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Jun 17 21:17
• SFA occlusion
+ d h k h k o
Thu Jun 21 13:18:40 2018 d h k h k o
Wire escalation was performed using 'gladius treasure anastado" wires
** • Gladius, Treasure, and Astato (all wires made by ASAHI) - taco
Thu Jun 21 13:30:42 2018 taco

**** • This is it! - d h k h k o
Thu Jun 21 13:32:08 2018 d h k h k o

** • Treasure series and the Astato series - k f f a b n
Thu Jun 21 13:27:35 2018 k f f a b n


• (ESL) vaginal hysterectomy, stumped on word, sm plse
+ mt
Thu Jun 21 12:15:37 2018 mt
The anterior lip of the cervix was secured with two single tooth tenacula. Then 20 mL of 0.25% Marcaine was infiltrated around the cervix for **ee-moodz** dissection and to reduce blood loss. A circumferential incision was made.
** • Since it is a local anesthetic, how about painless? - WAG
Thu Jun 21 13:35:29 2018 WAG

** • hemostatis? - taco
Thu Jun 21 12:25:13 2018 taco

**** • I think I can hear "hemo-dissection". Would that make sense? - mt
Thu Jun 21 12:32:41 2018 mt

****** • I don't think so... maybe "hemostasis in dissection" slurred together? + taco (sm)
Thu Jun 21 12:45:29 2018 taco (sm)
or maybe not hemostasis at all - maybe it is something like "ease in dissection"? (with less bleeding, dissection would be easier, I suppose)
******** • for a Metz dissection? (maybe of bladder off of cervix) - mn
Thu Jun 21 13:13:43 2018 mn

********** • Thanks everyone, had to flag, will probably never hear (liked the Metz suggestion) - OP
Thu Jun 21 13:25:33 2018 OP


• CT scan of the brain
+ sm please
Thu Jun 21 11:52:08 2018 sm please
Imaging: CT shows an old infarct involving the right frontal lobe with s/l a-sess-low-my-lasia.

The patient has a history of an intracranial hemorrhage with left-sided weakness since then. His presenting complaint is increased LUE weakness. Sorry I stopped up there at my s/l - but that is all that is dictated in the imaging section. Dr. then moved on to his assessments, which don't include the s/l again.
** • encephalomalacia - isgal
Thu Jun 21 11:55:32 2018 isgal

**** • That was it! Thank you again. + nm
Thu Jun 21 12:00:59 2018 nm
x
**** • I will check that out! Thank you very much. + nm
Thu Jun 21 11:56:16 2018 nm
x

• Preoperative Diagnosis: RIGHT MANDIBULAR AMELOBLASTOMA. Proc ...
+ wav
Thu Jun 21 09:17:18 2018 wav
Preoperative Diagnosis:
RIGHT MANDIBULAR AMELOBLASTOMA.

Procedure:
DELAYED MANDIBULAR RECONSTRUCTION WITH FREE FIBULA FLAP.

The head and neck team opened his previous incision which was a Wiser type incision along the inferior border of his mandible extending from the right midbody to the contralateral left parasymphysis. This was extended essentially angle to angle for complete visor incision, so that we could have good exposure of the mandible. Once this was completed, the osteotomies were performed using the custom _____ cutting guides. The osteotomy on the right mandibular ramus included resection of the right third molar.
** • 3D printed - isgal
Thu Jun 21 09:21:13 2018 isgal

**** • Thanks a lot. - guy
Thu Jun 21 09:23:24 2018 guy


• that he was operated on for subdural ______ he had a cranioplasty.
+ mp3
Thu Jun 21 08:42:42 2018 mp3
The patient is now several months status post cranioplasty for recurrent subdural hematoma that he was operated on for subdural ______ he had a cranioplasty.
** • got it, never mind - op
Thu Jun 21 08:47:01 2018 op


• Perfluoron was then brought up past the edges of the retinectomy site. ...
+ wav
Thu Jun 21 08:38:45 2018 wav
Perfluoron was then brought up past the edges of the retinectomy site. There was noted to be some mild bleeding at the margins that were attempted to cauterize. Laser was then applied 360 degrees in a continuous fashion to the retinectomy edge. Then, attention was drawn to the anterior chamber where an inferior _____ was placed with vitrectomy cutting settings on dense.
** • PI? (peripheral - isgal
Thu Jun 21 08:45:14 2018 isgal

