Got my operation report, thought I'd share

Three weeks into my new and so far knock on wood, very comfortable and good life where food is no longer my master. I don't want to repeat it again but I feel grrrrrreat! I started Ursodiol yesterday and so far no side effects. Food and protein and fluids right on track and well, there isn't much to report. The new normal is settling in. I have a few lunches with colleagues and friends this week and next so that will be challenging but I am pretty sure I can find adequate choices on every menu. I got my operation report, thought I would share with you all. Did everyone get one of these? I thought it was interesting...wish there had been a video!


PREOPERATIVE DIAGNOSIS: Morbid obesity, hypertension, hypercholesterolemia and type-2 diabetes. POSTOPERATIVE DIAGNOSIS: Same, and Hiatal Hernia.
OPERATION PERFORMED: Laparoscopic Sleeve Gastrectomy and Hiatal Hernia repair.
SPECIMEN: Gastric fundus and body
FINDINGS: Soft stomach without lesions, hiatus hernia was moderate with about 1-1.5 cm defect visible from anterior without any dissection, no splenomegaly, anterior pancreas looked normal, liver had no fatty liver infiltration, transverse colon and some small bowel loops of normal appearance, gallbladder appeared normal, and pelvic organs not visualized due to the patient position and obesity.
PROCEDURE:
After appropriate consent, time-out procedure, bilateral intermittent venous compressions to prevent thromboembolic phenomenon, Cefazolin 2gr. i.v. to decrease the risk of postoperative infectious complications, the surgical procedure was commenced. Under general anesthesia and endotracheal intubation, the abdominal skin and lower thorax were prepped with chlorexhidine and draped appropriately. I started with a supra-umbilical incision, and did an open insertion of a 12 mm trocar. After insufflations of CO2 at 15 mm Hg, a 30 degree 10 mm laparoscope permitted the inspection of the abdomen, with the above findings. More trocars were inserted under direct vision, a 5 mm reusable in the epigastric area, which was removed for the insertion of a Nathanson liver retractor, held by an orthostatic device attached to the right railing of the operating table, which retracted the left lobe of the
liver upward and rightward with light pressure. Other 5 mm trocars were inserted in the lateral left and right area, a 12 mm in the paramedian left areas for stapling. The operation was commenced by mobilizing the greater curvature of the stomach about midpoint, going upward towards the left crus, with Harmonic shears 5 mm. The fundus was mobilized posterior; the lower greater curvature was also mobilized and ended 4 cm from the pylorus. The stomach was already decompressed; stapling was initiated by using an Echelon 60, with green cartridges about 4 cm from the pylorus aiming toward the lesser curvature. A bougie, of approx. 38 Fr, was inserted by the anesthesiologist and positioned in the distal gastric tube against the lesser gastric curvature. More stapling of gold cartridges were done, including near the angle of His. Some portions of the stomach staple line were reinforced also with 3-0 PDS, to reinforce the staple line and diminish the risk of leakage and bleeding postoperatively. A nasogastric tube reinserted was used for a methylene blue test after compressing the prepyloric area, which was negative.
The Lesser omentum was open to expose the right crus and dissect the phreno esophageal membrane; the posterior vagus well identified and preserved was retracted using a penrose drain. The left crus was also exposed and dissected so we could close the hiatal defect with interrupted 2-0 Silk sutures, figure of eight. The penrose drain was removed under vision. After assurance that no active bleeding was seen from the staple line area, perisplenic and short gastric vessels area, omental area, the liver retractor was removed. The stomach was extracted from the umbilical trocar site, which had been slightly stretched with a Kelly clamp. After trocar removal under vision, the umbilical fascia was closed with 0 Surgipro, and the skin with 4-0 monocryl with steri-strips. The instruments and sponge counts were correct; the estimated blood loss was negligible. The patient was then transferred to recovery room in stable condition.

Glad you are doing so well.  Sounds like you are well on your way to being healthy.

I really really hope so

I'm glad you're doing so well. We should all get copies of our op reports. Good job!

 

WOW - No!  I didn't get one of these reports - how interesting....

Lunch out with friends will be a challenge at this point.  Order a salad with protein (if you can tolerate it) and pick at it.  If a comment is made, say you had a late breakfast, etc.  

Sounds like you're doing great!

I was already out on Monday and had a shrimp appetizer. It worked but I took more than half home for the dogs. I find that I want to make things fresh and eat them right there and then and not keep anything over for the next days. There are lots of suitable menu options around here and I have not yet had any intolerance. I haven't yet tried raw veggies and salads though. Waiting for three months for that according to my food progression plan. And everyone knows I had surgery so I don't have to make excuses about why I am not eating. Its easier that way for me. People are usually very supportive and those who are not or do not get it usually say what they think and move on. They don't keep harping on it and we then co tinue as before. And I try to take it philosophically!

That was an awesome report.  I hope I get one of those after I have my surgery.  Maybe I should ask for a copy just to be sure.  Good Luck with your new life...it sounds very positive.