lindacoder
Guest
Patient had undergone robotic prostatectomy earlier. General surgeon called in for exploration:
In the supine position the abdomen was prepped and draped. The site where the hematoma was on the right abdominal wall, I opened up and extended that port site. There was a large amount of clot resting underneath the anterior rectal sheath, but above the posterior rectal sheath. We were then able to evacuate the hematoma and irrigated out. There was approximately 150 mL of blood. THere was some oozing from the muscle site, but no actgive bleeding vessel identified. After ensuring that we completely evacuated this, to be safe we looked intraabdominally. Therefore I opened up his incision on his left lateral abdominal wall, and under direct visulalizationi a 5 mm Optiview port wa placed. The abdomen was infullated with 15 cm of pressure. Upon looking in the abdomen there was no significant blood at all present in the abdomen. You could see back up to the abdominal wall where that hematoma had been and there were no signs of bleeding intraabdominally from either. Therefore, after ensuring that lookied good, the air and instruments were removed. I then went back and explored the wound. You could see some bleeding sites from the muscle. I closed the posterior rectal sheath where the opening had been where it was oozy with a running 0 Vicryl. I then closed the anterior rectal sheath with running 0 Vicryls. Subcutaneous tissues closed with running 0 Vicry. The skin edges were approximated with running 4-0 Monocry. subcuticular stitch. Steri-strips and dressing applied.
Is there enough for 10140 and 49320 together????
Thanks
In the supine position the abdomen was prepped and draped. The site where the hematoma was on the right abdominal wall, I opened up and extended that port site. There was a large amount of clot resting underneath the anterior rectal sheath, but above the posterior rectal sheath. We were then able to evacuate the hematoma and irrigated out. There was approximately 150 mL of blood. THere was some oozing from the muscle site, but no actgive bleeding vessel identified. After ensuring that we completely evacuated this, to be safe we looked intraabdominally. Therefore I opened up his incision on his left lateral abdominal wall, and under direct visulalizationi a 5 mm Optiview port wa placed. The abdomen was infullated with 15 cm of pressure. Upon looking in the abdomen there was no significant blood at all present in the abdomen. You could see back up to the abdominal wall where that hematoma had been and there were no signs of bleeding intraabdominally from either. Therefore, after ensuring that lookied good, the air and instruments were removed. I then went back and explored the wound. You could see some bleeding sites from the muscle. I closed the posterior rectal sheath where the opening had been where it was oozy with a running 0 Vicryl. I then closed the anterior rectal sheath with running 0 Vicryls. Subcutaneous tissues closed with running 0 Vicry. The skin edges were approximated with running 4-0 Monocry. subcuticular stitch. Steri-strips and dressing applied.
Is there enough for 10140 and 49320 together????
Thanks