nsteinhauser
Expert
Hi there! I have an op note here that I'm having trouble coding. If anyone has any thoughts, I would love to hear them. The measurements of the lipomas were not taken, per the surgeon.The patient was taken to the OR, placed on table in the supine position. After induction of general anesthesia, his entire abdomen and chest was prepped and draped in the usual sterile fashion. The patient basically had his pannus replaced by multiple sizeable bothersome lipomas so we decided to remove the entire tissue. He was marked in a standing position. An ellipse was drawn from just over his umbilicus to the suprapubic area. Tumescent solution was then infiltrated along the proposed incisions, as well as on the lipomas on his upper abdomen which were fairly sizable and one on his right breast which was fairly sizable. Suction-assisted lipectomy was carried out to remove these lipomas using 3 mm and 4 mm cannula. Next, a 10 blade was used to excise the lower abdominal tissue and flap was raised to the umbilicus. A circum-umbilical incision was made and the inferior pannus was split in two and the entire lower tissue was removed, 1957 grams was removed. Once this was done, a new opening was made for the umbilicus via a vertical incision and the umbilicus was brought out through this opening and secured with 4-0 and 5-0 Monocryl sutures. Drains were placed and these were brought out through separate stab wounds in the suprapubic area and secured with 3-0 nylon sutures. The lower incision was closed in layers after washing with DAB solution and obtaining hemostasis with 3-0 Vicryl and a running 4-0 Monocryl stitch. He tolerated the procedure well, was sent to recovery in stable condition.