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Operative Dictations in General and Vascular Surgery
Operative Dictations in General and Vascular Surgery
Operative Dictations Made Simple
Jamal J. Hoballah, M.D., M.BA. Professor and Chairman, Division of Vascular Surgery, Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Carol E.H. Scott-Conner, M.D., Ph.D., M.DA. Professor and Head, Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Editors
~ Springer
Jamal J. Hoballah. M.D .. M.B.A. Profe,sor and Chairman Division of Va,cular Surgery Department of Surgery University of Iowa Hospitals and Clinics Iowa City, IA 52242-1086 USA j [email protected]
Carol E.H. Scott-Conner. M.D .. Ph.D., M.B.A.
Professor and Head Department of Surgery University of Iowa Hospitals and Clinics Iowa City, IA 52242-1086 USA [email protected]
Operative dictations in general and vascular surgery: operative dictations made simple I editors, Jamal J. Hoballah, Carol E.H. Scott-Conner.
p. ; em. Includes bibliographical references and index. ISBN 978-0-387-95589-6 ISBN 978-1-4757-4167-4 (eBook) DOI 10.1007/978-1-4757-4167-4
l. Surgery, Operative. 2. Blood-vessels-Surgery. 3. Surgery. 1. Title: Operative dictations made simple. II. Hoballah, Jamal 1. III. Scott-Conner. Carol E.H.
[DNLM: 1. Surgical Procedures, Operative-methods. 2. Vascular Surgical Proceduresmethods. WO 500 060132003] RD32.0583 2003 2002030574 617'.91-dc21
Additional material to this book can be downloaded from hUp:llextras.springer.com.
ISBN 978-0-387-95589-6 Printed on acid-free paper.
<D 2006 Springer Science+Business Media New York Originally published by Springer Science+Business Media, LLC in 2006 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher Springer SciencerBusiness Media, LLC, except for hrief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbiddcn. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identilicd as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights.
9 8 7 6
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Preface A Special Word to Surgical Residents and Fellows
Surgeons love to operate, but nobody likes paperwork. The operative dictation, or "op note" as it is commonly called, is one of the most important pieces of paperwork that a surgeon creates. Accurately recording what happened in the operating roomwhat the indications were, what was found, what was done, who was there, what sutures and devices were used, what individual differences in anatomy were encountered-is a crucial skill that all surgeons must learn. Yet, surgical residents rarely receive detailed instruction in how to dictate concise, informative operative notes.
Quite simply, this is a book we wish we had had when we were residents. It is a book we want our residents to have and to use. Personalize your copy. Use the space labeled "notes" to take note of particular technical variations favored by the various attending surgeons with whom you scrub. Note their preferences in suture materials, patient positioning, and other small details. Make it your practice to review this material before scrubbing on a case. Surgery is made up of thousands of small details. Note what works well, and what is less useful. Sooner than you might believe, you will be facing your board exams and working independently. When you do, this book will help you recall everything you have learned, and help you to determine your own technical preferences.
We hope you will enjoy using this unique resource. We welcome your comments or suggestions.
