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OB/GYN Residency
Laparoscopic BSO
Patient Name: ***
MRN: ***
Procedure Date: ***
Attending Surgeon: ***
Assistant: ***
PREOPERATIVE DIAGNOSIS: A ***-year-old, G*** P*** with ***, desires definitive management.
POSTOPERATIVE DIAGNOSIS: Same***
PROCEDURE: Laparoscopic bilateral salpingo-oophorectomy.
SURGEON: ***
ASSISTANT: ***
ANESTHESIA: General.
IV FLUIDS: ***
EBL: ***
UOP: ***
SPECIMENS: Bilateral tubes and ovaries.
FINDINGS: ***
DESCRIPTION OF PROCEDURE: The patient was re-consented as to the risks/benefits and indications of her procedure and was taken to the operating room where SCD devices were placed on both calves and general anesthesia was administered. She was then placed in dorsal lithotomy position and prepped and draped in the usual sterile fashion. A time out was performed. Retractors were placed to reveal the cervix. A single-tooth tenaculum was used to grasp the anterior lip of the cervix and the uterus was sounded to ***. A Humi uterine manipulator was then inserted and inflated. All other remaining instruments were then removed from the cervix and the vagina.
Attention was then turned to the abdomen where a *** Veress needle attached to CO2 gas was inserted through the umbilicus with entering pressures noted to be 0 mm Hg and the abdomen was insufflated to 15 mm Hg. **5-mm transverse umbilical incision was made with a scalpel. The abdomen was entered under direct visualization using a Visiport. A survey of the abdomen revealed findings as noted above. A 5 mm trocar and 12 mm trocar were inserted in the left and right lower quadrants respectively under direct visualization after injection of lidocaine***. The ureters were identified, and the IP ligaments were separately dissected and ligated and transected using the Ligasure device. The fallopian tubes were then transected from the uterus approximately 5 mm from the cornua using the ligasure. Both specimens were removed through ***.
All specimens were sent to Pathology. The surgical sites were then examined and noted to be hemostatic. ***The 12 step port was then closed with #0 Vicryl using a Carter Thomason device and a Grice needle. Following this, all instruments and the remaining ports were removed from the abdomen, which was then desufflated. All trocar sites were then closed with #4-0 Biosyn in a subcuticular fashion. The patient tolerated procedure well and was taken to recovery room in stable condition. All instrument, needle, and sponge counts were correct x3.
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