Laparotomy, exploratory. Partial gastric resection


Local Chapter Officer
Richlands, Virginia
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Procedure Details: After sterilely prepping and draping, a timeout was performed. A midline laparotomy was performed and the midline incised as was the peritoneum There was a large rush of air. An exploration was performed with the above findings. I could easily see the perforation mid way up the greater curve. The lesser sac was entered and the short gastrics taken down off the greater curve fully exposing this area. There was approximately 2 cm of induration at the ulcer. It seemed that a longitudinal resection laid more comfortably and there was plenty of room not to narrow the stomach so the ulcer was excised with 2 firings of the TA green stapler excising the portion of the stomach containing the ulcer. The staple line was oversewn with interrupted 3-0 silk lembert sutures. There was some clot and blood in the lesser sac up and around the spleen. This was all aspirated out. The area was packed for several minutes while I irrigated and aspirated and explored the rest of the abdomen. In removing the packs there was no further bleeding. The spleen was clearly intact and there was no bleeding. The LUQ was irrigated out as well. Still no bleeding and no pus. The omentum was laid over the closure and secured with a 3-0 Silk. The fascia was then closed with running #1 Maxon after changing gown, gloves, and drapes. The subQ was irrig with saline and the skin closed with staples.
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