SECTION V: Surgical GLossary The 5 Minute Pediatric Consult


	SECTION V: Surgical Glossary

Aaron E. Carroll and Nahush A. Mokadam

aortopexy—a procedure in which the aorta is approximated to the anterior thoracic wall; for the treatment of tracheomalacia.

Bishop-Koop procedure—resection of a dilated loop of bowel proximal to meconium obstruction, with end-to-side anastomosis between the proximal bowel and obstructed loop, combined with end ileostomy; for the treatment of meconium ileus.

bladder augmentation—a procedure in which a portion of the intra-abdominal gastrointestinal tract is used to increase the volume of the bladder.

Blalock-Taussig shunt—a procedure in which the subclavian artery is anastomosed to the pulmonary artery; for the temporary treatment of tetralogy of Fallot.

Boix-Ochoa procedure—restoration of the intra-abdominal esophageal length, repair of the esophageal hiatus, fixation of the esophagus to the hiatus, and restoration of the angle of His; for the treatment of incompetent lower esophageal sphincter.

chordee correction—a procedure in which the corpus spongiosum is moved ventrally and the corpus cavernosa are approximated dorsally; for the treatment of chordee (abnormal penile curvature associated with epispadias or hypospadias).

Clatworthy mesocaval shunt—division of the common iliac veins and side-to-end anastomosis of the inferior mesenteric vein to the left renal vein; for the treatment of portal hypertension.

Cohen procedure—trigonal reimplantation of the ureter; for the treatment of vesicoureteral reflux.

colonic conduit diversion—a procedure involving two stages: (1) a loop diversion using a colonic segment, and (2) an end-to-side anastomosis of the colonic segment to the gastrointestinal tract.

colonic interposition—replacement of the esophagus with a colonic segment; for treatment of esophageal atresia or stricture when gastric mobilization is not feasible.

diaphragmatic plication—surgical shortening of the diaphragm (abdominal, transthoracic, or bilateral); for the treatment of diaphragmatic eventration.

distal splenorenal shunt—see Warren shunt.

Drapanas mesocaval shunt—prosthetic graft implantation from the inferior mesenteric vein to the inferior vena cava; for the treatment of portal hypertension.

Duckett transverse preputial island flap—technique in which a flap of foreskin is used to elongate the urethra; for the treatment of hypospadias.

Duhamel procedure—resection of the aganglionic colon above the dentate line with stable anastomosis to the rectal stump, normally performed in children 6 to 12 months of age for the treatment of Hirschsprung disease (see Martin modification).

end-to-side portocaval shunt—procedure in which the portal vein is divided and anastomosed to the inferior vena cava; for the treatment of portal hypertension.

esophagectomy—resection of the esophagus, with gastric pull-up and anastomosis with the cervical esophagus; for the treatment of esophageal atresia or stricture.

Fontan procedure—a procedure in which a graft is created to connect the pulmonary artery to the right atrium; for the treatment of hyperplastic right heart syndrome.

Glenn shunt—a shunt from the superior vena cava to the pulmonary artery; for the treatment of tricuspid atresia or stenosis.

gridiron incision—see McBurney incision.

Hegman procedure—surgical release of the tarsal, metatarsal, and intertarsal ligaments; for the treatment of metatarsus adductus.

Heller myotomy—myotomy of the anterior lower esophagus (always accompanied by a Thal fundoplication); for the treatment of achalasia.

ileal loop diversion—resection and implantation of ureters into an isolated ileal segment, with an ileal stoma and primary anastomosis of ileum to cecum.

ileal ureter—ileal interposition between the renal pelvis and bladder when the ureteral length is insufficient for anastomosis; for the treatment of urinary obstruction.

ileocecal conduit diversion—bilateral ureteral diversion and anastomosis to an isolated ileocecal segment and cecostomy with primary anastomosis of ileum to the right colon.

J-pouch—creation of an ileal reservoir in the distal ileum using a “J”-shaped configuration; used following colectomy.

Jateene procedure—arterial retransposition; for the treatment of transposition of the great vessels.

Kasai procedure—resection of atretic extrahepatic bile ducts and gall bladder with Roux-en-Y anastomosis of the jejunum to the remaining common hepatic duct; for the treatment of biliary atresia or other extrahepatic obstruction.

