剖腹探查.ppt

剖腹探查术剖腹探查术 Exploratory Exploratory Laparotomy Laparotomy 主讲刘栋才副教授主讲刘栋才副教授 STRESSES AND DIFFICULTIES ● Abdominal mon Used ● Principles of Abdominal Exploration ● Conception: Limited-exploration General Considerations Indications: ◆ Every abdominal operation is an exploration. ◆ When disease is suspected but not demonstrated. ◆ Finding a Cause for acute or chronic abdominal or general symptoms such as pain, jaundice, or pyrexia. Contra-indications: ◆ Small incisions. ◆ An abscess is encountered. ◆ Generalized malignant disease is discovered. ◆ Dense generalised adhesions are discovered. Normal structure Abnormal mon incisions: ● Vertical incisions: ● Transverse incisions ● Oblique Incisions ● Thoraco -Abdominal Incisions ● Complicated Incisions ◆ In adults : vertical incisions. Choice of Incisions :◆ In infants(under the age of 18- 24months) : Transverse incisions. ◆ Other incisions : Anaesthesia and Piosition of Patient ● Local or General anaesthesia . Epidural Anaesthesia .● Lie Supine .