Jamal J. Hoballah, M.D., M.B.A. [email protected]
Carol E.H. Scott-Conner, M.D., Ph.D., M.B.A. [email protected]
Contents
Preface .. . . . .. . ...... ....... . . . . ........ v Contributors xix Introduction .................. . . .. .. . ... . xxv
PARTI GENERAL SURGERY Section I Esophagus
1 Esophagectomy: Right Thoracotomy and Laparotomy with Thoracic Anastomosis 2 Benjamin E. Schneider
2 Esophagectomy: Right Thoracotomy and Laparotomy with Cervical Anastomosis .. . . . 6 Benjamin E. Schneider
3 Esophagogastrectomy.................. 12 Natisha Busick
4 Transhiatal Esophagectomy . . . . . . . . . . . . .. 18 Benjamin E. Schneider
5 Transabdominal Nissen Fundoplication . . . . . 22 Kevin F. Satisky
6 Laparoscopic Nissen Fundoplication . . . . . .. 26 Kevin F. Satisky
7 Transthoracic Collis Gastroplasty and Nissen Fundoplication ... .. .. . ..... . .. . ... . .. 30 Natisha Busick
8 Cricopharyngeal Myotomy and Operation for Pharyngoesophageal (Zenker's) Diverticulum . . . . . . . . . . . . . . . . . . . . . . . . . 34 Benjamin E. Schneider
9 Esophagomyotomy for Achalasia and Diffuse Esophageal Spasm ........ . . . . .. 36 Carol E.H. Scott-Conner
10 Laparoscopic Esophagomyotomy . . . . . . . . . . 38 Benjamin E. Schneider
Section II Stomach and Duodenum 11 Gastrojejunostomy ......... . ... . . . .... 42
Natisha Busick
viii CONTENTS
12 Proximal Gastric Vagotomy . . . . . . . . . . . . .. 46 Carol EH. Scott-Conner
13 Truncal Vagotomy and Pyloroplasty . . . . . . . 50 Carol EH. Scott-Conner
14 Partial Gastrectomy with Billroth I Reconstruction ....................... 54 Roy R. Danks
15 Partial Gastrectomy with Billroth II Reconstruction . . . . ............ . . . .... 58 Roy R. Danks
16 Plication of Perforated Peptic Ulcer. . . . . . .. 64 Georgios Tsoulfas
17 Laparoscopic Plication of Perforated Ulcer .. . . . . . . . . . . . . . . . . . . .. 66 Roy R. Danks
18 Gastrostomy......................... 70 Carol EH. Scott-Conner
19 Percutaneous Endoscopic Gastrostomy ... . . 72 Mazen M. Hashisho
20 Radical Subtotal Gastrectomy for Cancer 74 Mazen M. Hashisho, Roy R. Danks, and Mario Martinasevic
21 Total Gastrectomy. . . . . . . . . . . . . . . . . . . . . 80 Mario Martinasevic
22 Vertical Banded Gastroplasty . ...... . .. . . 84 Mario Martinasevic
23 Roux-en-Y Gastric Bypass for Obesity . . . . .. 88 Yi-Homg Lee
24 Laparoscopic Roux-en-Y Gastric Bypass for Obesity . ...... . ........ . ......... 92 Yi-Homg Lee
25 Simple Excision of Duodenal Diverticulum 98 Roy R. Danks
26 Transduodenal Excision of Duodenal Diverticulum ............. . .... . . . . . . , 102 Roy R. Danks
Section III Small Intestine and Appendix 27 Small Bowel Resection ... . ............. 106
Ross Bengtson
CONTENTS ix --- - ---- - - - ---- -- - - -------
28 Enterolysis for Intestinal Obstruction . . . . . . 110 Mazen M. Hashisho
29 Feeding Jejunostomy. . . . . . . . . . . . . . . . . .. 112 Mazen M. Hashisho
30 Appendectomy ............... . . .. .... 114 Mohamad Allam
31 Laparoscopic Appendectomy . . . . . . . . . . . .. 118 Natisha Busick and Georgios Tsoulfas
32 Resection of Meckel's Diverticulum . . . . . . . . 122 Ross Bengtson
Section IV Large Intestine 33 Right Hemicolectomy . ................. 126
Carol E.H. Scott-Conner 34 Left Hemicolectomy .......... ... ...... 130
Nate Thepjatri 35 Low Anterior Resection . . . . . . . . . . . . . . . . . 134
Nate Thepjatri 36 Abdominoperineal Resection . . . . . . . . . . . . . 138
Carol E.H. Scott-Conner 37 Subtotal Colectomy with Ileostomy and
Hartmann's Pouch . .. . ................ 142 Mazen M. Hashisho
38 Total Proctocolectomy with Ileoanal Reservoir and Ileoanal Anastomosis . . . . . . . . 146 Carol E.H. Scott-Conner
39 Total Proctocolectomy with Ileostomy . . . . . . 150 Carol E.H. Scott-Conner
