ksb0211
Guest
This is the scrubbed op report. Any suggestions would be appreciated. Thanks.
Postoperative diagnosis:
Incarcerated internal hernia
Description of procedure:
...
An incision was made in the midline. The patient is quite obese with a BMI of 37. We entered the abdominal cavity and we were able to see that most of the bowel was decompressed but there was a large distended loop and as we tracked that back, we could see that there was a loop that was adhesed between probably the mid-jejunum and the dome of the uterus. With some difficulty, we had to use the Bookwalter, we were able to expose this area and because of the patient's girth, this made it a little bit more difficult than it normally would have been but eventually we were able to get that loop up. We <struggled> to some extent but we were able to get it up and at that point, the internal herniation was resolved. We then decompressed the small bowel back, we just sort of expressed the succuss entericus back up into the stomach and suction aspirated it. That allowed us to have decompressed gut so we could work more efficiently in this relatively small abdominal compartment in a very heavy patient. We then carefully <placed> the bowel in its normal anatomic position, laid it back in the abdominal cavity, covered it with the omentum, irrigated and closed with double stranded #1 PDS placed in two layers, followed by irrigation of th ewound, followed by 3-0 Vicryl, followed by skin staples....
Any suggestions?
Thanks.
~Kelly~
Postoperative diagnosis:
Incarcerated internal hernia
Description of procedure:
...
An incision was made in the midline. The patient is quite obese with a BMI of 37. We entered the abdominal cavity and we were able to see that most of the bowel was decompressed but there was a large distended loop and as we tracked that back, we could see that there was a loop that was adhesed between probably the mid-jejunum and the dome of the uterus. With some difficulty, we had to use the Bookwalter, we were able to expose this area and because of the patient's girth, this made it a little bit more difficult than it normally would have been but eventually we were able to get that loop up. We <struggled> to some extent but we were able to get it up and at that point, the internal herniation was resolved. We then decompressed the small bowel back, we just sort of expressed the succuss entericus back up into the stomach and suction aspirated it. That allowed us to have decompressed gut so we could work more efficiently in this relatively small abdominal compartment in a very heavy patient. We then carefully <placed> the bowel in its normal anatomic position, laid it back in the abdominal cavity, covered it with the omentum, irrigated and closed with double stranded #1 PDS placed in two layers, followed by irrigation of th ewound, followed by 3-0 Vicryl, followed by skin staples....
Any suggestions?
Thanks.
~Kelly~