DATE OF OPERATION: MM/DD/YYYY
PREOPERATIVE DIAGNOSIS:
Pyloric stenosis.
POSTOPERATIVE DIAGNOSIS:
Pyloric stenosis.
OPERATION PERFORMED:
Pyloromyotomy.
SURGEON: John Doe, MD
ANESTHESIA: General endotracheal.
ANESTHESIOLOGIST: Jane Doe, MD
ESTIMATED BLOOD LOSS: 10 mL.
INDICATIONS FOR OPERATION: This is a (XX)-month-old who presents with signs and symptoms of pyloric stenosis. The child did have an upper GI, which showed total gastric outlet obstruction and an ultrasound which was positive for pyloric stenosis. The child was brought to the operating room at this time for pyloromyotomy.
DESCRIPTION OF OPERATION: The patient was placed in the supine position, and under general endotracheal anesthesia, the abdomen was prepped and draped in the usual sterile manner. A right upper quadrant transverse incision was made. The superior and inferior rectus flaps were raised and the rectus muscle was split longitudinally. The peritoneum and posterior rectus sheaths were opened transversely.
The abdomen was entered. The stomach was grasped with a Babcock and the pyloric tumor was brought up through the wound. The pyloric tumor was fairly large. The pyloric tumor was held between the index finger and thumb, and the incision was made from the stomach to the duodenum in the anterior-superior avascular plane. The hypertrophic fiber was felt with the back of the knife handle and they were further spread with a clamp. Hemostasis was achieved. The pyloromyotomy was checked for completeness and it was complete. The mucosa was checked for perforation. There was no perforation in the mucosa. The stomach and duodenum were returned to the stomach and pylorus was returned to the abdomen.
The peritoneum and posterior rectus sheath were closed with 4-0 chromic continuous sutures. The rectus muscle was approximated with interrupted 3-0 chromic suture. The anterior rectus sheath was closed with 3-0 Vicryl in continuous suture. The subcutaneous Scarpa fascia was closed with 4-0 chromic and the skin was closed with 5-0 plain continuous subcuticular suture. Steri-Strips and dressing were applied. The patient tolerated the procedure well and was taken to the recovery room in good condition.
