Lumbar Spine Paramedian Anterior Surgical Approach Surgical 3...


Uploaded on August 23, 2011 by Medilaw.TV - Illustrates the surgical technique for performing an anterior approach to the lumbar spine using a paramedian abdominal skin incision. Also shown are the patient position, skin preparation and incision, and the surgical approach by incising and retracting the intervening muscles.

This is a surgical technique using an anterior approach to the lumbar spine through a paramedian skin incision.

You will be lying on your side. Your skin will be cleaned. An incision will be made on the side from the level of the umbilicus to the pelvis. The underlying muscles will be incised and moved to the sides.

Scar tissue formation is part of the natural healing process for all body tissues. In most people, scar tissue doesn't cause any problems. Adhesions however, are abnormal bands of scar tissue that take month or years to form. Abdominal adhesions often occur after abdominal surgery. They become attached to the abdominal wall and internal organs, and can cause pain. They can block the intestines, leading to an obstruction. Such adhesions may need surgical removal.

The common iliac artery in the lower abdomen supplies blood to the pelvis and leg on that side. Injury to the artery is uncommon, is usually obvious, and is repaired immediately.

Arteries are large blood vessels that can carry blood under pressure throughout the body. Your doctor will be very careful to avoid injuring arteries near your operation site. An artery perforation can result in significant bleeding and blood loss. This is very uncommon. If an artery is perforated, the artery can usually be repaired and the lost blood can be replaced by a blood transfusion. A specialist vascular surgeon is often asked to repair arteries. Late consequences of artery injury include fistula, hemorrhage, pseudo-aneurysm, thrombosis and emboli.

Arteries are large blood vessels that carry blood throughout the body. Sometimes they need to be moved to the side or compressed to allow access to the operation site. This pressure can lead to a clot forming within the artery, a process known as thrombosis. This is most likely in older patients with pre-existing blood vessel disease. A large clot can block the artery, while a small clot can dislodge, becoming an embolus, which travels and eventually blocks a small artery. Blocked arteries lead to insufficient blood flow, or ischemia in the tissues supplied by the artery. This can cause damage to these tissues, which may be permanent, depending on the duration of the blockage. Ischemia in the brain can cause a stroke. In the spinal cord it can cause paralysis and altered sensation. In the legs, it can cause pain and gangrene.

No surgeon can guarantee a risk-free operation. All operations have some risks. Some risks are minor inconveniences, while some are major disabilities. The risks increase with repeat operations on the same area of your body. Your entire medical staff will do their best to eliminate all risks to you, before, during and after your surgery. However sometimes, even after the surgery goes well, serious problems can arise that can result in death. These include pneumonia, pulmonary emboli, heart attack and stroke. You should discuss these risks with your Surgeon and your Anesthesiologist.

The intestines are adjacent to the surgical site, and must be moved to obtain access during surgery. Your surgeon will be careful to avoid perforating the intestine. Perforations are difficult to detect, but can be repaired. If not detected, they can lead to serious infection after a few days with pain, fever and bloating. An unseen perforation may need another operation to clean and seal the perforation.

During any surgery, some blood vessels will be cut. Your surgeon will stop all significant bleeding before suturing the wound shut. Sometimes bleeding recommences after the operation, forming a collection of blood in the tissues, called a ...

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