40 End Ileostomy . .. .. ...... . .. .. ....... 154 Kareem A. Hamdy
41 Loop Ileostomy . . . . . . . . . . . . . . . . . . . . . .. 158 Kareem A. Hamdy
42 Transverse Loop Colostomy. . . . . . . . . . . . . . 162 Kareem A. Hamdy
43 Closure of Transverse Loop Colostomy . . . . . 164 Kareem A. Hamdy
44 Subtotal Colectomy for Lower GI Bleeding .. 166 Mazen M. Hashisho
45 Hartmann's Procedure . . . . . . . . . . . . . . . . .. 170 Carol E.H. Scott-Conner
x CONTENTS
46 Ripstein Procedure for Rectal Prolapse ... . . 174 Carol E.H. Scott-Conner
Section V Anus, Rectum, and Pilonidal Region 47 Rubber Band Ligation of Hemorrhoids . .... 176
Shauna Lorenzo-Rivero 48 Hemorrhoidectomy . .. . ... . ............ 178
Shauna Lorenzo-Rivero 49 Drainage of Perirectal Abscess . . . . . . . . . . . . 180
Shauna Lorenzo-Rivero 50 Anorectal Fistulotomy . . . . . . . . . . . . . . . . .. 182
Shauna Lorenzo-Rivero 51 Lateral Internal Sphincterotomy for
Chronic Anal Fissure . . . . . . . . . . . . . . . . . . . 184 Shauna Lorenzo-Rivero
52 Anoplasty for Anal Stenosis. . . . . . . . . . . . .. 186 Carol E.H. Scott-Conner
53 Marsupialization of Pilonidal Sinus . . . ..... 188 Mohamad Allam
54 Excision and Primary Closure of Pilonidal Sinus . . .................... . 190 Mohamad Allam
Section VI Hepatobiliary Tract 55 Cholecystectomy......... . .... . ...... . 192
Mazen M. Hashisho 56 Laparoscopic Cholecystectomy ... . ..... .. 196
Mazen M. Hashisho 57 Open Common Bile Duct Exploration ..... . 200
Christopher T. Bunch 58 Roux-en-Y Hepaticojejunostomy or
Choledochojejunostomy ...... . ......... 204 Natisha Busick
59 Carcinoma of Hepatic Duct Bifurcation . . . . . 210 Natisha Busick
60 Hepatic Wedge Resection . . .. . .. .. ...... 216 Georgios Tsoulfas
61 Right Hepatic Lobectomy ............... 218 Georgios Tsoulfas
62 Left Hepatic Lobectomy .... . .. . ........ 222 Georgios Tsoulfas
CONTENTS xi
Section VII Pancreas 63 Partial Pancreaticoduodenectomy
(Whipple Procedure) . ..... . ......... . .. 226 Natisha Busick
64 Total Pancreaticoduodenectomy .......... 232 Natisha Busick
65 Distal Pancreatectomy . . . . . . . . . . . . . . . . . . 238 Natisha Busick
66 Pancreatic Cystogastrostomy Natisha Busick
67 Pancreaticojejunostomy
242
(Puestow Procedure) ........ . ........ . .. 246 Andrew A. Fedder
Section VIII Spleen 68 Splenectomy (Open) for Disease
Charles H. Mosher 250
69 Laparoscopic Splenectomy . ... .......... 254 Carol E.H. Scott-Conner
70 Splenectomy for Trauma . . . . . . . . . . . . . . .. 258 Charles H. Mosher
71 Partial Splenectomy ................... 262 Charles H. Mosher
72 Splenorrhaphy ............. . ......... 266 Charles H. Mosher
Section IX Hernia Repairs and Surgery for Necrotizing Fasciitis
73 Bassini Repair of Inguinal Hernia ......... 270 Mohamad Allam
74 Shouldice Repair of Inguinal Hernia . . . . . .. 274 Carol E.H. Scott-Conner
75 McVay Repair of Inguinal Hernia ......... 278 Peter Fretz
76 Mesh Repair of Inguinal Hernia .......... 282 Benjamin E. Schneider and Peter Fretz
77 Laparoscopic Inguinal Hernia Repair: Transabdominal Preperitoneal . .. . ...... . . 286 Alvina Won
xii CONTENTS
78 Laparoscopic Inguinal Hernia Repair: Totally Extraperitoneal ........ . ........ 290 Alvina Won
79 Repair of Femoral Hernia . .............. 294 Kareem A. Hamdy
80 Ventral Hernia Repair .................. 298 Peter Fretz
81 Operations for Infected Abdominal Wound Dehiscence and Necrotizing Fasciitis of the Abdominal Wall ...................... 300 Kristen Sihler
Section X Breast 82 Breast Biopsy ... . . . . . . . . . . . . . . . . . . . .. 302
Mazen M. Hashisho 83 Excision of Ducts ..................... 304
Carol E.H. Scott-Conner 84 Needle-Localized Breast Biopsy . . . . . . . . . .. 306
AbdiAhari 85 Lumpectomy (Partial Mastectomy) and
