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Epigastric Hernia – Open Suture Repair

General Surgery /

INCISION:Longitudinal incision over herniation in midline.FINDINGS: Epigastric hernia …cm defect with pre-peritoneal fat herniation.Contained only pre-peritoneal fat appearing healthy, no bowel involvement.PROCEDURE: Herniations cleared all round.Reduction of herniated fat.Ensured adequate clearance of fascia all around.CLOSURE:No 1 Ethilon interrupted fascial sutures closing hernial defect.Subcutaneous tissue approximated with 2.0 Vicryl.3.0 Monocryl Subcuticular sutures to skin.Dressings applied.

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Delorme’s operation

Colorectal /

INCISION: A single midline incision was made in the perineum.PROCEDURE:The prolapsed rectum was identified and mobilized.The rectal mucosa was resected leaving a cuff of 1cm of rectal wall remaining.The rectal cuff was then sutured to the sacral promontory using a non-absorbable suture and the rectal prolapse was corrected.Haemostasis was ensured.FINDINGS:CLOSURE:The skin incision was closed in

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Hiatus Hernia Repair

Upper GI /

INCISION: Primary port put in by open Hasson technique using blunt Hasson port.Secondary ports put in with direct visualisation.Five ports were used: one 12mm port in the umbilicus, and four 5mm ports in the left upper quadrant, right upper quadrant, left mid-clavicular line and right mid-clavicular line.FINDINGS:PROCEDURE:The stomach was mobilized and the esophagus was identified.The

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Nissen Fundoplication

Upper GI /

INCISION: Primary port put in by open Hasson technique using blunt Hasson port.Secondary ports put in with direct visualisation.Five ports were used: one 12mm port in the umbilicus, and four 5mm ports in the left upper quadrant, right upper quadrant, left mid-clavicular line and right mid-clavicular line.FINDINGS:PROCEDURE:The stomach was mobilized and the esophagus was identified.The

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Generic Template

General Surgery /

PRE-OPERATIVE Operation: Indication:Date: CEPOD: Surgeon:Assistant:Anaesthetist: Anaesthetic: ASA Grade: WHO Checklist: Antibiotics: Urinary Catheter:Patient Position: INTRA-OP Ports:Findings:Procedure:Closure: POST OPERATIVE INSTRUCTIONS Observations Q4HPost op bloods tomorrow (ddmmyy)Diet: Eat and Drink as toleratedLMWH at 18:00 hours

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Sigmoid Colectomy (Laparoscopic)

Colorectal /

INCISION: Primary port put in by open Hasson technique using blunt Hasson portSecondary ports under direct visualisationFour ports were used: one 12mm port in the umbilicus, and three 5mm ports in the left lower quadrant, right lower quadrant, and left mid-clavicular line.FINDINGS:PROCEDURE:The colon was mobilized and the sigmoid colon was identified.The mesentery was divided with

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Anterior Resection of the Rectum (Laparoscopic)

Colorectal /

INCISION: Primary port put in by open Hasson technique using blunt Hasson portSecondary ports under direct visualisationA 12mm port was placed in the umbilicus and three 5mm ports were placed in the left lower quadrant, right lower quadrant, and left mid-clavicular line.FINDINGS:PROCEDURE:The abdominal cavity was insufflated to 12mmHg with CO2.The colon was mobilized and the

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Right Hemicolectomy (Laparoscopic)

Colorectal /

INCISION:Ports: One 10mm blunt Hasson port introduced using open Hasson technique. Three 5mm ports introduced under direct visualisation, of which two in RUQ and one in RIF.FINDINGS:PROCEDURE:Left lateral position: Lateral to medial mobilisation of right colon with identification and preservation of the ureter and duodenum.Supine position: Right colic and right branch of middle colic artery

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Appendicectomy (Laparoscopic)

General Surgery /

INCISION: Open Hasson technique, Supraumbilical 10mm Hasson Blunt port, LIF 5mm and Suprapubic 5mm ports under direct visionFINDINGS:Inflammed Appendix with free fluid pelvisPROCEDURE:Appendix identifiedAdhesions taken offClips to appendicular vessels. Endoloop on Appendicular vessels as well.Endoloops 3 x PDS on Appendix base, 2 to stay.Appendix divided at base and brought out using BERT bagSuction irrigationHemostasis ensuredInstrument

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Cholecystectomy (Laparoscopic)

General Surgery, HPB, Upper GI /

INCISION: SupraUmbilical Open Hasson 10 mm port. 10 mm epigastric, 5mm right Sub costal and 5mm right lumbar under direct vision.FINDINGS:Elongated Gall BladderPROCEDURE:Correct identification of anatomical structures.Cystic duct and artery identified and dissected. Critical view achieved. Hem-O-loks applied.Cholecystectomy performed in standard fashion.Hemostasis and biliostasis ascertained in surgical bed.Washout with Normal Saline. Suction irrigation.No. 20 F

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