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 amal-hoballah@uiowa.cdu

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 carol-scott-conner@uiowa.edu

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.

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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. jamal-hoballah@uiowa.edu

Carol E.H. Scott-Conner, M.D., Ph.D., M.B.A. carol-scott-conner@uiowa.edu

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