Kimura procedure (parasitized cecal patch)—a multistep operation in which (1) a side-to-side anastomosis is made with a portion of the distal ileum and the right colon, and (2) an ileoanal pull-through is performed; for the treatment of Hirschsprung disease.

King operation—resection of the knee with placement of a Küntscher rod to fix the femur to the tibia, followed by a Syme amputation for the treatment of proximal focal femoral deficiency (PFFD).

Koch pouch diversion—a procedure involving bilateral ureteral diversion with anastomosis to a neobladder formed from an isolated ileal segment, combined with an ileal stoma and primary anastomosis of ileum to ileum.

Ladd operation—restoration of intestinal anatomy from a malrotated state; for the treatment of intestinal malrotation.

Lanz incision—an abdominal incision made in the left iliac fossa; for colostomy formation.

left hepatectomy—resection of the left hepatic lobe (medial and lateral segments).

Magpi procedure—distal advancement of the urethral meatus and granuloplasty; for the treatment of hypospadias.

Mainz pouch diversion—a procedure involving bilateral ureteral division with anastomosis to a neobladder formed from isolated cecum and terminal ileum; combined with an ileal stoma and primary anastomosis of the ileum to the right colon.

Martin modification (of Duhamel procedure)—right and transverse colectomy with ileoanal pull-through and side-to-side anastomosis of the remaining left colon to the ileum; procedure preserves some absorptive capacity of the large bowel; for the treatment of total colonic Hirschsprung disease.

McBurney (gridiron) incision—abdominal incision from the anterior superior iliac spine to the umbilicus; used for appendectomy.

Mikulicz procedure—a diverting enterostomy performed proximal to the meconium obstruction without resection; for the treatment of meconium ileus.

mini-Pena procedure—anterior sagittal anorectoplasty; for the treatment of anterior rectoperianal fistula (boys) or rectal-fourchette fistula (girls).

Mitrofanoff technique—a modification of neobladder diversion procedures, in which vascularized appendix is used to create the stoma.

Mustard technique—redirection of blood through an atrial septal defect (ASD) using a pericardial pathway; for the treatment of transposition of the great vessels; because of associated increased turbulence, this technique is not widely used today.

Mustarde procedure—correction, using simple mattress sutures, of a prominent ear with normal or absent antihelical folds.

Nissen fundoplication—a technique involving a 360-degree wrap of the gastric fundus around the gastroesophageal junction; for the treatment of incompetent lower esophageal sphincter; patient is rendered unable to vomit or belch.

Norwood procedure—a three-stage palliative procedure including (1) atrial septectomy, transection and ligation of the pulmonary artery, “neoaorta” formation using the proximal pulmonary artery, and creation of a synthetic porto-aortal shunt; (2) creation of a Glenn shunt; and (3) performance of a modified Fontan procedure; for the treatment of hypoplastic left heart syndrome.

onlay island flap—a technique in which a flap of foreskin is used to elongate the urethra; for the treatment of hypospadias.

orchidopexy—testicular pull-down and attachment; for the treatment of undescended testis.

orthoplasty—surgical correction of excessive penile curvature.

parasitized cecal patch—see Kimura procedure.

Pena procedure—posterior sagittal anorectoplasty performed in children 1 to 6 months of age; for the treatment of imperforate anus.

Pfannenstiel incision—an abdominal incision used to gain access to the lower abdomen and bring pelvic organs within reach without dividing muscular tissue.

pharyngoplasty—elevation of the posterior pharyngeal wall following a primary cleft palate repair (to narrow the pharyngeal space); for the treatment of velopharyngeal incompetence.

Potts shunt—anastomosis of the descending aorta to the pulmonary artery for the permanent treatment of tetralogy of Fallot.

proximal splenorenal shunt—end-to-side anastomosis of the splenic vein to the left renal vein with splenectomy; for the treatment of portal hypertension.

pyeloplasty—resection of an atretic ureter with primary anastomosis to the renal pelvis; for the treatment of ureteropelvic junction obstruction.

Ramstedt operation—relaxation of the pyloric sphincter; for the treatment of pyloric stenosis.

Rashkind procedure—balloon atrial septostomy; for the treatment of palliation of the great vessels.

Rastelli repair—a technique involving the closure of a ventricular septal defect (VSD) with a patch and the creation of a conduit from the distal pulmonary artery to the right ventricle; for the treatment of transposition of the great vessels.

