nylon on a keith
What is the purpose of the Surgeon doing a preoperative sigmoidoscopy on the LAR patient?
confirm the level of the lesion
to make a mess
for insurance coverage
to check the effectiveness of the enema
What are the qualification guidelines for the Bariatric Surgical Patient?
esophageal reflux
BMI of 40 or above
pelvic pain
blood in the stool
Which stapler combination is used for the bariatric procedure
TA-30 & GIA
LDS & EEA
GIA & LDS
TA-90 & EEA
The Abdominal Perineal Resection can best be defined as:
the excision of the distal colon, sigmoid, rectum and anus
a permanent colostomy is made with the proximal colon
the closing of the rectum for life
In addition to the surgery, what is commonly removed on the Bariatric Surgery patient during their procedure?
rectum
meckel's
appendix
gallbladder
Which of the following procedures would involve a surgeon working at the rectum?
All of the procedures, in different degrees.
The flow of food and liquids from the stomach to the small intestine is controlled by the
anal sphincter
sphincter of Oddi
ileocecal valve
pyloric sphincter
What is the official name for the J-Pouch procedure?
Pyloroplasty will result in?
a flat stomach
late & early dumping
rapid emptying of the stomach
reduction of gastric juice formation
Which stapler is used on the LAR procedure to perform the anastomosis of the colon and rectum?