Axillary Node Dissection ., . . . . . . . . . . . . .. 308 Abdi Ahari
86 Sentinel Node Biopsy for Breast Cancer .... 312 Mazen M. Hashisho
87 Modified Radical Mastectomy . . . . . . . . . . . . 314 Michael C. Fraterelli
88 Total (Simple) Mastectomy ...... . ....... 318 Michael C. Fraterelli
89 Operation for Breast Abscess ............. 320 Carol E.H. Scott-Conner
Section XI Lymph Nodes 90 Sentinel Node Biopsy for Melanoma . . . . . .. 322
Mazen M. Hashisho 91 Superficial Inguinal Lymph Node Dissection . 324
Mazen M. Hashisho 92 Excision of Melanoma . . . . . . . . . . . . . . . . .. 328
Mazen M. Hashisho 93 Inguinal and Pelvic Lymphadenectomy 330
Carol E.H. Scott-Conner
CONTENTS xiii
Section XII Head and Neck 94 Superficial Parotidectomy
Carol E.H. Scott-Conner 334
95 Thyroid Lobectomy . . . . . . . . . . . . . . . . . . .. 338 Michael C. Fraterelli
96 Total Thyroidectomy ... . . . .. ... . ... . . .. 342 Michael C. Fraterelli
97 Parathyroidectomy for Adenoma . . . . . . . . .. 346 Andrew A. Fedder
98 Parathyroidectomy for Secondary/Tertiary Hyperparathyroidism ........ . ......... 350 Andrew A. Fedder
99 Cricothyroidotomy .......... .. . ... . . .. 354 Amy Bobis
100 Tracheostomy........................ 356 Amy Bobis
101 Percutaneous Tracheostomy .......... . .. 358 Mazen M. Hashisho
Section XIII Miscellaneous Procedures 102 Placement of Subclavian Central Venous
Catheter ............... . ............ 360 Amy Bobis
103 Placement of Internal Jugular Central Venous Catheter . . . . . . . . . . . . . . . . . . . . . . 364 Amy Bobis
104 Renal Transplantation . . . . . . . . . . . . . . . . .. 368 Gustavo Martinez-Mier
Part II VASCULAR SURGERY Section XIV Cerebrovascular Occlusive Disease 105 Carotid Endarterectomy ................ 372
Jamal J. Hoballah 106 Carotid Endarterectomy Using the
Eversion Technique .................... 376 Dale Maharaj and R. Clement Darling III
107 Redo Carotid Endarterectomy . . . . . . . . . . .. 380 David Corry and Mark Adelman
108 Carotid Subclavian Bypass . ...... .. ..... 386 Julie Freischlag and John Lane
xiv CONTENTS
109 Carotid Subclavian Transposition ....... .. 390 Julie Freischlag and John Lane
110 Vertebral Artery Reconstruction ........ .. 394 David Cony and Mark Adelman
111 Aorto-Innominate Artery Bypass .......... 400 Christian Bianchi and Jeffrey L. Ballard
Section XV Mesenteric and Renal Artery Occlusive Disease
112 Antegrade Aortoceliac!Mesenteric Bypass for Chronic Mesenteric Ischemia . . . . . . . . .. 404 Roderick TA. Chalmers
113 Superior Mesenteric Artery Embolectomy with Primary/Patch Closure for Acute Embolic Mesenteric Ischemia ........... . 408 Roderick TA. Chalmers
114 Superior Mesenteric Artery Thrombectomy with Retrograde Aortomesenteric Bypass for Acute Thrombotic Mesenteric Ischemia ..... 412 Roderick TA. Chalmers
115 Bilateral Aortorenal Bypass ... ... . . ...... 416 Jamal J. Hoballah
116 Hepatorenal Artery Bypass . .. ....... . . . . 420 Jamal J. Hoballah
117 Transaortic Celiac and Superior Mesenteric Artery Endarterectomy ................. 424 Christian Bianchi and Jeffrey L. Ballard
118 Transaortic Renal Artery Endarterectomy 428 Christian Bianchi and Jeffrey L. Ballard
Section XVI Aortoiliac Occlusive Disease 119 Thoracofemoral Bypass . . . . . . . . . . . . . . . .. 432
Kelly S.A. Blair and Hisham Bassiouny 120 Aortobifemoral Bypass ........ .... .. ... 438
Jamal J. Hoballah 121 Retroperitoneal Aortofemoral Bypass . . . . . . . 446
Kelly S.A. Blair and Hisham Bassiouny 122 Axillobifemoral Bypass . . . .............. 452
Kelly S.A. Blair and Hisham Bassiouny
CONTENTS xv
123 Iliofemoral Bypass ...... . .... . ........ 456 Munier M.S. Nazzal
124 Femorofemoral Bypass ................. 460 Munier M.S. Nazzal
