Shadowing Practice: Splenectomy: step-by-step - Learn English Speaking with Video
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Hello and welcome to the GYO surgery series.
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This will be the first of several different explanations of individual surgeries that we perform in Gynonk,
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including some photos that I'll have referenced, as well as some handmade drawings.
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the first surgery that we'll be going over is the splenectomy
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and I only own the drawings other pictures will be referenced on individual slides
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and at the end this is for educational purposes only this is not intended to be medical advice
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so reference this lovely picture on the right the removal of
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the spleen is occasionally required to achieve optimal surgical cytoreduction in ovarian cancer
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and so knowing the relevant anatomy is important and
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so we'll go over the ligaments attaching to the spleen as well as the blood supply to the spleen
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so there are approximately five ligaments the splenophrenic ligament the splenorenal the pancreaticosplenic,
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the splenocolic, and the gastrosplenic ligaments.
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They are labeled here, 1 through 4.
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We have 1, 2, 3, 4, splenofrenic, which you can't see,
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but the diaphragm would be up here, the splenorenal, the pancreaticosplenic, the splenocolic, and then over here we have the gastrosplenic.
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Each of these ligaments are transected during a splenectomy.
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And then as far as our blood supply goes, it's a little bit easier.
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You just have the splenic artery and the splenic vein.
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As you can see here, these come off the celiac trunk.
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The artery comes off the celiac trunk, and the celiac trunk, as you may remember, is the splenic artery, the left gastric,
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and the common hepatic, and then the splenic vein coming back into the portal vein.
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the basic steps of a splenectomy are entering the lesser sac mobilizing the spleen
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and then ligating the vessels
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which sounds very easy however in practice is definitely scary for gynonks there is an anterior
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or posterior approach
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and the choice depends on the distribution of disease whatever approach would be easier based on disease
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and i will be going over the anterior your approach in this short lecture.
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So first entering the lesser sac of the omentum, you want to identify the gastrocolic ligament.
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This lies between the stomach's greater curvature and the transverse colon.
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The anterior leaf of the omentum attaches to the greater curvature of the stomach via the gastrocolic ligament, and the posterior leaf attaches to the margin of the transverse colon.
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And the lesser sac is kind of between these two leaves.
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So identifying the ligament and then transecting this in order to open the lesser sac.
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The dissection, then this is another depiction of opening the lesser sac, but the omentum is no longer there.
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And as you can see here, this is the gastrocolic ligament here.
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The dissection continues along the transverse colon with mobilization of the
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entire splenic flexure of the colon to eventually reach the splenocolic ligament,
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highlighted here, and then you're also dissecting upward to the greater curvature of the stomach towards the gastrosplenic ligament.
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That's here.
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once mobilized you can grasp the spleen
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and elevate it medially this will expose the splenophrenic ligament here
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and you can continue to dissect the spleen from the gastrosplenic ligament as well as the splenocolic ligament
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so you can see the gastrosplenic ligament in this picture as well as the splenocolic ligament here you'll continue dissecting
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that and then also the splenofrenic ligament, with this being the diaphragm.
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The gastrosplenic ligament is the most vascular and contains those short gastric arteries, so we are very careful in ligating and dividing these.
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And then finally, the spleen is elevated to the incision.
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You do some blunt dissection in order to identify the splenic artery and the splenic vein.
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Each one of these vessels are individually ligated and the artery is ligated first in order to prevent engorgement of the spleen.
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You can use, as depicted here, a right angle placed underneath the artery or individual
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vein artery or vascular pedicle
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and you can use a 2 -0 silk you will then place a second 2 -0 silk
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and then on the proximal end you can either tie
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or clip this end and then divide the artery vein
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or other vascular pedicle and then
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if you're done with the artery you do the vein and that is the end of the splinectomy.
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Woordenschat en spreektips bij deze les
Deze spreekles is gebaseerd op de video “Splenectomy: step-by-step”. Deze woorden komen het vaakst terug: ligament, artery, spleen, splenic, vein. Deze video bevat 54 zinnen en 709 woorden om na te spreken. Het gesproken deel duurt 5:25. De spreker praat in een gelijkmatig tempo van ongeveer 131 woorden per minuut, prettig om te shadowen. Slechts 72% van de woorden hoort bij de 3.000 meest gebruikte Engelse woorden, dus de woordenschat is pittig.