**** • Sorry, peripheral iridectomy - isgal
Thu Jun 21 08:45:56 2018 isgal

****** • Thanks a lot. - guy
Thu Jun 21 08:47:30 2018 guy


• Then, we placed a Penrose through the incision in the upper arm and tr ...
+ wav
Thu Jun 21 00:39:34 2018 wav
Then, we placed a Penrose through the incision in the upper arm and tracked it down to come out antecubital. We sutured it to itself and then we placed 0.25-inch iodoform packing though both incisions. A dry sterile dressing was applied. The patient tolerated the procedure well. He _____ in the OR for the infraclavicular block by Anesthesia.
** • I hear "He was admitted TO the OR for the etc" - Questyr
Thu Jun 21 01:54:56 2018 Questyr

**** • Thanks a lot. - guy
Thu Jun 21 08:39:03 2018 guy

** • ? was admitted from the OR for... - ltt
Thu Jun 21 00:43:15 2018 ltt

**** • Thanks a lot. - guy
Thu Jun 21 00:44:22 2018 guy


• The patient was placed under general endotracheal anesthesia. A time- ...
+ wav
Thu Jun 21 00:23:45 2018 wav
The patient was placed under general endotracheal anesthesia. A time-out was performed. The patient has already been on antibiotics. He was additionally given _____ for now. The arm was prepped with Betadine and sterilely draped. We noted that he had approximately 2 cm transverse incision at the antecubital which was draining pus.
** • Zosyn that he is due for now? (might be something after that) - poi
Thu Jun 21 00:32:08 2018 poi

**** • oops..I don't think there is something after that...I figured it out and didn't delete my + poi
Thu Jun 21 00:32:47 2018 poi
comment
****** • Thanks a lot. - guy
Thu Jun 21 00:33:51 2018 guy


• The patient is a 22-year-old male with history of IVDA who comes in wi ...
+ wav
Thu Jun 21 00:15:12 2018 wav
The patient is a 22-year-old male with history of IVDA who comes in with an abscess of the right upper extremity. After some recent drug use, he notes that his sister-in-law had tried to drain it recently making a _____ incision at the antecubital space and had some pus come out, but the area had continued to worsen and therefore he came in last night.
** • Note the after sentence ends at "drug use." Then "He notes that" - Q
Thu Jun 21 00:16:48 2018 Q

**** • Thanks for the correction. - guy
Thu Jun 21 00:17:13 2018 guy

** • transverse - Questyr
Thu Jun 21 00:15:54 2018 Questyr

**** • Thanks a lot. - guy
Thu Jun 21 00:16:54 2018 guy


• The spleen was visible and noted to contain disease throughout all vis ...
+ mp3
Wed Jun 20 21:18:48 2018 mp3
The spleen was visible and noted to contain disease throughout all visible portions. The transverse colon was noted to contain diffuse studding. The pelvic peritoneum was covered with _____. The serosa of the uterus contained several implants. The right ovary was partially visualized. The left ovary was stuck in the posterior cul-de-sac and could not be visualized due to adhesions of the bowel.
** • I honestly don't know how you make any money as many questions as you ask and voice files + ~C
Thu Jun 21 00:04:24 2018 ~C
as you post I'm sorry for you.
**** • I honestly don't know what business it is of yours. How rude! I'm sorry for you! - poi
Thu Jun 21 00:06:42 2018 poi

** • seeds? - wag-poi
Wed Jun 20 21:36:20 2018 wag-poi

**** • yeah, can't verify that - poi
Wed Jun 20 21:37:28 2018 poi

****** • Thanks a lot. - guy
Wed Jun 20 21:39:44 2018 guy


• Preoperative Diagnosis: ADENOCARCINOMA _____ IN ORIGIN. Proc ...
+ wav
Wed Jun 20 20:41:56 2018 wav
Preoperative Diagnosis:
ADENOCARCINOMA _____ IN ORIGIN.