Section XVII Infrainguinal Occlusive Disease 125 Femoropopliteal Bypass with PTFE Graft 464
Jamal 1. Hoballah 126 Femoroinfrapopliteal PTFE Bypass with
Adjunctive AVF or Vein Cuff ......... . ... 468 Sujata Subramanian, Keith D. Calligaro, and Matthew J. Dougherty
127 Femoroposterior Tibial Bypass with Reversed Greater Saphenous Vein .. . . . .... 472
128 Jamal J. Hoballah Femoroanterior Tibial Bypass with Nonreversed Greater Saphenous Vein Jamal J. Hoballah
476
129 In Situ Femoroperoneal Bypass .. . ....... . 480 Jamal 1. Hoballah
130 Femoroplantar Composite Vein Bypass . . ... 484 Jamal J. Hoballah
131 Midbypass Revision .... . ...... . ....... 488
132 Jamal J. Hoballah Distal Bypass Revision Jamal J. Hoballah
Section XVIII Thromboembolectomy
492
133 Aortic Saddle Embolus .. .. ............. 496 Theodore H. Teruya and Ahmed M. Abou-Zamzam
134 Lower-Extremity Thromboembolectomy .... 500 Theodore H. Teruya and Ahmed M. Abou-Zamzam
135 Upper-Extremity Thromboembolectomy ... . 504 Jamal J. Hoballah
Section XIX Aneurysmal Disease 136 Thoracoabdominal Aortic Aneurysm Repair .. 506
John W. York and Samuel R. Money
xvi CONTENTS
137 Elective Transabdominal Replacement of Infrarenal Abdominal Aortic Aneurysm ..... 512 Jamal J. Hoballah
138 Left Posterolateral Retroperitoneal Abdominal Aortic Aneurysm Repair ... .. ... . ...... . 518 Dale Maharaj and R. Clement Darling III
139 Transabdominal Replacement of Ruptured Infrarenal Abdominal Aortic Aneurysm ..... 522 Jamal J. Hoballah
140 Replacement of Common Femoral Aneurysm with PTFE Graft . . . . . . . . . . . . . . . . . . . . . . 528 Jamal J. Hoballah
141 Ligation of Popliteal Aneurysm: Femoropoplitealltibial Reversed Vein Bypass . ... ......... . ... . .. . ... . 532 Jamal 1. Hoballah
Section XX Endovascular Procedures 142 Endovascular Aneurysm Repair (AneuRx
bifurcated graft) ........ . ............. 536 Murray L. Shames and Luis A. Sanchez
143 Endovascular Abdominal Aortic Aneurysm Repair with the Ancure Endograft ....... . . 542 Daniel J. Bertges and Michel S. Makaroun
144 Renal Artery Angioplasty and Stenting .. .. . . 546 Murray L. Shames and Luis A. Sanchez
145 Iliac Artery Angioplasty and Stenting . ... . .. 550 Murray L. Shames and Luis A. Sanchez
146 Inferior Vena Cava Filters ........ . .... . . 554 Murray L. Shames and Luis A. Sanchez
147 Ultrasound-Guided Percutaneous Obliteration of Common Femoral Artery Pseudoaneurysm with Thrombin Injection . . . . . . . . . . . . . . . . 558 Jamal J. Hoballah
Section XXI Venous Disorders 148 Stripping of the Greater Saphenous Vein
and Stab Avulsion of Branch Varicosities 560 Michael S. Connors III and Samuel R. Money
CONTENTS xvii
149 Femorofemoral Vein Bypass (Palma Procedure) ........................ . . 564 Munier M.S. Nazzal
Section XXII Creation of Arteriovenous Fistulae for Dialysis
150 Radiocephalic Arteriovenous Fistula for Hemodialysis . . . . . . . . . . . . . . . . . . . . .. 568 Christopher T. Bunch
151 Creation of Brachiocephalic Fistula . . . . . . .. 572 Christopher T. Bunch
152 Creation of Brachiobasilic Fistula . ...... . . 574 Mazen M. Hashisho
153 PTFE Forearm Graft for Hemodialysis 576 Mazen M. Hashisho
154 Creation of Upper-Arm Prosthetic Arteriovenous Grafts . . . . . . . . . . . . . . . . . .. 580 Christopher T. Bunch
Section XXIII Sympathectomy 155 Supraclavicular Cervical Sympathectomy. . . . 584
Mario Martinasevic 156 Lumbar Sympathectomy ..... . .. . ... . .. . 588
Mario Martinasevic
Section XXIV Amputations 157 Above-Knee Amputation
Mohamad Allam 158 Below-Knee Amputation
Mohamad Allam
590
594
159 Transmetatarsal Foot Amputation . . . . . . . .. 598 Jamal J. Hoballah
160 Transmetatarsal (Ray) Toe Amputation .. ... 600 Jamal J. Hoballah
161 Transphalyngeal Toe Amputation Jamal J. Hoballah
Section XXV Miscellaneous Procedures
