amanda19791
Networker
Could some one give me advice on the procedure for resection of mesenteric mass?
Procedure:
Resection of mesenteric mass
Dx:
Left lower quadrant abdominal mass [R19.04]
The patient was placed in the supine position. Adequate anesthesia was initiated. Antibiotics were administered. The abdomen was prepped and draped in a sterile fashion. A small umbilical incision was made and brought down through the subcutaneous tissues and fascia. A 5mm Step trocar was placed through this incision into the peritoneum. Pneumoperitoneum was established with carbon dioxide to 15mmHg, which was tolerated well. A 5mm 30-degree laparoscope was inserted and exploration was undertaken. A 12mm trocar was placed in the left upper quadrant and another 5mm one in the right lower quadrant. The mass was identified in the expected location. It was readily dissected out bluntly, though the most distal (closest to the intestine) was divided with cautery owing to a suspected pedicle. The mass was brought out through the left upper quadrant trocar site in an EndoPouch and sent to Pathology for frozen section, with the results as listed above. Hemostasis was assured. The fascia of the left upper quadrant incision was closed with a 2-0 Vicryl suture. Each incision was closed with subcuticular 4-0 Monocryl sutures and Dermabond. The procedure was well tolerated and there were no apparent complications.
Procedure:
Resection of mesenteric mass
Dx:
Left lower quadrant abdominal mass [R19.04]
The patient was placed in the supine position. Adequate anesthesia was initiated. Antibiotics were administered. The abdomen was prepped and draped in a sterile fashion. A small umbilical incision was made and brought down through the subcutaneous tissues and fascia. A 5mm Step trocar was placed through this incision into the peritoneum. Pneumoperitoneum was established with carbon dioxide to 15mmHg, which was tolerated well. A 5mm 30-degree laparoscope was inserted and exploration was undertaken. A 12mm trocar was placed in the left upper quadrant and another 5mm one in the right lower quadrant. The mass was identified in the expected location. It was readily dissected out bluntly, though the most distal (closest to the intestine) was divided with cautery owing to a suspected pedicle. The mass was brought out through the left upper quadrant trocar site in an EndoPouch and sent to Pathology for frozen section, with the results as listed above. Hemostasis was assured. The fascia of the left upper quadrant incision was closed with a 2-0 Vicryl suture. Each incision was closed with subcuticular 4-0 Monocryl sutures and Dermabond. The procedure was well tolerated and there were no apparent complications.