Endotracheal anesthesia procedure laparoscopic gastrojejunostomy

The article was professionally consulted by Specialist Doctor I Nguyen Xuan Tinh - Anesthesiologist - Resuscitation - Department of General Surgery - Vinmec Phu Quoc International General Hospital.

Anesthesia is intended for the patient to be able to lie still, without pain, to ensure the safety of the patient during the surgical procedure.
It can be said that surgery and anesthesia are a pair of parallel cards, but anesthesia is always accompanied by emergency resuscitation, this is the continuous chain of a common surgery.

Gastrojejunostomy is a type of surgery to build an anastomosis between the jejunal loop and the stomach when the way down to the duodenum in the body is blocked, or is obstructed (due to narrow ulcers, tumors, resections). entire X nerve...) or by actively not allowing food to pass through the duodenum (large duodenal diverticulum, duodenal rupture,...).

2.1 Indicated for cases where the descending duodenum of the patient is diagnosed with obstruction because of tumors in the antrum, or duodenum, ampulla of Vater, pancreas. The descending duodenum is having poor circulation because of total X-nerve resection, due to pyloroplasty. Actively prevent food from passing through the duodenal area, often accompanied by pyloric closure such as: the duodenal diverticulum is too large to be resected. 2.2 Contraindication in cases 2.2.1 General contraindications The patient's whole body condition is too severe, diagnosed with many co-morbidities, or severe malnutrition... it is necessary to adjust the water and electrolytes , nutrition and blood, ... to be able to operate.
The tumor has invaded the entire stomach, metastasized to many places, and the survival time is too short.
2.2.2 Contraindications for laparoscopic surgery For patients with multiple cardiovascular and respiratory diseases, and unable to perform intra-abdominal inflation, it may be due to a history of multiple abdominal surgeries.

2.3 Preparation The technician performing the procedure includes: Gastroenterology surgeon, experienced in performing laparoscopic surgery, anesthesiologist and nursing assistant.
Means of implementation: A synchronized laparoscopic surgery kit, if the surgery is performed by Stapler, it is necessary to prepare a 60mm endoscope.
Patient:
Perform basic tests: Blood biochemistry test, complete blood count, coagulation, at the same time conduct cardiopulmonary, electrocardiogram ... Gastroscopy of the patient: Purpose to give the most accurate diagnosis of the cause of the obstruction. Gastroscopy with contrast: To accurately assess the shape of the stomach and diagnose pyloric stenosis. At medical facilities that have all the necessary equipment, an abdominal CT-Scan should be performed to easily assess the injury. Gastric lavage before surgery. Patient's medical record: Completing administrative procedures as prescribed by the Ministry of Health: minutes of consultation, detailed medical records, minutes of examination before anesthesia, together with a certificate Make sure the patient and family agree to the surgery.

\2.4 Steps to carry out endotracheal anesthesia
Patient's position: Lie on your back, give 100% oxygen at a dose of 3-6 l/min, paying attention to at least 5 minutes before induction of anesthesia. Install the tracker. Establish an effective transmission line. Perform pre-anesthesia (if necessary). Anesthesia 2.5 Endotracheal intubation There are two techniques used for endotracheal intubation: oral and nasal.
The procedure of endotracheal anesthesia for gastrojejunostomy requires technicians with good experience and professional skills. Therefore, it is advisable to choose reputable medical facilities with modern equipment to examine and perform this surgery.
Doctor Nguyen Xuan Tinh has more than 18 years of experience studying and working in the field of Anesthesia - Resuscitation. Before being an anesthesiologist at the Department of General Surgery - Vinmec Phu Quoc International General Hospital, Dr. Tinh worked for a long time at Cam Xuyen Tinh District General Hospital, Ha Tinh
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