Belangrijke woorden in deze video
15 woorden uit de video die het leren waard zijn, met uitspraak en betekenis:
| Woord | Uitspraak | Betekenis |
|---|---|---|
| artery zelfstandig naamwoord | /ˈɑɹ.təɹ.i/ | slagader, arterie |
| vein zelfstandig naamwoord | /veɪn/ | ader |
| colon zelfstandig naamwoord | /ˈkoʊ.lən/ | dubbele punt, dubbelpunt |
| leaf zelfstandig naamwoord | /lif/ | blad |
| trunk zelfstandig naamwoord | /tɹʌŋk/ | stam |
| attach werkwoord | /əˈtæt͡ʃ/ | vastmaken |
| stomach zelfstandig naamwoord | /ˈstʌmək/ | maag |
| vessel zelfstandig naamwoord | /ˈvɛsəl/ | vaartuig |
| divide werkwoord | /dɪˈvaɪd/ | verdelen |
| silk zelfstandig naamwoord | /sɪlk/ | zijde, rag |
| explanation zelfstandig naamwoord | /ˌɛkspləˈneɪʃən/ | verklaring, toelichting |
| label zelfstandig naamwoord | /ˈleɪ.bəl/ | etiket, label |
| occasionally bijwoord | /əˈkeɪʒənəli/ | af en toe, wel eens |
| angle zelfstandig naamwoord | /ˈæŋ.ɡəl/ | hoek |
| scary bijvoeglijk naamwoord | /ˈskɛə.ɹi/ | eng |
Uitspraak om op te letten
De spreker gebruikt 7 samentrekkingen en verkorte vormen, zoals we'll, you're, can't. Spreek ze kort uit, zoals je ze hoort.
- De klanken “sh” en “zh”: explanation /ˌɛkspləˈneɪʃən/, occasionally /əˈkeɪʒənəli/, dissection /dɪˈsɛkʃən/, depiction /dɪˈpɪkʃən/, flexure /ˈflɛkʃə(ɹ)/
- Lange woorden — let op de klemtoon: anterior /ænˈtɪɹ.i.ɚ/, explanation /ˌɛkspləˈneɪʃən/, occasionally /əˈkeɪʒənəli/, anatomy /əˈnætəmi/, individually /ˌɪndɪˈvɪd͡ʒ(u)əli/
Klanken die Nederlandstaligen lastig vinden:
- Stemhebbende eindmedeklinker — /b/, /d/, /g/, /z/, /v/ niet verscherpen: divide /dɪˈvaɪd/, slide /ˈslaɪ̯d/, depend /dɪˈpɛnd/, intend /ɪnˈtɛnd/, expose /ɪkˈspoʊz/
- /æ/ — opener dan de Nederlandse “e”: attach /əˈtæt͡ʃ/, anterior /ænˈtɪɹ.i.ɚ/, vascular /ˈvæskjələ/, angle /ˈæŋ.ɡəl/, grasp /ɡɹæsp/
- /g/ — een harde plofklank, geen Nederlandse “g”: angle /ˈæŋ.ɡəl/, grasp /ɡɹæsp/, ligament /ˈlɪɡəmənt/, ligate /ˈlɪɡeɪt/, gastric /ˈɡæstɹɪk/
Zo oefen je met deze video
- Luister de hele video één keer zonder te spreken en noteer de woorden die je niet kent.
- Spreek zin voor zin na op normale snelheid en herhaal elke zin tot je ritme gelijk is aan dat van de spreker.
- Neem jezelf op en vergelijk met het origineel; let daarbij op woorden als artery, vein, colon.
Wat is de Shadowing-techniek?
Shadowing is een wetenschappelijk onderbouwde taalleermethode die oorspronkelijk is ontwikkeld voor professionele tolkentraining en gepopulariseerd door polyglot Dr. Alexander Arguelles. De methode is eenvoudig maar krachtig: je luistert naar native Engelse audio en herhaalt het onmiddellijk hardop — als een schaduw die de spreker volgt met slechts 1–2 seconden vertraging. In tegenstelling tot passief luisteren of grammaticadrills, dwingt shadowing je hersenen en mondspieren om echte spraakpatronen tegelijkertijd te verwerken en te reproduceren. Onderzoek toont aan dat het de uitspraaknauwkeurigheid, intonatie, ritme, verbonden spraak, luisterbegrip en spreekvaardigheid aanzienlijk verbetert — waardoor het een van de meest effectieve methoden is voor IELTS Speaking-voorbereiding en echte Engelse communicatie.