ADD DETAIL PER INSTRUCTOR FEEDBACK
PER INSTRUCTOR: 11/27/2024 REVISE AND RESUBMIT
You have some good information within, however we need to make a few observations to call this complete. Remember your role is becoming much more than a little bit of knowledge with the use of a preference card. First put your name on the document Use the exposure by, hemostasis by, and tissue cutting/handling sections to give me a brief visual of the case. You can combine them and give the visual of the case as a lot of people do that. As a very simple example for a lap chole I expect to see the triangle of calot (or target anatomy) and how it was dealt with. That goes for any case. I observe bits and pieces in others, however I need that information for any case. I do not need a dictation of any case, however I need to see how you are participating, what you are doing, and how it is being done. Then for layer closure for any suture placed whether you placed it or not I want to see the suture and size = 4-0 monocryl, the needle=PS-2, the specific layer closed=deep dermal and the specific technique=inverted simple interrupted=buried knot. As an addition when you just say interrupted or running that does not give the same visual as a simple running, simple interrupted, running locking, interrupted figure of eight etc… I need a visual as I am not there to see that knowledge of whether you identify properly with wound closure. I cannot assume anything. I need to see it through your explanation. Address the above consistently and throughout to complete this exercise. Your learning logs look good! Dean Here is an example of a laparoscopic appendectomy :
LAPAROSCOPIC Appendectomy
Intra-op: Positioning: Supine. Right arm on arm board less than 90* with safety strap. Left arm tucked at side with toboggan sled. Pillow under knees. SCDs on bilateral lower legs. Safety strap to thighs, attached at bed.
Prepping/Draping: Chloraprep. 4 sterile towels to square off abdomen(top at xyphoid, bottom at symphis pubis) Laparotomy drape.
Special instruments: Lap tray, Lap Grasper tray ( Maryland grasper, Debakey grasper, wavy grasper, duckbill grasper, etc.), Camera, Light cord, 5/30 scope, Voyant, Verese needle, two 5mm trocar/ports, one 12mm trocar port (all optical ports) Endo gia and Endo Gia staples in room 30s and 60s. Insufflator. Endo catch bag. Carter-Thompson
Exposure/Tissue Handling: 15 Blade used for infraumbilical skin incision. Kochers used to grab umbilical stalk. Veress needle inserted, saline drop test done to confirm intra-abdominal placement. Insufflation started to abdomen to 12mm HG. 5mm trocar placed using camera (optiview). 5mm trocar placed in the supra pubic area and 12mm port in Left lower quadrant with camera view. Appendix grasped with Debakey graspers, Mesoappendix was divided using voyant energy device. Endo linear staple placed after visualizing the base of the appendix and cecum was well defined. Appendix removed using the Endo catch bag thru the 12 mm port. Assist ran camera thru the 5mm umbilical port. Inspection done of abdomen.
Hemostasis: Voyant Energy Device. Endo Gia staples