DATE OF OPERATION: MM/DD/YYYY
PREOPERATIVE DIAGNOSIS: Right dorsal carpal ganglion.
POSTOPERATIVE DIAGNOSIS: Right dorsal carpal ganglion.
OPERATION PERFORMED: Excision of right dorsal carpal ganglion.
SURGEON: John Doe, MD
ESTIMATED BLOOD LOSS: Minimal.
COMPLICATIONS: None.
SPECIMENS: None.
ANESTHESIA: General.
DESCRIPTION OF OPERATION: After obtaining informed consent, identifying correct patient and operative site, the patient was taken to the operating suite for excision of right dorsal carpal ganglion. The patient was placed supine on the operating table. Adequate general anesthesia was induced. The right hand and the upper extremity was then prepped and draped in the usual sterile fashion. He received preoperative IV antibiotics. The arm was exsanguinated with an Esmarch bandage and a well-padded brachial tourniquet inflated to appropriate arm pressure.
A transverse incision was created, directly centered over to mass, just distal to lesser tubercle. Dissection was carried down through the skin and subcutaneous tissues, superficial veins and nerves mobilized and retracted. Interval between the second and fourth dorsal compartment was utilized releasing the distal 1 cm of extensor retinaculum for improved visualization.
The mass was identified and capsular window was excised along with the stalk between the dorsal intercarpal and radiotriquetral ligaments.
The mass was traced down to its stalk emanating from the membranous portion of the scapholunate interosseous ligament; this bed was debrided sharply, followed by rongeur debridement.
The bed was then scarified with bipolar electrocautery. The midcarpal and radiocarpal articulations were inspected and felt to be free of pathology. There was no evidence of ligamentous instability.
The bed was then thoroughly irrigated with normal saline and ensured adequate hemostasis. It was then closed with inverted 5-0 plain gut suture and 4-0 nylon horizontal mattress sutures, infiltrated with 0.5% Marcaine without epinephrine, then was dressed with a standard dry sterile dressing, a short arm bulky lightly compressive bandage, and a volar plaster splint, mobilizing the wrist in slight extension.
The tourniquet was deflated with good circulatory return to the digits. The patient was then taken to the recovery room in stable condition having tolerated the procedure without difficulty.
