DATE OF OPERATION: MM/DD/YYYY
PREOPERATIVE DIAGNOSIS: Pancreatic mass.
POSTOPERATIVE DIAGNOSIS: Pancreatic carcinoid tumor.
OPERATION PERFORMED: Laparoscopic biopsy of pancreatic tumor.
SURGEON: John Doe, MD
ASSISTANT: Jane Doe, MD
ANESTHESIA: General and local.
BLOOD LOSS: Minimal.
SPECIMENS REMOVED:
1. A small fragment of the tumor.
2. Core needle biopsy using the Monopty device x2 of the pancreatic mass.
OPERATIVE FINDINGS: A large mass in the body of the pancreas.
INDICATIONS FOR OPERATION: This is a (XX)-year-old male who had an episode of pancreatitis last month. He was admitted to the hospital for this. This resolved with nonoperative management. He had imaging scans at that time, which showed a large pancreatic mass in the body of the pancreas. He has remote history of a tumor being removed from his abdomen. Operative intervention was indicated for biopsy of this mass as other attempts at biopsy were not successful.
DESCRIPTION OF OPERATION: The patient was brought to the operating room. General anesthesia was induced. The patient’s abdomen was prepped and draped in the usual sterile fashion. An incision was made approximately 1 cm long in the inferior aspect of the patient’s previous abdominal scar. We dissected using blunt technique through the scar. We elevated the fascia and the peritoneum and incised under direct vision. We placed the Hasson cannula. The abdomen was insufflated with CO2 to pressure of 15 mmHg, which he tolerated well.
We then surveyed the abdomen. There was a large mass in the body of the pancreas. Right at the level of the umbilicus, we then inserted the 5 mm trocar in the left lower quadrant. We first used biopsy forceps to remove a large piece of the outer part of the tumor. This was sent to pathology. However, the frozen section did not reveal the diagnosis. Therefore, we used the Monopty needle x2 through the tumor. This fragment was then sent to the pathologist, and they said that this was consistent with a carcinoid tumor and that no additional tissue was necessary for the diagnosis and treatment of this tumor.
We then achieved hemostasis in the tumor using electrocautery and Surgicel. We then removed all of the trocars, and we placed a figure-of-eight 2-0 Vicryl stitch through the midline fascia to close it. We closed all the skin using deep dermal Monocryl sutures. Steri-Strips and dressings were applied. The patient tolerated the procedure well and was taken to the PACU in stable condition. Sponge and needle count was correct x2.
