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General Surgery
Stomach Surgical Anatomy
Built from Skandalakis' Surgical Anatomy: The Embryologic and Anatomic Basis of Modern Surgery
What’s inside
12 sections · 199 slides
Overview
- Scope of this topic
- Definition of the surgical stomach
- Historical landmarks in gastric surgery
- Anatomic and Surgical History of the Stomach
- Anatomic and Surgical History of the Stomach (continued)
- Anatomic and Surgical History of the Stomach (continued)
- Anatomic and Surgical History of the Stomach (continued)
- Anatomic and Surgical History of the Stomach (continued)
- Anatomic and Surgical History of the Stomach (continued)
Embryogenesis of the stomach
- Formation of the gastric primordium
- Rotation about the longitudinal axis
- Rotation about the anteroposterior axis
- Two hypotheses for gastric rotation
- Growth theory of the curvatures
- Prenatal and adult gastric shape
- Left-hand mnemonic for gastric embryogenesis
- Left hand at the embryonic foregut
- Sequence of gastric wall differentiation
- Development of gastric pits and surface epithelium
Congenital anomalies of the stomach
- How to read the anomaly table
- Anomalies of the Stomach
- Anomalies of the Stomach (continued)
- Anomalies of the Stomach (continued)
- Chief locations of congenital anomalies
- Five types of gastric atresia
- Proposed mechanisms of gastric atresia
- Gastric atresia and stenosis: presentation
- Rammstedt pyloromyotomy
- Infantile hypertrophic pyloric stenosis
- Locations of congenital gastric diverticula
- Duplication of the stomach
- Congenital defects of the gastric musculature
- Inversion of the stomach
- Heterotopic tissue within the stomach
- Distribution of heterotopic pancreatic tissue
- Heterotopic gastric mucosa elsewhere in the body
- Gastric teratoma
Topography, peritoneal reflections and the omenta
- Mobility and position of the stomach
- Fixed points of reference
- Relations of the stomach in the cadaver
- Operative hazards from gastric relations
- Direct extension of gastric cancer
- Reported frequencies of local invasion and metastasis
- Peritoneal covering of the stomach
- Peritoneal reflections and ligaments of the stomach
- Derivatives of the ventral mesentery
- Falciform and coronary ligaments
- Exposing the gastro-oesophageal junction
- Contents of the hepatogastric ligament
- Hepatoduodenal ligament and the hepatic triad
- Arterial variations in the lesser omentum
- Frequency of lesser omentum arterial patterns
- Distribution of aberrant hepatic arteries
- Reported positional distribution in the same series
- Aberrant left hepatic artery from the left gastric artery
- Triple vascularisation of the liver
- Derivatives of the dorsal mesentery
- Inconstant peritoneal folds of the gallbladder
- Gastrocolic ligament
- Gastrosplenic ligament and the bare area
- Gastrophrenic ligament
- Phrenoesophageal ligament
- Ageing of the phrenoesophageal ligament
- Coronal anatomy of the gastro-oesophageal junction
- Formation of the greater omentum
- Greater omentum: structure and function
- Arterial supply of the greater omentum
- Preserving the arc of Barkow
Gastric divisions and the two surgical units
- Arbitrary subdivisions of the stomach
- Absence of external landmarks
- Morphology of the stomach by discipline
- The two surgical gastric units
- Proximal gastric surgical unit
- Level and relations of the abdominal oesophagus
- Histological oesophagogastric junction
- Barrett's oesophagus
- Closure of the cardia
- Lower oesophageal sphincter and reflux
- Distal gastric surgical unit
- The gastric antrum
- Boundary of the antrum on the curvatures
- Pyloric sphincter, normal and hypertrophied
- Muscular architecture of the pylorus
- First part of the duodenum
Gastric wall, mucosa and secretory cells
- Layers of the gastric wall
- Muscular layer of the stomach
- Submucosa: the vascular layer
- Mucosal lining region by region
- Parietal and chief cells
- Enteroendocrine cells and their products
- The Exocrine and Endocrine Cells of the Stomach and Their Secretory Products
- Gastric mucosal barrier
- Brunner's glands of the proximal duodenum
Acid, peptic ulcer disease and Helicobacter pylori
