01085585
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Pre-op dx- small recurrent inguinl hernia and rt inguinal pain and retration of testis.
Post-op: Externsive adhesions of caught in contents to surrounding tissues with retraction of testis. No obvious hernia identified and no obvious neuroma identified.
Procedure: Rt inguinal recurrent hernia exploration, right inguinal region exploration, lysis of adhesions, binding the testis with replacement of the testis in the scrotum.
Procedure in detail:Rt inguinal region was prepped and draped aspetically. Previous scar was excised. The incision was deepened through the subcutaneous tissue. The external oblique aponeurosis was dissected off the subcantaneous tissue and the inguinal canal opened. There were extensive adhesions. These adhesions were taken down.
Procedure was carried out under magnification. There was no neuroma identified to account for the pain. The hernia described the the CT scancould not be identified. There was a small cystic area in the medial aspect of the internal ring which most likely was what was being described. This was emptied. It was not connecting with the peritoneal cavity. After the adhesions were taken down, it was possible to retract the testis into the wound and the testis was then repositioned in the scrotum. The woundwas then closed. The external oblique aponeurosis being closed with a running suture and skin was closed using running subcuticular suture. After closing, the testis was again tugged down into the scortum and was found to be lying comfortably in the scrotum. The patient tolerated well.
That is the op not for procedure.. Any help or guidance would be appreciated.
Post-op: Externsive adhesions of caught in contents to surrounding tissues with retraction of testis. No obvious hernia identified and no obvious neuroma identified.
Procedure: Rt inguinal recurrent hernia exploration, right inguinal region exploration, lysis of adhesions, binding the testis with replacement of the testis in the scrotum.
Procedure in detail:Rt inguinal region was prepped and draped aspetically. Previous scar was excised. The incision was deepened through the subcutaneous tissue. The external oblique aponeurosis was dissected off the subcantaneous tissue and the inguinal canal opened. There were extensive adhesions. These adhesions were taken down.
Procedure was carried out under magnification. There was no neuroma identified to account for the pain. The hernia described the the CT scancould not be identified. There was a small cystic area in the medial aspect of the internal ring which most likely was what was being described. This was emptied. It was not connecting with the peritoneal cavity. After the adhesions were taken down, it was possible to retract the testis into the wound and the testis was then repositioned in the scrotum. The woundwas then closed. The external oblique aponeurosis being closed with a running suture and skin was closed using running subcuticular suture. After closing, the testis was again tugged down into the scortum and was found to be lying comfortably in the scrotum. The patient tolerated well.
That is the op not for procedure.. Any help or guidance would be appreciated.