What is Trauma?
 Trauma is a serious injury or shock to the body. It is caused by a physical force such as violence or an accident. The injury may be complicated by psychiatric, behavioral, and social factors.
It is critical to have an entire team immediately available to provide care to an injured patient 24-hours a day. This teamwork starts at the scene of the injury where a coordinated, statewide pre-hospital medical system rapidly transports the injured patient from the scene to the hospital providing the appropriate level of care according to criteria established in the statewide trauma regulations. Once at the hospital, a complete team of surgeons, emergency physicians and nurses continue the life-saving treatment.
This team approach to care of the injured patient has had a dramatic impact on saving lives.
Minimally Invasive Procedures for Massive Bleeding
Injuries take many forms. The most advanced hospitals can treat injuries with a variety of approaches that involve well-known ones, like surgery, and newer ones where minimally invasive procedures can replace some surgeries.
As a Level 1 Trauma Center, Hartford Hospital has Interventional Radiologists as part of the Trauma Team. They perform procedures such as "embolization" which is a recognized interventional radiology technique that is used to treat trauma patients with massive bleeding.
Click here to see some of the advanced interventional techniques available at Hartford Hospital.
Learn more about trauma, or search below to learn about other health conditions. |
Vertical Sleeve Gastrectomy—Open(Sleeve Gastrectomy—Open; VSG—Open)
by
Sarah J. Kerr, BA
Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Doctor
DefinitionVertical sleeve gastrectomy (VSG) is a surgery to decrease the size of the stomach. Reasons for ProcedureBody mass index
(BMI) determines if a person is
overweight
or obese. A normal BMI is 18.5-25. This surgery is an option for people with:
- BMI greater than 40
- BMI 35-39.9 and a life-threatening condition or severe physical limitations that affect employment, mobility, and family life
If lifestyle changes are made, the benefits of VSG include: - Weight reduction
- Improvement in obesity-related conditions
- Improved mobility and stamina
- Enhanced mood and self-esteem
Possible ComplicationsComplications are rare. But no procedure is completely free of risk. Complications may include: - Stitches or staples may loosen
- Pouch stretches or leaks
- Bleeding
- Infection
- Reaction to anesthesia
- Heart attack
- Blood clots
- Nausea, vomiting
Long-term complications include vomiting and
gallstones.
Factors that may increase the risk of complications include: - Smoking
- Recent or chronic illness (eg, kidney, heart, or lung disease)
- Diabetes
- Old age
- Bleeding or clotting disorders
Discuss risks with your doctor. What to ExpectYou may have the following done: - Physical exam and review of medical history
- Blood test and other tests to check your health
- Attempts to lose weight (about 10%) through medically-approved diets
- Meetings with a registered dietitian
- Mental health test and counseling
Prior to the procedure: -
Talk to your doctor about your medicines, herbs, and dietary supplements. You may be asked to stop taking some medicines up to one week before the procedure, like:
- Aspirin
or other anti-inflammatory drugs
- Blood thinners
- You may be given antibiotics.
- You may be given laxatives or an enema.
- Arrange for a ride to and from the hospital.
- The night before, eat a light meal. Do not eat or drink anything after midnight.
General anesthesia
will be given through an IV (needle) in your hand or arm. It will block pain and keep you asleep through the surgery.
A nurse will place an IV line in your arm to give you fluids and medicines. The doctor will place a breathing tube through your mouth and into your throat. This will help you breathe during surgery. You will also have a catheter placed in your bladder to drain urine. The doctor will make an 8-10 inch incision to open the abdomen. Surgical staples will divide the stomach vertically. The new stomach will be the shape of a slim banana. The rest of the stomach will be removed. Your new stomach can hold 50-150 milliliters (mL) of food, about 10% of what a normal adult stomach can hold. Staples or stitches will be used to close the incision. The breathing tube and catheter will be removed. Anesthesia will prevent pain during surgery. You will be given pain medicine after surgery. The usual length of stay is 4-6 days. If there are any problems, you will need to stay longer. - The doctor may use a small tube with a camera to look down your throat and into your stomach to check for problems.
- You will receive nutrition through an IV at first, but slowly start eating again.
While in the hospital, you may be asked to: - Use a device called an incentive spirometer to prevent breathing problems
- Wear elastic surgical stockings or boots to promote blood flow in your legs
- Walk
For a smooth recovery: - Ask your doctor about when it is safe to shower, bathe, or soak in water.
- Do not drive or lift anything heavy for at least two weeks or until advised by your doctor.
- Walk every day.
- Your doctor may recommend that you meet with a therapist if you have emotional ups and downs.
- Follow your doctor’s instructions.
Return to normal activities in 2-3 weeks. For good nutrition: -
Eat a
clear liquid diet
for about one week or as advised by your doctor.
- You will begin with 4-6 small meals per day. A meal is two ounces of food.
- Progress from soft, pureed foods to regular foods.
- Solid food must be well-chewed.
- Get enough protein.
- Do not eat too much or too quickly.
- Avoid high-calorie foods.
-
Avoid
dehydration
by drinking fluids before or after meals.
Call Your DoctorContact your doctor if any of the following occurs: - Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
- Pain that you cannot control with the medicines you have been given
- Blood in the stool
- Pain, burning, urgency, or frequency of urination, or persistent bleeding in the urine
- Persistent nausea and/or vomiting
- Severe abdominal pain
- Pain and/or swelling in your feet, calves, or legs
- Cough, shortness of breath, or chest pain
In case of an emergency, call for medical help right away.
Bariatric surgery. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed/what.php. Updated November 2010. Accessed November 22, 2010.
Gastric sleeve. University of California, San Diego Health System website. Available at:
http://health.ucsd.edu/specialties/obesity/surgery/gastric-sleeve.htm. Accessed November 22, 2010.
Laparoscopic sleeve gastrectomy. Baylor College of Medicine website. Available at:
http://debakeydepartmentofsurgery.org/home/content.cfm?proc_name=Laparoscopic+Sleeve+Gastrectomy&content_id=272. Updated November 2010. Accessed November 22, 2010.
Sleeve gastrectomy. Cleveland Clinic website. Available at:
http://weightloss.clevelandclinic.org/WhatisBariSurg1.aspx. Accessed November 22, 2010.
Sleeve gastrectomy. Virginia Mason Medical Center. Bariatric Surgery Center of Excellence website. Available at:
https://www.virginiamason.org/home/body.cfm?id=6214. Updated October 2010. Accessed November 22, 2010.
Sleeve gastrectomy. Yale New Haven Health website. Available at:
http://www.greenhosp.org/pe_pdf/bariatrics_sleeve.pdf. Updated January 2010. Accessed November 22, 2010.
Walsh J. Sleeve gastrectomy as a stand alone bariatric procedure for obesity. California Technology Assessment Forum website. Available at:
http://www.ctaf.org/UserFiles/File/2010%20Oct/Vertical%20Sleeve%20Gast%20final%20draft.pdf. Updated October 2010. Accessed November 22, 2010.
Weight loss surgery. North Shore Medical Center website. Available at:
http://nsmcweightloss.org/web/surgical_procedures.aspx. Accessed November 22, 2010.
Last reviewed November 2012 by Daus Mahnke, MD Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Publishing. All rights reserved. |
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