Esu Laparotomy Case Summary

The patient was draped next. After Dr. Selo was gowned and gloved, he took four blue disposable towels and squared off the flank incision that would be incised later. The towels were then clipped together at the corners with four Backhaus perforating towel clamps. A transverse laparotomy sheet was then placed with the transverse fenestration over the incision site. The sheet was clipped by the anesthesiologist to the ivy poles at the head of the bed. And ¾ drape was the placed at the foot of the bed to ensure sterile coverage. A Magnetic instrument pad was then placed on the patient’s thighs to have an extra level of protection.
Surgical Procedure After the draping was completed a surgical time out took place. The time out consisted of the patient’s name, patient’s …show more content…
The ESU cautery was also used to divide subcutaneous fat, fascia, and muscle bellies (muscle that attaches high to a tendon) to expose the patient’s eleventh rib. Once was the rib was exposed, the rib was excised with a Bethune rib cutter. The muscle bellies were then split using electrical cautery. The first assistant would assist by using a Pool suction tip and suction tubing to suction blood and to keep the open cavity clean. The retroperitoneum was entered. A Harrington Retractor was inserted and held by the first assistant to allow for more visualization. There was no evidence of an intraperitoneal opening during any of dissection and inspection of the patient’s diaphragm showed no evidence of a Pleurotomy. Beginning laterally, the line of Toldt was dissected free laterally with Long Metzenbaum scissors and Long DeBakey Forceps, freeing the patient’s kidney and then dissection was carried posteriorly and inferiorly. The junction between the patient’s small bowel, peritoneal cavity and the anterior surface of the kidney was identified. A moist lap was placed over the small bowel to protect the bowel from laceration. The GU Balfour was then put into place. The