Behind The Knife: The Surgery Podcast Behind the Knife ABSITE 2025 - Quick Hits 3
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Jan 18, 2025 Dive into a whirlwind of surgical knowledge, covering esophageal anatomy and ideal surgical access points. Unpack the complexities of Zenker's diverticulum and its repair, alongside the latest in esophageal cancer epidemiology. Explore the intricacies of stomach blood supply and the vital role of parietal cells in acid secretion. Tune in for insights on post-gastric bypass nutrient deficiencies and hepatic anatomy, with a focus on liver tumors and essential management strategies. This episode is packed with high-yield surgical education!
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Esophageal Structure And Vagal Orientation
- The esophagus lacks serosa and transitions from striated to smooth muscle along its length.
- The right vagus runs posteriorly and the left vagus anteriorly near the distal esophagus.
Choose Side Based On Esophageal Level
- For cervical esophageal access use a left-sided incision and for the upper two-thirds of the thoracic esophagus approach from the right.
- Return to the left side for distal thoracic (lower one-third) esophageal exposure.
Manage Zenker Diverticulum Based On Size
- Treat a Zenker diverticulum with cricopharyngeal myotomy or excision and choose endoscopic repair for larger, mobile pouches.
- Use open repair for <3 cm or when neck extension is limited.
