elainehopf
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one of my doctors did a right and left scrotal excision of masses ..I can not seem to find anything to fit the procedure ..
Any thoughts ??
weight loss and these bilateral scrotal masses were noted. The Transplant
Service consulted Urology after obtaining an ultrasound which showed that
he had these scrotal masses not associated with either testicle, epididymis
or cord. PTLD is in the discussion of what this could be and Transplant
Service wanted us to get tissue confirmation to either confirm or refute,
discussed excising both with the patient. He agreed understanding
potential complications of infection, bleeding, scrotal hematoma, pain. He
consented accordingly.
DESCRIPTION OF OPERATION: The patient was taken to the operating room. He
was identified verbally and by wrist bracelet. Preoperative IV antibiotics
were given. He was placed on the operative table. IV sedation was given.
Once in place, he was then placed in relaxed dorsal lithotomy. His scrotum
was shaved, prepped and draped. Attention was drawn first to the right
scrotal mass, which was smaller. Lidocaine was used over the mass and a
knife was used to make a horizontal incision over the mass. Pickups with
teeth and fine tenotomy scissors were used to begin showing up this mass
under the scrotal skin, a little bit of bleeding was encountered. I did
end up cauterizing that with the Bovie, able to get around the entire mass
and submit that in whole. Again, reinspection of the right scrotum where
the mass was excised was meticulous and any bleeding was managed with the
Bovie cautery. Attention was drawn to the left scrotal mass. Again,
lidocaine was used over the planned incision. An incision was made with a
15 blade. Again, tenotomy scissors were used to begin to shell out this
mass. We then turned to Metzenbaum scissors and using a combination of
sharp dissection and cautery, the mass was excised. Note that this mass
looked grossly different than the other and that there was some fluid noted
within the mass but did get expressed as this mass was being excised,
almost looked a bit cystic; however, was submitted as a separate specimen.
Again, reinspection of the left scrotum where this mass was performed and
any bleeding was cauterized. Again, the skin edges were closed from both
of these incisions using 4-0 chromic. Bacitracin was applied over both
incisions. Fluffs and mesh panties were applied. The patient was then
taken out of lithotomy. He was awoken and transferred to the recovery room
stretcher and taken to the recovery room in stable condition.
Any thoughts ??
weight loss and these bilateral scrotal masses were noted. The Transplant
Service consulted Urology after obtaining an ultrasound which showed that
he had these scrotal masses not associated with either testicle, epididymis
or cord. PTLD is in the discussion of what this could be and Transplant
Service wanted us to get tissue confirmation to either confirm or refute,
discussed excising both with the patient. He agreed understanding
potential complications of infection, bleeding, scrotal hematoma, pain. He
consented accordingly.
DESCRIPTION OF OPERATION: The patient was taken to the operating room. He
was identified verbally and by wrist bracelet. Preoperative IV antibiotics
were given. He was placed on the operative table. IV sedation was given.
Once in place, he was then placed in relaxed dorsal lithotomy. His scrotum
was shaved, prepped and draped. Attention was drawn first to the right
scrotal mass, which was smaller. Lidocaine was used over the mass and a
knife was used to make a horizontal incision over the mass. Pickups with
teeth and fine tenotomy scissors were used to begin showing up this mass
under the scrotal skin, a little bit of bleeding was encountered. I did
end up cauterizing that with the Bovie, able to get around the entire mass
and submit that in whole. Again, reinspection of the right scrotum where
the mass was excised was meticulous and any bleeding was managed with the
Bovie cautery. Attention was drawn to the left scrotal mass. Again,
lidocaine was used over the planned incision. An incision was made with a
15 blade. Again, tenotomy scissors were used to begin to shell out this
mass. We then turned to Metzenbaum scissors and using a combination of
sharp dissection and cautery, the mass was excised. Note that this mass
looked grossly different than the other and that there was some fluid noted
within the mass but did get expressed as this mass was being excised,
almost looked a bit cystic; however, was submitted as a separate specimen.
Again, reinspection of the left scrotum where this mass was performed and
any bleeding was cauterized. Again, the skin edges were closed from both
of these incisions using 4-0 chromic. Bacitracin was applied over both
incisions. Fluffs and mesh panties were applied. The patient was then
taken out of lithotomy. He was awoken and transferred to the recovery room
stretcher and taken to the recovery room in stable condition.