SURGEON: John Doe, MD
DESCRIPTION OF OPERATION: The patient was placed in supine position under general endotracheal anesthesia, and the abdomen was prepped and draped in usual sterile manner. A right upper quadrant transverse incision was made. The abdomen was entered. The bowel was eviscerated. The cecum was in the right upper quadrant and medial. The right colon was mobilized without difficulty and the right colon was reflected to the left. Next, there was no formal ligament of Treitz. Part of the duodenum was retroperitoneal, but the duodenum was anterior to the superior mesenteric artery. There were bands from the cecum over the duodenum which were Ladd’s bands which were lysed. There were also bands that went over the duodenum that did not come from the cecum that were also divided. At the conclusion of the procedure, the duodenojejunal junction could not be definitely demarcated, which is what would be expected. Next, an appendectomy was done. The mesoappendix was doubly clamped, divided, and ligated. Crushing clamps placed at the base of the appendix. The clamp was moved a little more distally. The 2-0 chromic ties were placed at the base of the appendix. Appendix was divided and sent for pathological examination. The bowel was then returned to the abdomen. The cecum was placed in the left upper quadrant and the proximal small bowel on the right and the distal small bowel on the left side of the abdomen. The bowel returned easily to the abdomen. The peritoneum and posterior rectal sheath were closed with 3-0 Vicryl continuous suture and the anterior rectus sheath was closed with 3-0 PDS continuous suture. The subcutaneous was closed with 4-0 chromic and the skin was closed with 5-0 Vicryl continuous subcuticular suture. A Steri-Strip dressing was applied. The patient tolerated the procedure well and was taken to recovery room in good condition.
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