Wiki Open revision of subq port & lap revision of gastric lap band

nlbarnes

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43866 & 43999?

5-mm trocar was placed under direct vision with the
Optiview system without difficulty. We did immediately entered the
abdomen and under direct observation, the abdomen completely
insufflated. We identified the band tubing in the left lower
quadrant, which was just lying on some small intestines and it was not
damaging any intestines. There was no purulence associated with it.
We placed additional trocars, 5 mm right upper quadrant and midline to
facilitate the revision. Then essentially we made an incision over
the band port and freed up the band port, identified the tubing of the
band port that was disconnected in the subcutaneous tissue. Once this
was freed up, we then made a separate stab wound incision, but this
one was actually too close to the band port, so we actually used our
initial left lower quadrant 5 mm port site to bring the band tubing
from the abdomen up into the incision where the band port was. We
then freshened up the free end of the band tubing and by cutting it
and then using the metal connector that was already in place, we then
reconnected the band tubing and made it so that it was going into the
abdomen through the 5 mm trocar site very flushed without any problems
and not kinking. We did suture the port with a 2-0 Prolene suture in
1 area where we had cut 1 suture, but we left the other sutures
intact, so the port was very nicely left in place. We then used a
Huber needle. We did aspirate out plenty of air from the system using
the Huber needle attached to a 10 mL syringe with saline and we did
also note that there was 2 mL of saline already within the band.
 
43886, because it was only manipulated and put back. It was not removed as some are leaving only the band in place and it was not replaced with another. Since there was no note of puncture to the port from missing the mark at adjustment time.
 
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