Ravitch procedure—a procedure involving (1) creation of osteotomies between the manubrium and costal cartilages, (2) a greenstick fracture of the manubrium, and (3) the temporary insertion (for 6 to 12 months) of a stabilizing bar; for the treatment of pectus excavatum or pectus carinatum.

right colon pouch—a procedure involving bilateral ureteral division with anastomosis to a neobladder (formed from an isolated segment of the right colon), combined with an ileal stoma and primary anastomosis of the ileum to the transverse colon.

right hepatectomy—resection of the right hepatic lobes (anterior and posterior segments).

rooftop (bilateral subcostal) incision—an abdominal incision used to access the liver and portal structures.

Roux-en-Y anastomosis—division of the jejunum distal to the ligament of Treitz with end-to-side anastomosis of the duodenum to the distal jejunum and anastomosis of the proximal jejunum (typically) to the bile duct.

S-pouch—the creation of an ileal reservoir in the distal ileum using an “S”-shaped configuration following colectomy.

Santulli-Blanc enterostomy—a modification of the Bishop-Koop procedure that involves the resection of a distal dilated bowel segment with side-to-end anastomosis to the proximal enterostomy; for the treatment of meconium ileus.

Senning procedure (venous switch)—technique involving intra-atrial redirection of venous return so that systemic caval return is shunted through the mitral valve to the left ventricle, and pulmonary return is brought through the tricuspid valve to the right ventricle; for the treatment of transposition of the great vessels.

side-to-side portocaval shunt—a procedure in which the portal vein is anastomosed to the inferior vena cava; for the treatment of portal hypertension.

side-to-side splenorenal shunt—side-to-side anastomosis of the splenic vein to the left renal vein; for the treatment of portal hypertension.

Sistrunk operation—complete excision of a thyroglossal duct cyst.

Soave procedure—a technique involving endorectal pull-through; for the correction of rectal resection.

Stamm gastrostomy—placement of an open gastrostomy tube; the opening is designed to close spontaneously on removal of the tube.

Sting procedure—subureteric Teflon injection; for the endoscopic correction of vesicoureteral reflux.

Sugiura procedure—a technique that involves lower esophageal transection and primary anastomosis, devascularization of the lower esophagus and stomach, and splenectomy; for the treatment of esophageal varices.

Swenson procedure—resection of the posterior rectal wall to the dentate line (aganglionic region); for the treatment of Hirschsprung disease; technically difficult and rarely performed.

Syme amputation—amputation of the foot, calculated to bring the end of the stump above the opposite knee at maturity; for the treatment of proximal focal femoral deficiency (PFFD).

Thal procedure—a procedure involving a 180-degree anterior wrap of the gastric fundus around the gastroesophageal junction, preserving the patient’s ability to vomit and belch; for the treatment of incompetent lower esophageal sphincter.

Thiersch operation—a procedure in which a distal rectal segment that has prolapsed is approximated to the external sphincter muscle; for the treatment of rectal prolapse.

trisegmentectomy—resection of the right hepatic lobe and the quadrate lobe of the liver (right posterior segment, right anterior segment, and medial segment).

ureteropyelostomy—partial resection and side-to-side anastomosis of a partially duplicated ureter.

uretocalycostomy—a technique for the treatment of urinary obstruction involving division of the ureter (distal to the obstruction) and intrarenal anastomosis to the most dependent renal calyx; when the renal pelvis is insufficient for anastomosis, the lower pole of the kidney is resected.

vaginal switch operation—a procedure in which the vagina is separated from the urinary tract; for treatment of duplicated vagina.

Van Ness procedure—rotational 180-degree osteotomy of the femur in which the foot and ankle are brought to the level of the opposite knee; for prosthetic attachment for the treatment of femoral deficiency.

venous switch—see Senning procedure.

ventricular shunt procedure—a procedure in which a Silastic catheter is positioned in a lateral ventricle and tunneled subcutaneously to drain into the central venous system or peritoneal cavity; for the treatment of hydrocephalus.

Warren (distal splenorenal) shunt—a procedure in which the splenic vein is anastomosed to the left renal vein; for the treatment of portal hypertension.

Waterston aortopulmonary anastomosis—a procedure involving anastomosis of the ascending aorta and the right pulmonary artery; for the temporary treatment of tetralogy of Fallot.

Whipple procedure—resection of the pancreatic head, duodenum, and gall bladder with gastrojejunostomy, hepatojejunostomy, and pancreaticojejunostomy.

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