jacqiebarnes
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PREOP DX: Intracranial hypotension related cyst pleural shunt
POST OP DX: Same
Procedure: LIGATION OF THORACIC CYST - PLEURAL SHUNT
Description of Procedure:
The patient was taken to the operating suite and after the induction of general anesthesia the patient was positioned prone on the Jackson table. She was given preoperative antibiotics. The thoracic area was prepped and draped in standard fashion. Intraoperative fluoroscopy was used to localize the shunt tubing. The preop imaging suggested that both the cervical and thoracic catheter were in close proximity before entering the chest. The skin was marked over the catheters and the skin incisions then carried down to the fascia. The catheters could not be located and a second incision was made over the midline where the catheters looped before they entered the soft tissue over the chest wall. Only a single catheter was identified and it was presumed that the second catheter was already intrapleural and at some higher point and then enterer the right chest cavity. The exposed thoracic catheter was ligated with a 2.0 silk ligature. Both wounds were then irrigated copiously with saline and prepared for closure. The fascia was reapproximated with 2.0 vicryl. Subsequent layers were closed with 3.0 vicryl. A running statofix suture was used to close the skin in a subcuticular manner. Wide steri strips were used to cover the skin closure. Sponge and needle counts were correct. The patient was stable throughout the procedure and transferred to the recovery area in good condition.
PREOP DX: Intracranial hypotension related cyst pleural shunt
POST OP DX: Same
Procedure: LIGATION OF THORACIC CYST - PLEURAL SHUNT
Description of Procedure:
The patient was taken to the operating suite and after the induction of general anesthesia the patient was positioned prone on the Jackson table. She was given preoperative antibiotics. The thoracic area was prepped and draped in standard fashion. Intraoperative fluoroscopy was used to localize the shunt tubing. The preop imaging suggested that both the cervical and thoracic catheter were in close proximity before entering the chest. The skin was marked over the catheters and the skin incisions then carried down to the fascia. The catheters could not be located and a second incision was made over the midline where the catheters looped before they entered the soft tissue over the chest wall. Only a single catheter was identified and it was presumed that the second catheter was already intrapleural and at some higher point and then enterer the right chest cavity. The exposed thoracic catheter was ligated with a 2.0 silk ligature. Both wounds were then irrigated copiously with saline and prepared for closure. The fascia was reapproximated with 2.0 vicryl. Subsequent layers were closed with 3.0 vicryl. A running statofix suture was used to close the skin in a subcuticular manner. Wide steri strips were used to cover the skin closure. Sponge and needle counts were correct. The patient was stable throughout the procedure and transferred to the recovery area in good condition.