602
162 Transaxillary First Rib Resection . . . . . . . . . . 604 William J. Sharp
xviii CONTENTS
163 Surgical Repair of Femoral Pseudoaneurysm . . . . . . . . . . . . . . . . . . . . .. 608 Gregory A. Carlson
164 Surgical Repair of Femoral Arteriovenous Fistula . . . . . . .. . ... . .... . . . . .. ..... . 610 Gregory A. Carlson
165 Four-Quadrant Fasciotomy . .. . .. . . . . . ... 612 Jamal J. Hoballah
166 Split-Thickness Skin Graft .......... . . . .. 614 Jamal 1. Hoballah
Index of Procedures . . . . . . . . . . . . . . . . . . . . . . .. 616
Contributors
Ahmed M. Abou-Zamzam, M.D. Division of Vascular Surgery, Lorna Linda University Medical Center, Lorna Linda, CA 92354, USA
Mark Adelman, M.D. Division of Vascular Surgery, Department of Surgery, New York University School of Medicine, University Vascular Associates, New York, NY 10016, USA
Abdi Ahari, M. D. Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1086, USA
Mohamad Allam, M.D. Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1086, USA
Jeffrey L. Ballard, M.D. Division of Vascular Surgery, Lorna Linda University Medical Center, Lorna Linda, CA 92354, USA
Hisham Bassiouny, M.D. Section of Vascular Surgery, Department of Surgery, University of Chicago, Chicago, IL 60637, USA
Ross Bengtson, M.D. Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1086, USA
Daniel J. Bertges, M.D. Division of Vascular Surgery, Department of Surgery, University of Pittsburgh School of Medicine, Presbyterian University Hospital, Pittsburgh, PA 15213, USA
xx CONTRIBUTORS ---------------------------------------------
Christian Bianchi, M.D. Division of Vascular Surgery, Lorna Linda University Medical Center, Lorna Linda, CA 92354, USA
Kelly S.A. Blair, M.D. Section of Vascular Surgery, Department of Surgery, University of Chicago, Chicago, IL 60637, USA
Amy Bobis, M.D. Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1086, USA
Christopher T. Bunch, M.D. Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1086, USA
Natisha Busick, M.D. Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1086, USA
Keith D. Calligaro, M.D. Division of Vascular Surgery, Department of Surgery, University of Pennsylvania School of Medicine, University of Pennsylvania Hospital, Philadelphia, PA 19106, USA
Gregory A. Carlson, M.D. Division of Vascular Surgery, Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1086, USA
Roderick T.A. Chalmers, M.D. Vascular Surgical Service, Royal Infirmary of Edinburgh, Edinburgh EH3 9YW, UK
Michael S. Conners Ill, M.D. Division of Vascular Surgery, Department of Surgery, Ochsner Clinic, New Orleans, LA 70121, USA
David Corry, M.D. Division of Vascular Surgery, Department of Surgery, New York University School of Medicine, University Vascular Associates, New York, NY 10016, USA
CONTRIBUTORS xxi
Roy R. Danks, D.D. Department of Surgery, Northeast Regional Medical Center, Kirksville, MO 63501, USA
R. Clement Darling III, M.D. Division of Vascular Surgery, Department of Surgery, Albany Medical College, Albany, NY 12208, USA
Matthew 1. Dougherty, M.D. Division of Vascular Surgery, Department of Surgery, University of Pennsylvania School of Medicine, University of Pennsylvania Hospital, Philadelphia, PA 19106, USA
Andrew A. Fedder, M.D. Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1086, USA
Michael C. Fraterelli, M.D. Aurora, CO 80011 , USA
Julie A. Freischlag, M.D. Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
Peter Fretz, M.D. Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1086, USA
Kareem A . Hamdy, M.D. Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1086, USA
Mazen M. Hashisho, M.D. Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1086, USA
Jamal 1. HobaUah, M.D., M.B.A. Division of Vascular Surgery, Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1086, USA
