| 8:17 PM
Talk Show with Nepali Model-Health Related
DESCRIPTION OF PROCEDURE:
The patient was taken to the operating room with IV fluids running. Spinal anesthesia was found to be
adequate. She was prepped and draped in
the dorsal supine fashion. Pfannenstiel
incision was made with a scalpel and carried down to the fascia with a
scalpel. The fascia was incised and extended
laterally. Two Kochers were placed on
the inferior aspect of the fascia and the rectus muscle and pyramidalis was
dissected off bluntly. Attention was
paid to the superior aspect of the fascia, which was elevated with Kocher
clamps and rectus muscle dissected off bluntly.
The rectus muscle was divided in midline and entered into the peritoneal
cavity bluntly. There are no adhesions
or bowel noted. Upon entering to the
vesicouterine peritoneum, again no adhesions.
The bladder blade was then placed.
Using Metzenbaum and pickups, the bladder flap was developed and the
bladder blade was replaced. The uterine
incision was incised and extended bluntly to the cephalad region. There was noted to be meconium fluid. Infant was in the frank breech position. Buttocks was delivered 1st and the legs were
brought into the incision. Infant was
turned back down. The arms were
delivered and then the head was delivered atraumatically. The infant was suctioned, cord was clamped
and cut. The infant was handed off to
the waiting NICU team. Cord segment was
collected and cord blood. The placenta
was delivered with manual extraction and the laparotomy sponge was used to
ensure removal of all placental membranes.
The uterus was closed with 0 chromic suture in running locked fashion
and the 2nd stitch of the same in the imbricating fashion. Good hemostasis was noted. The cavity was then irrigated with warm water
and again good hemostasis was noted. The
ovaries and tubes were normal bilaterally.
Attention was paid back to the uterine incision where good hemostasis
was again noted. The rectus muscle was
closed with 2-0 Vicryl stitch in interrupted fashion. The fascia layer was closed with 1 Vicryl
stitch and the subcutaneous fat was closed with 3-0 chromic in 2 layers. The skin was re-approximated with
staples. The patient tolerated the
procedure well. All counts were correct
x3. She was taken to the recovery room
in stable condition.
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