MSUEEMBRY
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1. subtotal colectomy basically removing right colon and transverse colon
2. Extensive lysis of adhesions
3. Rapair of 2 iatrogenic small bowel injuries
4. Ileocolic side to side anastomosis
the abdomen was entered, extensive lysis of adhesions performed between small bowel omentum to anterior abdominal wall.
The patient has descending end ostomy in left side of abdomen, liver normal, gallbladder absent, pancreas and retroperitoneum normal, extensive adhesions involving small bowel to ligament of Treitz to terminal ileum. In process of lysis of adhesions 2 enterotomies were created mid jejunum and mid small bowel. They were repaired.
The right colon was mobilized and the transverse colon was mobilized. The splenic flexure was not mobilized. The patient has end ostomy on left side of body and incision was made in skin and ostomy was dissected off abdominal wall then delivered back into the abdomen and mobilized.
the patient has a segement of left colon attached to the rectum from previous surgery, measuring about 1 foot long. The mesentery to the transvers colon, splenic flexure and right colon was taken down close to the bowel in order to prevent damage to marginal artery. The blood supply to the specimen in the right colon specimen was removed and opened and examined.
After this procedure was done, a sis to side terminal ileum to left colon asastomosis was performed, the mesentery defect was closed. The abdomen was washed out, counts were correct, no bleeding, anastomosis was secure, the enterotomies were secure, the bowel was laid down, not twisted, the abdominal wall defect from the ostomy was closed. the abdominal fascia was closed, skin left open and packed.
2. Extensive lysis of adhesions
3. Rapair of 2 iatrogenic small bowel injuries
4. Ileocolic side to side anastomosis
the abdomen was entered, extensive lysis of adhesions performed between small bowel omentum to anterior abdominal wall.
The patient has descending end ostomy in left side of abdomen, liver normal, gallbladder absent, pancreas and retroperitoneum normal, extensive adhesions involving small bowel to ligament of Treitz to terminal ileum. In process of lysis of adhesions 2 enterotomies were created mid jejunum and mid small bowel. They were repaired.
The right colon was mobilized and the transverse colon was mobilized. The splenic flexure was not mobilized. The patient has end ostomy on left side of body and incision was made in skin and ostomy was dissected off abdominal wall then delivered back into the abdomen and mobilized.
the patient has a segement of left colon attached to the rectum from previous surgery, measuring about 1 foot long. The mesentery to the transvers colon, splenic flexure and right colon was taken down close to the bowel in order to prevent damage to marginal artery. The blood supply to the specimen in the right colon specimen was removed and opened and examined.
After this procedure was done, a sis to side terminal ileum to left colon asastomosis was performed, the mesentery defect was closed. The abdomen was washed out, counts were correct, no bleeding, anastomosis was secure, the enterotomies were secure, the bowel was laid down, not twisted, the abdominal wall defect from the ostomy was closed. the abdominal fascia was closed, skin left open and packed.