Category Reference
Alimentary Tract Procedures
31 procedures tested on the ABS Certifying Exam
Alimentary tract questions on the ABS Certifying Exam range from common bread-and-butter cases (appendicitis, cholecystitis, small bowel obstruction, diverticulitis) to oncologic resections (esophagectomy, gastrectomy, colectomy for cancer) and benign foregut work (Nissen fundoplication, Heller myotomy, paraesophageal hernia repair). Examiners test indications, operative steps, intraoperative decision points, and the handling of common complications like anastomotic leak, bleeding, and recurrence.
Esophagus
Nissen Fundoplication
A 360-degree gastric fundus wrap around the distal esophagus performed to treat gastroesophageal reflux disease refractory to maximal medical therapy. The examiner expects you to j…
Heller Myotomy
A longitudinal myotomy of the lower esophageal sphincter performed laparoscopically for achalasia. The examiner expects you to confirm the diagnosis with high-resolution manometry …
Esophagectomy
Resection of the esophagus most commonly performed for esophageal cancer (squamous cell or adenocarcinoma). The examiner expects you to stage the patient (EGD with biopsy, CT chest…
Zenker's Diverticulum Repair
Repair of a posterior pharyngoesophageal (Zenker's) diverticulum, a pulsion diverticulum arising through Killian's triangle between the oblique fibers of the inferior pharyngeal co…
Esophageal Perforation Repair
Repair of a full-thickness esophageal perforation, a surgical emergency with mortality rates exceeding 20% if diagnosis is delayed. The examiner expects you to classify the cause (…
Paraesophageal Hernia Repair
Repair of a paraesophageal hernia where the gastric fundus (Type II) or the entire stomach and other organs (Type III/IV) herniate through the hiatus alongside the esophagus. The e…
Stomach
Gastrectomy (Partial & Total)
Partial (distal/subtotal) or total resection of the stomach, most commonly performed for gastric adenocarcinoma, refractory peptic ulcer disease, or GIST tumors. For cancer, the ex…
Vagotomy (Truncal & Highly Selective)
Division of vagal nerve fibers to reduce gastric acid secretion, historically performed for peptic ulcer disease refractory to medical management. Truncal vagotomy divides both vag…
Pyloroplasty
Widening of the pyloric channel to facilitate gastric emptying, most commonly performed as a companion drainage procedure to truncal vagotomy. The Heineke-Mikulicz technique is mos…
Roux-en-Y Gastric Bypass
A combined restrictive and malabsorptive bariatric procedure creating a small (15–30 mL) gastric pouch with a Roux-en-Y gastrojejunal anastomosis. The examiner expects you to know …
Sleeve Gastrectomy
A restrictive bariatric procedure involving resection of approximately 75–80% of the stomach along the greater curvature, creating a tubular gastric sleeve. The examiner expects yo…
PEG Tube Placement
Percutaneous endoscopic gastrostomy — placement of a feeding tube directly into the stomach through the abdominal wall under endoscopic guidance. The examiner expects you to know t…
Graham Patch Repair (Perforated Ulcer)
Emergency repair of a perforated peptic ulcer using a pedicled omental (Graham) patch sutured over the perforation with interrupted silk sutures. The examiner expects you to diagno…
Small Bowel
Small Bowel Resection & Anastomosis
Resection of a segment of small intestine with restoration of intestinal continuity via anastomosis. The examiner expects you to determine the indication, assess bowel viability (c…
Strictureplasty
A bowel-preserving technique that widens a fibrotic stricture without resecting bowel, primarily used in Crohn's disease to prevent short bowel syndrome. The Heineke-Mikulicz techn…
Meckel's Diverticulectomy
Resection of a Meckel's diverticulum, a true diverticulum (containing all bowel wall layers) representing a remnant of the omphalomesenteric (vitelline) duct, found on the antimese…
Lysis of Adhesions for SBO
Operative intervention for small bowel obstruction caused by adhesions, involving careful adhesiolysis to relieve the obstruction. The examiner expects you to first attempt nonoper…
Colon & Rectum
Right Hemicolectomy
Resection of the cecum, ascending colon, and hepatic flexure with an ileocolic anastomosis, performed primarily for right-sided colon cancer. The examiner expects you to describe t…
Left Hemicolectomy
Resection of the splenic flexure and descending colon with a colorectal or colocolic anastomosis, performed for left-sided colon cancers. The examiner expects you to ligate the inf…
Sigmoid Colectomy
Resection of the sigmoid colon with a colorectal anastomosis, the most commonly performed elective colon operation. For diverticular disease, the entire diseased sigmoid must be re…
Total Abdominal Colectomy
Removal of the entire colon from the cecum to the rectosigmoid junction, preserving the rectum. This differs from total proctocolectomy, which also removes the rectum. The examiner…
Low Anterior Resection (LAR)
Resection of the rectum with a colorectal or coloanal anastomosis, preserving the anal sphincter complex. The cornerstone of rectal cancer surgery is total mesorectal excision (TME…
Abdominoperineal Resection (APR)
Combined abdominal and perineal resection of the rectum, anus, and sphincter complex with creation of a permanent end colostomy. APR is indicated when the tumor involves the anal s…
Hartmann's Procedure
Resection of the sigmoid colon with creation of an end colostomy and oversewing/stapling of the rectal stump (Hartmann's pouch), avoiding an anastomosis in a contaminated or unstab…
Colostomy & Ileostomy Creation/Reversal
Creation of an abdominal wall stoma from either colon (colostomy) or ileum (ileostomy) for fecal diversion, and subsequent reversal to restore intestinal continuity. The examiner e…
Hemorrhoidectomy
Surgical excision of hemorrhoidal tissue, most commonly using the Ferguson (closed) or Milligan-Morgan (open) technique. The examiner expects you to classify hemorrhoids by grade (…
Fistulotomy & Fistula-in-Ano Management
Definitive treatment of an anal fistula by laying open the fistula tract (fistulotomy) or using sphincter-preserving techniques for complex fistulas. The examiner expects you to kn…
Lateral Internal Sphincterotomy
Division of the internal anal sphincter muscle in the lateral position to treat a chronic anal fissure that has failed conservative medical therapy. The pathophysiology of chronic …
Rectal Prolapse Repair
Surgical correction of full-thickness rectal prolapse (procidentia), where the full thickness of the rectal wall protrudes through the anus. The examiner expects you to distinguish…
Transanal Excision
Local full-thickness excision of rectal lesions performed transanally, either directly (for distal rectal lesions within reach of retractors) or using a transanal platform (TAMIS —…
Practice Alimentary Tract cases with an AI examiner
Talk through these procedures out loud, exam style. The AI examiner adapts to your answers and introduces complications.