drhoads
Guru
Procedure Performed: Excision of sinus tract and removal of mesh. Closureof gastrotomy.
Description of procedure: After the induction of general anesthesia, the pt was prepped and draped in sterile fashion. Methylene blue was instilled within the sinus tract with q-tip. The opening to the sinus tract was elliptically excised and the tract was followed down to the abd wallwith the discovery of the infected mesh. The incision was therefore extended to allow excision of the mesh and this was quite tedious. It was carefully dissected from the overlyng abdominal wall and once the margin was reached, we were able to get within the adb cavity and take down the underlying adhesions from omentum as wall as the above noted adhesions to gastric wall and small portion of the liver. After removing the mesh from the gastric adhesion, the opening was grasped in Allis clamps and closed with TA-55 stapler. The staple line was oversewn with a running suture of 3-0 Prolene. The mesh was finally excised and note this was done in segments depending on exposure. The adhesions to the adb were taken down about 3-4 cm in all directions around the wound edges to allow placement of the sutures. The wound was copiously irrigated with the skin loosely reapproximated with widely spaced staples and packed between the antibiotic solution-soaked kling.
Description of procedure: After the induction of general anesthesia, the pt was prepped and draped in sterile fashion. Methylene blue was instilled within the sinus tract with q-tip. The opening to the sinus tract was elliptically excised and the tract was followed down to the abd wallwith the discovery of the infected mesh. The incision was therefore extended to allow excision of the mesh and this was quite tedious. It was carefully dissected from the overlyng abdominal wall and once the margin was reached, we were able to get within the adb cavity and take down the underlying adhesions from omentum as wall as the above noted adhesions to gastric wall and small portion of the liver. After removing the mesh from the gastric adhesion, the opening was grasped in Allis clamps and closed with TA-55 stapler. The staple line was oversewn with a running suture of 3-0 Prolene. The mesh was finally excised and note this was done in segments depending on exposure. The adhesions to the adb were taken down about 3-4 cm in all directions around the wound edges to allow placement of the sutures. The wound was copiously irrigated with the skin loosely reapproximated with widely spaced staples and packed between the antibiotic solution-soaked kling.