Korbc
Expert
hey guys!
the following is a portion of the procedure, my doc sent it through as open abdominal myomectomy with mod 53 but from what i see she still did lapro because the port incision was just extended and she just used trocars instead of the da vinci and she morcellated with a blade. But just want to double check, i don't see anything open about this procedure but as I'm still learning i might be way off. But I think still lapro since she trocars were used? it's just not robotic assisted but lapro assisted technically?..... and to my knowledge expanding ports sites doesn't count toward open... it's not the full report but just the main portion
thanks!
Two 8 mm robotic ports were then placed on the left side, the first 8 cm lateral and 2 cm inferior to the camera port and the second another 8 cm lateral and 2 cm inferior to that port. A single 8 mm robotic port was placed on the right side approximately 12 cm lateral to the umbilicus. Steep Trendelenburg was applied to the patient. A side-dock approach was taken for Da Vinci placement. The Da Vinci laparoscope was then docked and targeting performed.
Survey of the pelvis revealed uterus deviated to patient's right pelvic sidewall with large adnexal mass measuring approximately 6-7 cm. Posterior uterine fibroid noted with overlying dense adhesion to bowel. Posterior cul de sac obliterated. Vesicular lesions on surface of posterior uterus noted most consistent with endometriosis. Right fallopian tube with narrowing at the ampulla. Intraoperative photographs obtained. Decision was made to abort procedure.
The robot was undocked and the 8 mm camera port was replaced with a 15 mm port. A bag was placed through the port, and the fibroids were placed into the bag. The bag was brought out via the umbilical incision after enlarging the incision. The myomas were morcellated using a #10 blade within the bag. The supraumbilical fascia was closed with running 0-vicryl suture. The trochars were removed, and the pneumoperitoneum was decompressed. The incisions were closed with a 4-0 Monocryl in a subcuticular fashion and covered with Dermabond.
the following is a portion of the procedure, my doc sent it through as open abdominal myomectomy with mod 53 but from what i see she still did lapro because the port incision was just extended and she just used trocars instead of the da vinci and she morcellated with a blade. But just want to double check, i don't see anything open about this procedure but as I'm still learning i might be way off. But I think still lapro since she trocars were used? it's just not robotic assisted but lapro assisted technically?..... and to my knowledge expanding ports sites doesn't count toward open... it's not the full report but just the main portion
thanks!
Two 8 mm robotic ports were then placed on the left side, the first 8 cm lateral and 2 cm inferior to the camera port and the second another 8 cm lateral and 2 cm inferior to that port. A single 8 mm robotic port was placed on the right side approximately 12 cm lateral to the umbilicus. Steep Trendelenburg was applied to the patient. A side-dock approach was taken for Da Vinci placement. The Da Vinci laparoscope was then docked and targeting performed.
Survey of the pelvis revealed uterus deviated to patient's right pelvic sidewall with large adnexal mass measuring approximately 6-7 cm. Posterior uterine fibroid noted with overlying dense adhesion to bowel. Posterior cul de sac obliterated. Vesicular lesions on surface of posterior uterus noted most consistent with endometriosis. Right fallopian tube with narrowing at the ampulla. Intraoperative photographs obtained. Decision was made to abort procedure.
The robot was undocked and the 8 mm camera port was replaced with a 15 mm port. A bag was placed through the port, and the fibroids were placed into the bag. The bag was brought out via the umbilical incision after enlarging the incision. The myomas were morcellated using a #10 blade within the bag. The supraumbilical fascia was closed with running 0-vicryl suture. The trochars were removed, and the pneumoperitoneum was decompressed. The incisions were closed with a 4-0 Monocryl in a subcuticular fashion and covered with Dermabond.
