OPSX31MayweatherCora
MCCG240 Case Scenario OPSX31 Mayweather, Cora.html[10/21/2021 10:55:48 AM]
Outpatient Surgery
Patient Case Number: OPSX31-Mayweather, Cora
Patient Name: Cora Mayweather DOB: 03-01-66 Sex: F
Date of Service: 08-13-XX Surgeon: Matthew Bordelon, MD
Pre-Operative DiagnosisMetastatic stage IIIC cancer ofovary w/ involvement of therectosigmoidcolon and ovaries
Post-Operative DiagnosisMetastatic stage IIIC cancer of ovary w/ involvement of therectosigmoid colon and ovaries
Procedure Performed: Insertion of single-lumen infusaport, debridement of necrotic tissue aroundstoma, removal of PICC line
Anesthesia: General Complications: None
PREOPERATIVE DIAGNOSES:1. Metastatic stage IIIC cancer of the ovary with involvement of the rectosigmoid, both the ovaries andthe cul-de-sac, status post ovarian cancer debulking.2. Lack of vascular access.
POSTOPERATIVE DIAGNOSES:1. Metastatic stage IIIC cancer of the ovary with involvement of the rectosigmoid, both the ovaries andthe cul-de-sac, status post ovarian cancer debulking.2. Lack of vascular access.
OPERATIVE PROCEDURE CARRIED OUT:1. Insertion of a single-lumen infusaport.2. Debridement of necrotic tissue around the stoma.3. Removal of PICC line.
DESCRIPTION OF PROCEDURE:After successful induction of general anesthesia, the patient was placed in steep Trendelenburg position.The neck and the chest wall was prepped and draped in the usual sterile fashion. An infraclavicularsubclavian puncture was then made. Guidewire was inserted into the right atrium. The needle was thenremoved. The position of the guidewire was tested radiographically. A dilator introducer kit was insertedover the guidewire into the right atrium. The right guidewire was removed. The catheter was insertedinto the right atrium under fluoroscopic guidance. A transverse incision was then made on the anteriorchest wall. Subcutaneous tissue was incised along the line of the incision. The catheter was tunneledsubcutaneously to the point on the anterior chest wall. The catheter was connected to the reservoir suchthat the tip of the catheter was located in the right atrium. The catheter was then attached to the
OPSX31MayweatherCora
MCCG240 Case Scenario OPSX31 Mayweather, Cora.html[10/21/2021 10:55:48 AM]
reservoir. The reservoir was then flushed. The reservoir was sutured to the anterior chest wall. Thepatient tolerated the procedure well. The skin was closed with subcuticular suture. The skin was closedwith subcuticular sutures. The patient tolerated the procedure well. The patient was transferred to therecovery room under satisfactory conditions. The PICC line was removed by gentle traction. The tip ofthe catheter was intact. A sterile dressing was applied on the right arm where the PICC line has beentaken out. The ostomy in the left lower quadrant was revisualized. The tissue around the colostomy wasexcised. A new colostomy bag was then placed over this site. Minimal debridement of necrotic tissuearound the base of the stoma was carried out and by sharp dissection.
Dictating Clinician: Matthew Bordelon, MD
Electronically Signed By: Matthew Bordelon, MD
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