John Lane, M.D. Division of Vascular Surgery, University of California at Los Angeles School of Medicine, Los Angeles, CA 90095-1361 , USA
xxii CONTRIBUTORS
Yi-Homg Lee, M.D. Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1086, USA
Shauna Lorenzo-Rivero, M.D. Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1086, USA
Dale Maharaj, M.D. Division of Vascular Surgery, Department of Surgery, Albany Medical College, Albany, NY 12208, USA
Michel S. Makaroun, M.D. Division of Vascular Surgery, Department of Surgery, University of Pittsburgh School of Medicine, Presbyterian University Hospital, Pittsburgh, PA 15213, USA
Mario Martinasevic, M.D. Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1086, USA
Gustavo Martinez-Mier, M.D. Division of Transplant Surgery, Department of Surgery, IMSS CMN Adolfo Ruiz Corti nez, Boca del Rio, Veracruz, Veracruz 91919, Mexico
Samuel R. Money, M.D. Division of Vascular Surgery, Department of Surgery, Ochsner Clinic, New Orleans, LA 70121, USA
Charles H. Mosher, M.D. Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1086, USA
Munier M.S. Nazzal, M.D. Division of Vascular Endovascular Surgery, Department of Surgery, Medical College of Ohio, Toledo, OH 43614, USA
Luis A. Sanchez, M.D. Division of Vascular Surgery, Department of Surgery, Washington University of S1. Louis, School of Medicine, St. Louis, MO 63110, USA
CONTRIBUTORS xxiii
Kevin F. Satisky, M.D. Department of Surgery, UniversiLy of Iowa Hospitals and Clinics, Iowa City, IA 52242-1086, USA
Benjamin E Schneider, M.D. Advanced Minimally Invasive Surgery Program, Beth Israel Deaconess Medical Center, Harvard Medical School, Shapiro Institute, Boston, MA 02215, USA
Carol EH. Scott-Conner, M.D., Ph.D., M.B.A. Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1086, USA
Murray L. Shames, M.D. Division of Vascular Surgery, Department of Surgery, Washington University of St. Louis, School of Medicine, St. Louis, MO 63110, USA
William 1. Sharp, M.D. Division of Vascular Surgery, Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1086, USA
Kristen Sihler, M.D. Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1086, USA
Sujata Subramanian, M.D. Division of Vascular Surgery, Department of Surgery, University of Pennsylvania School of Medicine, University of Pennsylvania Hospital, Philadelphia, PA 19106, USA
Theodore H. Teruya, M.D. Division of Vascular Surgery, Lorna Linda University Medical Center, Lorna Linda, CA 92354, USA
Nate Thepjatri, M.D. Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1086, USA
Georgios Tsoulfas, M.D. Department of Surgery, University of Iowa Hospitals and Clinics, iowa City, IA 52242-1086, USA
xxiv CONTRIBUTORS
Alvina Won, M.D. Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1086, USA
John W. York, M.D. Division of Vascular Surgery, Department of Surgery, Ochsner Clinic, New Orleans, LA 70121, USA
Introduction
This book seeks to put a world of technical information in your pocket or OR locker or handheld personal digital assistant. The volume has two primary objectives. First, it is designed to serve as a source of model operative dictations that may be individualized and used as templates. Second, it is intended as an aidememoir, giving the surgeon a short list of pertinent information about each procedure. Ample space is provided to allow each surgeon to add notes. By reviewing this introductory material before scrubbing on a procedure, the trainee surgeon will enter the operating room better prepared to participate actively and to learn as much as possible. At the end of training, this book, with the notes accumulated by the resident, will serve as an invaluable review resource analogous to the individualized notebooks many surgeons keep.
