 Good day everybody. Dr. Sanjeev Sanyal, Professor, Department Chair. So this is going to be a demonstration, preliminary demonstration of the contents of the abdomen. So this is a supine kit ever. I'm standing on the right side. Camera person is on the right side. And I've got numerous assistants who are all over the place. So we have opened up the abdomen and we have retracted the abdominal wall. This is the liver, which one of my assistants is lifting up here. And you can see this is the right anatomical lobe of the liver. And this is the left anatomical lobe of the liver. Above that we can see this is the right dome of the diaphragm. And this is the left dome of the diaphragm. Okay. Having given you the orientation, just a quick backward glance. This can ever had undergone a surgery at intra-abdominal, intra-umbular surgery. Midline laparotomy was done and you can see the remnants of the suture material. So therefore, understandably, when we opened the abdomen, there was dense additions all over the place. And therefore many structures could not be visualized. And especially this greater omentum, we could salvage only a small portion of it. The whole thing was completely matted and the abdomen was frozen. So we managed to salvage a little bit of it. So what you see here is the remnant of the greater omentum. Ideally, the greater omentum is supposed to hang down like an apron from the greater curvature of the stomach. So this is how it is supposed to have been and this is how it was. So we removed most of the frozen fibro-structures and we retracted it. Having done that, now let's take a look at what are the structures we can see here. Okay. So I have put the stomach in its relative anatomical position or the way it is supposed to be. Let's start from the beginning. We can see this structure here. This is the abdominal portion of the esophagus. And this abdominal portion of the esophagus is coming through this opening here. This is the esophageal hiatus. And if you look, this is the open mouth thorax. You can see the esophagus is in the mediastinal. My finger is tracing that. So the thoracic portion of the esophagus does not have any cirrhosis. But as we go into the abdomen, there is a little bit of cirrhosis and we have retained a portion of it. Again, this was also highly fibrozed and we had to remove quite a bit of it. We can see this structure here. This is the anterior vagus. But we cannot see the posterior vagus because it was part of the fibro-stissue. To continue down further, we can see this is the cardiac notch where my instrument is moving right now. And extending from the cardiac notch, we have this portion of the stomach. This is the fundus of the stomach. Tracing the fundus, this is the greater curvature of the stomach. And this is the greater curvature ending into the diurnal. To continue from the right margin of the esophagus, we can see this is the lesser curvature. And if we keep the stomach in its anatomical position, we find that at one place, the lesser curvature is most dependent. This is known as the incissura angularis. So therefore, if we drop a vertical line from here and if we drop a horizontal line from here, this portion of the stomach is the corpus or the body of the stomach. The portion of the stomach above this horizontal line is the fundus of the stomach, which is normally located under the left dome of the diaphragm, which is held up by my assistant here. And this is always filled with gas, which is called the gastric bubble in an X-ray. And then the portion after the vertical line from here, this is the pyloric anterum. And if you feel here, you'll feel a thick portion here. This is the pylorus or the pyloric sphincter. And after that is the beginning of the diurnal. This is the superior part of the diurnal or D1. This is the descending part of the diurnal or D2. And the rest of the diurnal, we have not yet dissected out, but we will do it in a subsequent video. So this is about the stomach. Now I'm going to lift up the stomach to show you the posterior surface. This is the posterior surface of the stomach. This is the anterior surface. The stomach was resting on this portion here. This is the region of the bed of the stomach. And in front of that was a space, which is known as the lesser sac or the omental bursa. But like when I was dissecting it out, the omental bursa had to be completely cleared off. That brings me to the next point. How do we enter? What is the doorway to the omental bursa? I put my finger in one space here. This is the doorway to the omental bursa. In front of my finger are three structures. And I will draw your attention to the three structures one by one. The first one is this one here on the right side. This one. This is the common bile duct. That's the first structure. The next structure in front of my finger is this one here, which I have lifted up. This is the hepatic artery proper. I