Suture Self

Author: sutureself_hulewi

  • Acute Mesenteric Ischemia: Recognize It Early

    The Next Step · Emergency General Surgery

    Severe abdominal pain with few early examination findings should raise concern for acute mesenteric ischemia, especially in patients with embolic risk, vascular disease, or a low-flow state.

    The next step: urgent CT angiography

    When suspicion is high, obtain CT angiography without delay while starting resuscitation and engaging the surgical and vascular teams. A normal lactate does not exclude early ischemia.

    Identify the mechanism

    • Arterial embolism
    • Arterial thrombosis
    • Non-occlusive mesenteric ischemia
    • Mesenteric venous thrombosis

    Treat the patient and the cause

    Early priorities include restoring perfusion, broad-spectrum antibiotics, and considering anticoagulation unless contraindicated. Revascularization, bowel assessment, and resection of nonviable bowel depend on the mechanism and physiology. Peritonitis requires urgent operative assessment.

    Do not wait for advanced examination findings before investigating threatened bowel.

    Further reading

    Bala M, et al. Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery. World J Emerg Surg. 2022;17:54. Read the guideline.

    ← Back to the educational library

  • Robotic Surgery: Who Is Really in Control?

    Surgery Made Simple · Robotic Surgery

    Robotic surgery is surgeon-controlled surgery. In commonly used systems, the surgeon directs instruments from a console while the operating-room team works alongside the patient.

    What does the system add?

    A camera provides a magnified view of the surgical field. The console translates the surgeon’s movements into instrument movements, helping with tasks in confined spaces. Features vary between systems.

    Is it always the best approach?

    The approach should fit the patient, operation, and team’s experience. Robotic surgery is one option alongside conventional laparoscopy and open surgery. The device alone does not determine the outcome.

    Questions worth asking

    • Why is this approach appropriate for this operation?
    • What are the alternatives and their tradeoffs?
    • What training and experience does the team have?
    The technology assists the surgeon. The surgeon remains responsible for the operation.

    Source

    FDA: Computer-Assisted Surgical Systems. Accessed November 8, 2026.

    ← Back to the educational library

  • Hello world!

    Welcome to WordPress. This is your first post. Edit or delete it, then start writing!