kelsmith4471
Contributor
INDICATIONS FOR SURGERY:
This baby was diagnosed as a newborn with left lung sequestration has been followed and has been doing well at home. He now presents for definitive exploration and resection of left lung sequestration.
PRE-OPERATIVE DIAGNOSIS:
Left lung sequestration.
POST-OPERATIVE DIAGNOSIS:
Left lung sequestration.
ANESTHESIA:
General endotracheal.
SPECIMEN:
PROSTHETIC DEVICE/IMPLANT:
NARRATIVE:
With the patient under adequate anesthesia, he was then placed in the left side up decubitus position. Left chest was then prepped and draped in usual sterile fashion. We had marked out inferior border up to the scapula and a transverse incision was made approximately two fingerbreadths the low-dose. Approximate sixth intercostal space was identified and was then entered and upon entry into the thoracic cavity we followed the lung to the base and we noted feeding vessels coming off the aorta. There were two branches feeding into pulmonary sequestration. These vessels were then dissected free and ligated using silk ligatures and hemoclip. After ligation of these vessels, sequestration was mobilized and we noted that there was intermittent attachment to the left lower lobe and at this juncture then we lifted the specimen into operative field and using a GIA stapling device, we came across the sequestration with a rim of normal-appearing lung tissue. Hemostasis was then obtained. Specimen was handed off to field. Chest tube was placed into the left thoracic cavity and secured in position. Thoracic cavity was then irrigated and the chest was then closed using pericostal sutures of 0 PDS and overlying musculature and fascia closed using running sutures of 3-0 Vicryl and Caprosyn for the skin. Sterile dressing was then placed over suture line. The patient was then returned to the supine position, awakened from anesthesia, and transferred to recovery in stable condition.
This baby was diagnosed as a newborn with left lung sequestration has been followed and has been doing well at home. He now presents for definitive exploration and resection of left lung sequestration.
PRE-OPERATIVE DIAGNOSIS:
Left lung sequestration.
POST-OPERATIVE DIAGNOSIS:
Left lung sequestration.
ANESTHESIA:
General endotracheal.
SPECIMEN:
PROSTHETIC DEVICE/IMPLANT:
NARRATIVE:
With the patient under adequate anesthesia, he was then placed in the left side up decubitus position. Left chest was then prepped and draped in usual sterile fashion. We had marked out inferior border up to the scapula and a transverse incision was made approximately two fingerbreadths the low-dose. Approximate sixth intercostal space was identified and was then entered and upon entry into the thoracic cavity we followed the lung to the base and we noted feeding vessels coming off the aorta. There were two branches feeding into pulmonary sequestration. These vessels were then dissected free and ligated using silk ligatures and hemoclip. After ligation of these vessels, sequestration was mobilized and we noted that there was intermittent attachment to the left lower lobe and at this juncture then we lifted the specimen into operative field and using a GIA stapling device, we came across the sequestration with a rim of normal-appearing lung tissue. Hemostasis was then obtained. Specimen was handed off to field. Chest tube was placed into the left thoracic cavity and secured in position. Thoracic cavity was then irrigated and the chest was then closed using pericostal sutures of 0 PDS and overlying musculature and fascia closed using running sutures of 3-0 Vicryl and Caprosyn for the skin. Sterile dressing was then placed over suture line. The patient was then returned to the supine position, awakened from anesthesia, and transferred to recovery in stable condition.