OperationNote

Paraumbilical Hernia Open Suture Repair

INCISION:Longitudinal incision over herniation in midlineFINDINGS:ParaUmbilical hernia 1cm defect with pre-peritoneal fat herniation.Contained only pre-peritoneal fat appearing healthy, no bowel involvement.PROCEDURE:Herniations cleared all round.Excess herniated fat suture transfixed.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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Paraumbilcal Hernia Open Mesh Repair (Ventral Patch)

INCISION:Longitudinal incision over herniation in midlineFINDINGS:Paraumbilical hernia approx. 3cm 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:Ventra Patch Mesh (Parietex) applied – securedNo 1 Ethilon interrupted fascial sutures closing hernial defect.Subcutaneous tissue approximated with 2.0 Vicryl.3.0 Monocryl Subcuticular

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Examination under Anaesthesia (EUA) Rectum + Incision and drainage Ischiorectal Abscess

INCISION:Elliptical incision excising unhealthy tissue overlying abscess FINDINGS:Ischiorectal Abscess … O’Clock measuring … x … cm PROCEDURE:Examination under Anaesthesia Rectum – no internal opening identifiedPus sent for C&SDe-roofing of abscess cavity with removal of unhealthy skinPus evacuated – CurettageHemostasisWash with salinePacked with SorBact CLOSURE:Dressings applied

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Pilonidal abscess Incision and Drainage

INCISION:Ellipitical incision Pilonidal area including sinusesFINDINGS:Large abscess cavity with about 50 ml pusPROCEDURE:Pus for c&SLoculations disrupted using gloved fingerSlough evacuated – CurettageHemostasisWash with saline & betadinePacked with SorBactCLOSURE:Dressings applied Pressure dressingPOST OPERATIVE INSTRUCTIONS:Observations Q4HHome later today all being wellDiet: Eat and Drink as toleratedPressure dressing to stay for 24-48 hoursAlternate day dressings; starting day after

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Inguinal Hernia Open Mesh Repair

INCISION: Medial 2/3 of line joining ASIS and Pubic Tubercle FINDINGS: Large indirect inguinoscrotal hernia containing bowelPROCEDURE: Dissected down to and through External Oblique AponeurosisHernial sac identifiedHerniation reducedSac suture transfixedDeep ring tightenedSoft mesh 10x15cm cut to sizeSecured with Tacs and suturesNew superficial ring createdHemostasis ensuredCLOSURE: Subcutaneous 2.0 vicryl suturesClips to skinPOST OPERATIVE INSTRUCTIONS:Observations Q4HDiet: Eat and

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Epigastric Hernia – Open Suture Repair

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

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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