nagivijay
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Procedure details:
Patient was brought to the operating room placed in supine position general anesthesia was induced all complications IV antibiotics administered prior to incision bilateral pneumatics were placed patient was then prepped and draped usual sterile fashion I went ahead began with a left upper quadrant incision using Optiview technique abdominal cavity was accessed we then insufflated to appropriate pressures this was then followed by placement of 3 additional trochars suprapubic left lower quadrant left mid lateral after all trochars placed surveyed the abdomen findings are stained summary we then proceeded to docked the robot once robot was docked I was able to mobilize the appendix off the sidewall also took the mesoappendix using combination of bipolar cautery as well as Metzenbaum scissors. Once appendix has been completely mobilized we went inserted a blue sure form 60 stapler and I took the cecum along the inferior border of the terminal ileum as well as the appendix. I was able to go across with 1 firing. After this was performed there was little bleeding vessel the lateral edge of the staple line which was easily controlled with just a touch of bipolar cautery. After this was done we went ahead undocked the robot LapSac was placed in the peritoneal cavity appendix and the mesoappendix was placed I then extended the 12 mm trocar site in the left mid lateral abdomen appendix came out with ease no struggling whatsoever. No spillage of content. We then went ahead and closed that defect using a 0 Vicryl suture utilizing Carter Thompson suture passer. Suctioned out the minimal blood that was present within infiltrated all the wounds local anesthetic bupivacaine this then followed by closure with 4-0 Vicryl subcuticular dressed with Exofin. Overall she tolerated the procedure well blood loss minimal less than 10 cc sponge needle counts correct x2 at the end of the case.
Procedure details:
Patient was brought to the operating room placed in supine position general anesthesia was induced all complications IV antibiotics administered prior to incision bilateral pneumatics were placed patient was then prepped and draped usual sterile fashion I went ahead began with a left upper quadrant incision using Optiview technique abdominal cavity was accessed we then insufflated to appropriate pressures this was then followed by placement of 3 additional trochars suprapubic left lower quadrant left mid lateral after all trochars placed surveyed the abdomen findings are stained summary we then proceeded to docked the robot once robot was docked I was able to mobilize the appendix off the sidewall also took the mesoappendix using combination of bipolar cautery as well as Metzenbaum scissors. Once appendix has been completely mobilized we went inserted a blue sure form 60 stapler and I took the cecum along the inferior border of the terminal ileum as well as the appendix. I was able to go across with 1 firing. After this was performed there was little bleeding vessel the lateral edge of the staple line which was easily controlled with just a touch of bipolar cautery. After this was done we went ahead undocked the robot LapSac was placed in the peritoneal cavity appendix and the mesoappendix was placed I then extended the 12 mm trocar site in the left mid lateral abdomen appendix came out with ease no struggling whatsoever. No spillage of content. We then went ahead and closed that defect using a 0 Vicryl suture utilizing Carter Thompson suture passer. Suctioned out the minimal blood that was present within infiltrated all the wounds local anesthetic bupivacaine this then followed by closure with 4-0 Vicryl subcuticular dressed with Exofin. Overall she tolerated the procedure well blood loss minimal less than 10 cc sponge needle counts correct x2 at the end of the case.