PREOPERATIVE DIAGNOSIS: Right adnexal mass.

LOCATION: Inpatient, Hospital

PATIENT: Brenda Gunnison

SURGEON: Andy Martinez, M.D.

PREOPERATIVE DIAGNOSIS: Right adnexal mass.

POSTOPERATIVE DIAGNOSIS: Probable dermoid.

PROCEDURES PERFORMED: Right oophorectomy.

ANESTHESIA: General endotracheal anesthesia.

SPECIMEN: Right ovary.

COMPLICATION: None apparent. DRAIN: Foley catheter with 100 mL clear urine output.

ESTIMATED BLOOD LOSS: 50 ML. FLUID REPLACEMENT: 1,500 mL.

INDICATION FOR PROCEDURE: Patient is status post gastric bypass. She has been having abdominal pain. She was identified during imaging studies to have a right adnexal mass. This was quite large, requiring removal. Surgical risks, benefits, indications and alternatives were outlined to the patient in entirety as outlined in the preoperative history and physical.

PROCEDURE IN DETAIL: The patient was taken to the operating room where a midline skin incision was made. The large right adnexa was smooth and freely mobile. There were no signs of carcinomatosis. This was roughly 10 x 10 x 8 cm in size with a smooth surface. The uteroovarian complexes and infundibulopelvic ligament on the right were doubly clamped, transected and suture ligated. Hemostasis was noted. The mass was sent to Pathology, which was a dermoid by frozen. Abdominal cavity was copiously irrigated and cleared of clot and debris. The fascial incision was closed with loop-stitch of 0 PDS, originating from the superior and inferior aspects. They were met in the midline. It was ensured that no underlying tissues were enclosed. Subcutaneous tissue was reapproximated with running stitch of 2-0 Vicryl. Skin was closed subcuticularly with 4-0 Vicryl. The patient tolerated the procedure well. Sponge and needle counts were reported as correct x2. The patient received antibiotics preoperatively, and will be followed with routine postoperative cares.

Pathology Report Later Indicated: Benign dermoid ovarian cyst.