Procedure:
DIAGNOSTIC LAPAROSCOPY, PERITONEAL BIOPSIES, DILATION AND CURETTAGE, REMOVAL OF IUD.

** • of ovarian origin? - poi
Wed Jun 20 21:34:26 2018 poi

**** • Thanks a lot. - guy
Wed Jun 20 21:39:39 2018 guy


• The testicle was sutured into place with air knots and was returned in ...
+ wav
Wed Jun 20 18:03:51 2018 wav
The testicle was sutured into place with air knots and was returned into the scrotum and was noted to be sitting in proper orientation. The right testicle _____ was sutured in place with air knots and was then delivered back into the scrotum where it was noted to be sitting in proper orientation.
** • never mind. Thanks to anyone who tried. - guy
Wed Jun 20 18:23:46 2018 guy


• Procedure: SCROTAL EXPLORATION, BILATERAL ORCHIOPEXY. The te ...
+ wav
Wed Jun 20 17:59:16 2018 wav
Procedure:
SCROTAL EXPLORATION, BILATERAL ORCHIOPEXY.

The testicle was then wrapped in warm gauze and we proceeded to perform a right orchiopexy. The right testicle was then delivered again through the midline scrotal incision. It was noted that the right testicle had a right appendix testis. This was cauterized and removed without issue. A three-point fixation was then performed at 10 oclock, 2 oclock, and 6 oclock with 4-0 Prolene sutures. The testicle was sutured into place with _____ returned into the scrotum and was noted to be sitting in proper orientation. The right testicle
** • air knots and was - poi
Wed Jun 20 18:00:50 2018 poi

**** • what I hear..could use some research - fwiw-poi
Wed Jun 20 18:03:23 2018 fwiw-poi

**** • Thanks a lot. - guy
Wed Jun 20 18:03:16 2018 guy


• An air/silicone oil exchange was then performed with injection _______ the desir
- wav
Wed Jun 20 16:38:22 2018 wav

** • Thank you all so much!! - wav
Wed Jun 20 21:39:37 2018 wav

** • I hear "with injection port filled to the desired fill" (see link confirming + Questyr
Wed Jun 20 17:27:02 2018 Questyr
use of the term injection port)
** • s/l he says quote - i.e. "with injection filled to the desired fill" - ltt
Wed Jun 20 17:19:18 2018 ltt

** • port?? - poi
Wed Jun 20 16:41:16 2018 poi

**** • There is not another 'port' in the dictation. Not sure on this one. Thanks again, poi. - wav
Wed Jun 20 16:44:03 2018 wav


• additional PVR membranes were peeled peripherally ___________ approximately 5 to 6..
+ mp4
Wed Jun 20 16:09:11 2018 mp4
Once the view of the contact was not adequate due to the peripheral location, the viewing system was switched to the indirect system and additional PVR membranes were peeled peripherally ___________ approximately 5 to 6 clock hours of the retina.
** • from the bottom, - poi
Wed Jun 20 16:34:28 2018 poi

**** • Thanks again so much, poi. - mp4
Wed Jun 20 16:35:28 2018 mp4


• The ILM was grasped, peeled_____________surrounding the macular hole a ...
+ mp3 posted
Wed Jun 20 16:06:43 2018 mp3 posted
The ILM was grasped, peeled_____________surrounding the macular hole and a complete ILM removal was performed over the macula. This _________ peel as well as some proliferative vitreoretinopathy was peeled using the contact lens extending into the inferior midperiphery.
** • 2. broadly 2. ILM - poi
Wed Jun 20 16:31:49 2018 poi

**** • Thanks, poi! - mp3 posted
Wed Jun 20 16:35:15 2018 mp3 posted


• Cannot confirm. Thank you
+ m d m d i p
Wed Jun 20 15:59:28 2018 m d m d i p
In the right eye, there had been a pneumatic Retina Pack C?? treatment for a macula-off retinal detachment
** • pneumatic retinopexy treatment - poi
Wed Jun 20 16:30:29 2018 poi