- Distribution of parietal cell mass
- Gastrin and mucus territories
- The acid antrum
- Nerve of Latarjet and parietal cell mass
- Proximal gastric vagotomy for duodenal ulcer
- Algorithm for the perforated duodenal ulcer
- Choice of Operative Procedure Based on Indication
- Ulcers form on the alkaline side of the junction
- Postbulbar ulcer: a problem of definition
- Resistance of the four mucosae
- The Oi concept
- Gastric ulcer and cancer risk
- Acquisition of Helicobacter pylori infection
- Two outcomes of Helicobacter gastritis
- Natural history of Helicobacter gastritis
- Eradication and its evidence
- Pernicious anaemia and gastric neoplasia
Arterial supply of the stomach
- Origin of the principal gastric arteries
- Principles of gastric arterial supply
- Arterial supply of the stomach
- Left gastric artery: origin and variations
- Left gastric artery: course and branches
- Arteries of the distal oesophagus and proximal stomach
- Right gastric artery
- Gastroduodenal artery
- Right gastroepiploic artery
- Left gastroepiploic and short gastric arteries
- Blood supply of the fundus
- Posterior gastric artery
- Why the reported incidence varies so widely
- the Posterior Gastric Artery: Frequency of Incidence by Radiography or Dissection
- the Posterior Gastric Artery: Frequency of Incidence by Radiography or Dissection (continued)
- the Posterior Gastric Artery: Frequency of Incidence by Radiography or Dissection (continued)
- Reported Incidence of Posterior Gastric Artery
- Reported Incidence of Posterior Gastric Artery (continued)
- Reported Incidence of Posterior Gastric Artery (continued)
- Reported Incidence of Posterior Gastric Artery (continued)
- Median arcuate ligament
- Coeliac artery compression syndrome
- Treating coeliac compression
- Arterial circulation of the gastric walls
- Inferior phrenic arteries and the first duodenum
- Ischaemic gastropathy
Venous drainage of the stomach
- General arrangement of the gastric veins
- Splenic vein occlusion and gastric varices
- Selective distal splenorenal shunt
- Left gastric or coronary vein
- What a Kocher clamp on the lesser omentum includes
- Right gastric vein and the prepyloric vein of Mayo
- Right gastroepiploic vein and Henle's trunk
- Vascular structures at the oesophageal hiatus
Lymphatic drainage and the surgery of gastric cancer
- Coller's four drainage zones
- All drainage converges on the coeliac nodes
- Lymphatic Drainage of the Stomach
- Lymphatic drainage of oesophagus, stomach and duodenum
- Eight groups of gastric lymph nodes
- Evidence on lymphadenectomy
- Node classification and prognosis
- Concept of Visalli and Grimes
- Plans for en bloc resection
- Practical problems of lymphatic drainage
- Distant metastasis and the extent of resection
- Ideal specimen from total gastrectomy
- Surgical drainage of the two units
Gastric innervation
- Vagal trunks and their four divisions
- Terminology of the vagal structures
- Vagal structures at the hiatus
- Relation of the vagal trunks to aorta and oesophagus
- Four or more vagal structures at the hiatus
- Anterior gastric division and the nerve of Latarjet
- Variants of the anterior gastric division
- The crow's foot
- Visible Distal Extent of the Anterior and Posterior Gastric Divisions of the Vagus
- Posterior gastric division and the criminal nerve
- Gastric branches in superior and inferior groups
- Hepatic and coeliac divisions
- Variations in Number and Position of Elements of the Hepatic Division of the Vagus
- Variations in Number and Position of Elements of the Hepatic Division of the Vagus (continued)
- Types of vagotomy
- Truncal vagotomy
- Selective vagotomy
- Parietal cell vagotomy
- Techniques of vagal section from 1814 to 1979
- The seven areas of vagotomy
- Technique of proximal gastric vagotomy
- Sympathetic innervation of the stomach
- Visceral pain pathway and the enteric plexuses
Summary and sources
- Key points: development and attachments
- Key points: vessels, nodes and nerves
- Practical rules from this topic
- References
- References (continued)
- References (continued)
- Skandalakis' Surgical Anatomy: The Embryologic and Anatomic Basis of Modern Surgery
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