Intra operative Adenexal mass removal .pptx

Details and steps to remove adenexal mass intra op

1. Intra op Notes Adenexal Mass

2. Name: Arnjanama Mystri Age: 45 YEARS Diagnosis: left Adnexal SOL Procedure- Laparoscopic frozen and proceed. Uterine mass removed , and sent for frozen. Procedure time: 4 hr 00min Position- Llyod Davies Position

3.   Incision- Three Ports placed -Supraumbilical 10 mm camera port, 1 right 12 mm port placed in rt iliac fossa , 1 left 5 mm port in lt iliac fossa . Anaesthesia - GA Procedure done- 1.peritoneal wash for cytology 2.Laparoscopic mass removal

4. Intra-op Findings-on systemic inspection and palpation: 1.E/o 7x7 cm solid lesion arising from uterus, adhered to omentum . E/o few seedling fibroids on posterior surface of uterus. 2 . Right ovary with rt tube normal 2. Left ovary with left tube normal . 3. Uterus bulky in size. 4. E/o flimsy adhesions between uterus and anterior abdominal wall 5. Grossly omentum , bowel surface and liver surface normal.

5. Steps- Patient laid in Llyod Davis position. Parts cleaned and draped. Foleys catheterization done. 1. Entry done supra-umbilically with the help of veres needle. 2. After pneumoperitoneum, a 10 mm supraumbilical port inserted. 3. Under vision, the above ports placed. 4. E/o 7x7 cm solid lesion arising from uterus, adhered to omentum . . E/o flimsy adhesions between uterus and anterior abdominal wall. Adhesiolysis done .Mass removed with the help of ligasure , sent for frozen section . Frozen section was negative for malignancy . Decision for closure taken. 5. Pelvic wash given. Haemostasis secured. 6. Specimen removed by enlarging the left sided port and delivered intact in endobag . 7. ports closed using vicryl . Skin closed with staplers. No Intra-operative injury or critical steps. Blood loss: around 20 ml blood. No drain kept.

6. Thank You