will come more into the hepatic artery just a little later. And behind of these two structures is this bluish. This is the portal vein. So these three structures are referred to as the extra hepatic portal triad. Duct artery vein. And these three were enclosed in the hepato-deodernal ligament. And that constituted the anterior border of the doorway, which is called the epiploid for oven of Binslow. And through that, you can enter into the lesser side. The inferior boundary of this is formed by the first part of the deodernum, which is here. The superior boundary is formed by the caudate lobe of the liver. And the posterior boundary is formed by the inferior vena keva, which you cannot see here because we have not yet decided to go out. That's the next important point I wanted to mention. So in cases of during gallbladder surgery or during any hepatic surgery, if there's excessive bleeding and we want to stop it, we do this maneuver here. This is called the Pringle maneuver. And by so doing, we can compress the hepatic artery and the portal vein between the thumb and the index finger, and we can stop the bleeding and so that we can find the source of bleeding and clamp it. Now I will bring your attention to the next structure here. That is the three branches of the celiac trunk. So let's take them one by one. That incidentally will also be the branches of the stomach, which supply the arteries, which supply the stomach. This artery that we see here, this is the left gastric artery. Left gastric artery gives a branch. These are visual branch, and then it continues, and we can see that continuing along the lesser curvature of the stomach here. This is the left gastric artery, which runs from left to right. So you will ask me, where is the right gastric artery? This right gastric artery was enclosed in a dense mass of adhesions, as I said earlier, but we can see the beginning of the right gastric artery here. I am holding up the stump of the right gastric artery. This right gastric artery arises from the hepatic artery proper, and it runs from right to left, and the two of them will anastomose in the lesser momentum, in the lesser curvature. Now let's continue further. The next branch of the celiac trunk is this one here. This is the second largest branch of the celiac trunk. This is the common hepatic artery. It runs transversely, and then it makes a sharp bend upwards, as you can see very clearly here. So this is the hepatic artery proper, and at the place where it makes a 90 degrees bend, we can see this branch coming out. This is the gastrodural artery, and we can see the gastrodural artery is running behind the first part of the diurnal. This is the source of bleeding in a posterior diurnal ulcer. It can perforate into the gastrodural artery, and the patient can have profuse hematomasis. To continue this gastrodural artery, we will trace it further, and we can see it is dividing into two branches. We can see it is giving rise to this branch here. This is the right gastroepiploid or the right gastroomental artery, and this is the superior pancreatic or diurnal artery. The right gastroepiploid artery runs on the greater curvature of the stomach in the leaves of the gastrocolic ligament or the greater omentum. So now you will be asking, where is the left gastroepiploid artery? Again, the left gastroepiploid artery arises from this clinic artery, which I am going to show you just now. So for that, I have retracted the stomach to my side. Now, let's focus the camera more clearly, and we can see this artery here. This artery, I have lifted it up here. This is the splenic artery, and I have traced the full course here. Just to bring up to speed, this was the select trunk. This was the right hepatic, common hepatic artery. This is the splenic artery. This splenic artery is highly tortuous, and it runs along the superior border of the pancrease, and it forms part of the bed of the stomach, and you can see how tortuous it is. This is the superior border of the pancrease, and this is entering into the spleen, and you can see this is the spleen here. And as it enters into the spleen and ramifies, it has given off this branch here. This is the remnant of the left gastroepiploid, which was running in the greater omentum, but as I told you, we had to remove most of it because it is all fibros. So this left gastroepiploid artery, runs from left to right, and the right gastroepiploid artery runs from right to left. They supply branches to the stomach, so the gastric branches, and they supply the great omentum, by means of omental branches. So these are the branches that we see of the select trunk and the blood supply of the stomach. So these are the structures which I wanted to show you in this particular section of the cadaver. More will follow, stay tuned. Thank you very much for watching. Dr. Sanjay Sanyal signing out. Have a nice day. Please like and subscribe.