This book is intended for practicing surgeons as well as surgical trainees. The practicing surgeon may modify each template to reflect individual practice. An electronic version compatible with Palm as personal digital assistants is included on a CD-ROM packaged with this book to further simplify the process of generating operative notes and the evolution into paperless medical records.
Here you will find concise summaries of 166 operations; this comprises the majority of procedures commonly performed by general and vascular surgeons. For each procedure, a list of common indications is given. This list is by no means exhaustive, but is intended to cover 95% of the situations in which a particular procedure will be used.
A list of essential steps follows. These can be used to mentally rehearse the procedure before it is performed. The next heading, Note these technical variations, introduces a list that is intended to prompt the surgeon for particular things to note and dictate within the template. These particular things must be individualized-they range [rom fundamental variations such as a stapled versus sutured anastomosis, through such details as type of suture or whether an autotransfusion device was used. A list of possible complications that are typically associated with
xxvi INTRODUCTION
that particular surgical procedure follows. Complications (such as myocardial infarction, bleeding, infection) which can follow any operative intervention are not listed unless they are characteristically more common after that operation.
Finally, a template operative dictation is provided. We believe that paper is cheap and time is precious, and have assumed that the reader of this part of the chapter wants completeness and convenience. We have minimized the need to refer to other chapters by including all the parts of the operative note regardless of duplication across chapters. To this end, we have included common opening and terminating sequences (for example, how to enter and close the abdomen) in all laparotomy dictations. (Although fundamental to any operative notes, comments regarding blood loss, fluid replacement, and instrument counts were not included in these templates to avoid redundancy.) More complicated procedures are more prone to variation, and we have tried to strike a balance between conciseness and completeness. Thus, under operative findings, we have enumerated those most pertinent to the procedure in question and prompted for additional findings .
These surgery operative dictations are intended to be used in conjunction with the following texts by the editors:
Scott-Conner CEH (ed). Chassin's Operative Strategy in General Surgery, 3rd edition, Springer-Verlag, New York, 2001. This detailed review of strategy in general surgery includes almost all of these procedures. The sections of the present book correspond directly to the sections of this text.
Scott-Conner CEH (ed). The SAGES Manual: Fundamentals of Laparoscopy and GI Endoscopy. Springer-Verlag, New York, 1999. Endoscopic and laparoscopic procedures are discussed in detail.
Scott-Conner CEB, Cuschieri A, Carter AF. Minimal Access Surgical Anatomy. Lippincott Williams & Wilkins, Philadelphia, 2000. This text covers the anatomy of laparoscopic surgery in color plates and line drawings .
Scott-Conner CEH, Dawson DL. Operative Anatomy, 2nd edition. Lippincott Williams & Wilkins, Philadelphia, 2002. The anatomy and technique of common procedures, including thoracic, vascular, and transplant, is covered.
Lumley JSP, Hoballah JJ. Vascular Surgery. Springer Surgery Atlas Series. Springer, Heidelberg (forthcoming 2004).
Hoballah, JJ. Vascular Reconstructions: Anatomy, Exposures, and Techniques. Springer-Verlag, New York, 2000. Step-by-step
INTRODUCTION xxvii
review of all common vascular reconstructions, along with basics of exposure and access, and technical tips.
The vast majority of these chapters were written by surgical residents at the University of Iowa College of Medicine. These residents are introduced to you on the pages which follow. The virtues of this book must accrue to them; any faults rest squarely with the section editor. The hard work and assistance of Ms. Katherine Carolan, the encouragement of Laura Gillan, and the input of residents and colleagues is gratefully acknowledged.
Jamal J. Hoballah, M.D., M.B.A. Professor and Chair, Division of Vascular Surgery University of Iowa
Carol E.H. Scott-Conner, M.D., Ph.D., M.B.A. Professor and Head, Department of Surgery University of Iowa
Operative Dictations in General and Vascular Surgery