TY  - CHAP
M1  - Book, Section
TI  - Gastrectomy, Subtotal—Omentectomy
A1  - Ellison, E. Christopher
A1  - Zollinger, Jr., Robert M.
A1  - Pawlik, Timothy M.
A1  - Vaccaro, Patrick S.
A1  - Bitans, Marita
A1  - Baker, Anthony S.
Y1  - 2022
N1  - 
T2  - Zollinger’s Atlas of Surgical Operations, 11e
AB  - In  cases  of  malignancy  of  the  stomach,  it  is  desirable  to  resect  the  greater  omentum  because  it  allows  for  improved  removal  of  lymph  nodes  along  the  greater  curvature  of  the  stomach  and  any  metastatic  implants  in  this  structure.  Removing  the  omentum  is  not  difficult  and  frequently  can  be  performed  with  less  technical  effort  than  dividing  the  gastrocolic  ligament  adjacent  to  the  greater  curvature  of  the  stomach.  For  this  reason,  some  surgeons  prefer  to  use  this  procedure  rather  routinely,  regardless  of  the  indication  for  subtotal  gastrectomy.  The  transverse  colon  is  brought  out  of  the  wound,  and  the  omentum  is  held  sharply  upward  by  the  operator  and  assistants  (FIGURE  1).  Using  scissors  of  the  Metzenbaum  type,  dissection  is  started  at  the  right  side,  adjacent  to  the  posterior  taenia  of  the  colon.  In  many  instances,  the  peritoneal  attachment  can  be  divided  more  easily  with  a  scalpel  or  electrocautery  than  with  scissors.  A  thin  and  relatively  avascular  peritoneal  layer  can  be  seen,  and  it  can  be  rapidly  divided  (FIGURES  1,  2,  3).  Upward  traction  is  maintained  on  the  omentum  as  blunt  gauze  dissection  is  used  to  sweep  the  colon  downward,  freeing  it  from  the  omentum  (FIGURE  2).  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - accesssurgery.mhmedical.com/content.aspx?aid=1187820884
ER  -