D-2
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Transcript of D-2
![Page 1: D-2](https://reader033.fdocuments.us/reader033/viewer/2022061114/5461e276af7959cf1d8b49e3/html5/thumbnails/1.jpg)
Kocherization 1
Assistant’s hands holding Assistant’s hands holding the duodenumthe duodenum
Inf. vena cavaInf. vena cava Transv. colonTransv. colon
22ndnd part of the part of the duodenumduodenum
HeadHead
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Kocherization 2
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Kocherization 3
Inf. vena cavaInf. vena cavaTransv. colonTransv. colon
AortaAorta
Lt. renal V.Lt. renal V.
Rt. kidneyRt. kidney
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Bursectomy
OmentumOmentum
DuodenumDuodenum
Ant. sheet of transv. mesocolonAnt. sheet of transv. mesocolon
Post. sheet of transv. mesocolonPost. sheet of transv. mesocolon
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Completion of Bursectomy
Pancreatic tailPancreatic tail
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Exposure of the Gastro-colic Trunk
Middle colic V.Middle colic V.
Acc. rt. colic V.Acc. rt. colic V.
Rt. gastro-epiploic V.Rt. gastro-epiploic V.
Ant. sup. panc. duod. V.Ant. sup. panc. duod. V.
Sup. mesenteric V.Sup. mesenteric V.
Gastro-colic trunkGastro-colic trunk
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Division of the Right Gastro-epiploic Vein
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Exposure of the Supra-pyloric Area
Rt. gastric A.Rt. gastric A.
Sup. duodenal A.Sup. duodenal A.
PylorusPylorus
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Exposure of the Right Gastric Argery
Gastroduodenal A.Gastroduodenal A.
Rt. gastric A.Rt. gastric A.
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Transection of the Duodenum
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Dissection of the Upper Border of the Pancreas
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Identification of the Splenic Artery
Splenic A.Splenic A.
Gastroduodenal A.Gastroduodenal A.
No. 8a LNNo. 8a LN
Common hepatic A.Common hepatic A.
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Dissection of the No. 12a Nodes
No. 12a LNNo. 12a LN
Common hepatic A.Common hepatic A.Proper hepatic A.Proper hepatic A.
Portal V.Portal V.
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Taping of the Common Hepatic Artery
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Lymphadenectomy along the Splenic Artery
Great pancreatic A.Great pancreatic A.
Splenic V.Splenic V.
Post. gastric A.Post. gastric A.
Splenic A.Splenic A.
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Ligation of the Splenic Artery
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Division of the Left Gastric Artery
Lt. gastric A. stumpLt. gastric A. stump
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Exposure of the Esophageal Hiatus
Diaphragmatic crusDiaphragmatic crus
Post. wall of the cardiaPost. wall of the cardiaPost. vagal trunkPost. vagal trunk
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Exposure of the Abdominal Esophagus
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Transection of the Esophagus
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Mobilization of the Pancreas 1
Pancreatic bodyPancreatic bodySpleenSpleen
Lt. adrenalLt. adrenal
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Mobilization of the Pancreas 2
Pancreatic tailPancreatic tailSpleenSpleen
Lt. kidneyLt. kidney
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Mobilization of the Spleen
SpleenSpleen
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Completion of Mobilization
SpleenSpleenStomachStomach
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Exposure of the Splenic Vein
Splenic V.Splenic V.
Splenic A.Splenic A.
Celiac A.Celiac A.
Lt. gastric A. stumpLt. gastric A. stump
Pancreatic tailPancreatic tail
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Distal Pancreatectomy
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Completion of No. 14v Dissection
Sup. mesenteric Sup. mesenteric V.V.
Acc. rt. colic V.Acc. rt. colic V.
Ant. sup. panc. duod. V.Ant. sup. panc. duod. V.
Middle colic V.Middle colic V.
Rt. gastro-epiploic V. stumpRt. gastro-epiploic V. stump
Tape on the gastro-colic trunkTape on the gastro-colic trunk
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Esophago-jejunostomy 1
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Esophago-jejunostomy 2
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Closure of the Jejunal Stump
EsophagojejunostomyEsophagojejunostomy
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Jejuno-jejunostomy
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Completion of Roux-en-Y Reconstruction
Jejuno-jejunostomyJejuno-jejunostomy
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Closure of the Mesenteric Defect