Wangensteen suction

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Wangensteen suction is a medical procedure used in gastrointestinal surgery to remove gastric contents and prevent aspiration during surgery. It was first described by Dr. Owen H. Wangensteen, an American surgeon, in the 1930s. This technique has since become a standard practice in many surgical procedures involving the gastrointestinal tract.

Procedure

The Wangensteen suction procedure involves the insertion of a nasogastric tube into the patient's stomach. The tube is connected to a suction device, which creates negative pressure and allows for the removal of gastric contents. This helps to prevent the accumulation of gastric secretions and reduces the risk of aspiration during surgery.

Indications

Wangensteen suction is commonly used in surgeries involving the upper gastrointestinal tract, such as gastric bypass surgery, gastrectomy, and esophagectomy. It is particularly useful in cases where there is a high risk of gastric contents regurgitation, such as in patients with a history of gastroesophageal reflux disease or hiatal hernia.

Contraindications

There are few absolute contraindications to Wangensteen suction. However, caution should be exercised in patients with esophageal varices, as the negative pressure created by the suction may cause bleeding. Additionally, patients with a history of nasal or sinus surgery may have a higher risk of complications due to the presence of scar tissue.

Complications

Complications associated with Wangensteen suction are rare but can include nasal irritation, epistaxis (nosebleeds), and sinusitis. These complications can usually be managed conservatively with saline irrigation and nasal decongestants. In rare cases, more serious complications such as esophageal perforation or bleeding may occur, but these are extremely rare.

Equipment

The equipment required for Wangensteen suction includes a nasogastric tube, a suction device, and appropriate tubing to connect the two. The nasogastric tube should be of appropriate size and length to reach the patient's stomach comfortably. The suction device should be capable of generating sufficient negative pressure to effectively remove gastric contents.

Outcomes

The use of Wangensteen suction during gastrointestinal surgery has been shown to significantly reduce the risk of aspiration and related complications. By removing gastric contents, the procedure helps to maintain a clear surgical field and improves patient safety. However, it is important to note that the success of the procedure also depends on proper technique and careful monitoring during surgery.