Certified Surgical First Assistant (CSFA) Practice Test

Which incision is indicated for performing an esophagogastrectomy?

1. Transabdominal

2. Thoracoabdominal

3. Subcostal

4. Laparoscopic

The correct answer is: Thoracoabdominal

The thoracoabdominal incision is particularly suited for performing an esophagogastrectomy because it provides the surgeon with adequate access to both the thoracic and abdominal cavities. This access is crucial for a procedure involving both the esophagus and stomach, as it allows for optimal visualization and manipulation of the involved structures. In esophagogastrectomy, which may involve the resection of portions of the esophagus and stomach, the thoracoabdominal approach enables the surgeon to work effectively around the diaphragm and access the lower esophagus, the gastroesophageal junction, and the upper stomach. This incision allows for sufficient exposure to address any potential complications and aids in the safe and thorough resection of the affected tissues. Other incision types do not provide the same level of access. For instance, a transabdominal incision is more limited in exposure to higher thoracic structures, and a subcostal incision primarily provides access to the abdominal cavity but may not adequately reach the thoracic portion. Laparoscopic techniques, while minimally invasive, may not always be suitable for more complex cases or for patients with significant anatomical considerations, making the thoracoabdominal incision a more reliable choice in such situations.