**** • Thanks poi! - wav
Wed Jun 20 16:35:01 2018 wav

** • Sorry, wav posted. - wav
Wed Jun 20 15:59:42 2018 wav


• referring to hand, s/l "inter-seeze" pls sm
+ mt
Wed Jun 20 14:57:36 2018 mt
(scaphoidectomy, 4-corner fusion)
We created a small window in the distal radius at the level of Lister tubercle and harvested some cancellous bone. There was not good quality bone and we opted to use some bone graft substitute. The autogenous bone graft was impacted about the **inter-seeze** of the proposed of the fusion site. We then maintained our reduced 4 corner fusion.
** • interstices - my guess
Wed Jun 20 15:17:16 2018 my guess

**** • thanks, that fits. - OP
Wed Jun 20 17:10:46 2018 OP

** • doc uses it again, this time s/l inter-cease - OP
Wed Jun 20 15:04:49 2018 OP

**** • flagged - OP
Wed Jun 20 15:13:54 2018 OP


• Mono test?
+ tlh
Wed Jun 20 14:17:05 2018 tlh
______[s/l Graze/Graves/Gray's?] mono test was negative. The patient is complaining of some fatigue.
** • I think 2 separate tests, for Graves disease and mono. - mt
Wed Jun 20 14:59:08 2018 mt

**** • Thanks! - tlh
Wed Jun 20 15:00:45 2018 tlh


• s/l ALTR - cannot come up with anything
+ sm
Wed Jun 20 13:15:18 2018 sm
MRI shows a collection of fluid outside of his trochanter, but it does not show significant destruction of the abductor musculature, so it looks like we do not have a massive soft tissue response, and the MRI is even read as showing no mass concerning for s/l ALTR. He continues to have no significant symptoms in the hip and wants to proceed with his revision.
** • Changed up my search terms and finally came up with an answer: sm + OP
Wed Jun 20 13:17:29 2018 OP
Thank you anyway! :D (http://www.thegreatdictator.com/word/adverse local tissue reaction)

• acute-phase reaction as well as the low incidence of hypercalcemia and (s/l NONJ)
+ help!
Wed Jun 20 12:41:44 2018 help!
I had a discussion with ** with regard to antiresorptive therapy. I explained the potential benefits as well as the potential adverse effects including the acute-phase reaction as well as the low incidence of hypercalcemia and (s/l NONJ). I believe, given the significant activity as well as involvement of the right tibia, antiresorptive therapy would be indicated.
** • Your s/l has a few possibilities, so accuracy of what you + Questyr
Wed Jun 20 17:35:35 2018 Questyr
are hearing is important....the possibilities include:
ONJ
BRONJ
ARONJ
You can google each for there definitions, but they are all related to antiresorptive agent side effects. Also, I stopped after finding those 3, but it's possible there may be other possibilities.

• Preoperative Diagnosis: A 35-YEAR-OLD GRAVIDA 2, PARA 0-0-1-0 WITH ...
+ wav
Wed Jun 20 09:18:15 2018 wav
Preoperative Diagnosis:
A 35-YEAR-OLD GRAVIDA 2, PARA 0-0-1-0 WITH 29 WEEKS AND 5 DAYS WITH FAILED INDUCTION OF LABOR WITH RUPTURE OF MEMBRANE IN 48 HOURS PRIOR TO DELIVERY COMPLICATED BY CHORIOAMNIONITIS, FOR PRIMARY CESAREAN SECTION.

Procedure:
LOW-TRANSVERSE CESAREAN SECTION VIA PFANNENSTIEL SKIN INCISION.

FINDINGS: _____ and dilated in cephalic presentation _____ engaged in the pelvis prior to starting the procedure. Low-transverse hysterotomy was made with two-layer closure via transverse #1 Vicryl.
** • never mind. Thanks to anyone who tried. - guy
Wed Jun 20 09:46:00 2018 guy


• Would you leave the "like"? Or change it something else? Or just take it out?
+ tia
Wed Jun 20 08:06:36 2018 tia
During her physical, it was noted that her pulse was running high at like 108 beats per minute.
** • I would just leave it - g o m g c l
Wed Jun 20 08:11:02 2018 g o m g c l

**** • ... - thanks
Wed Jun 20 08:22:43 2018 thanks


• Preoperative Diagnosis: RIGHT KNEE DEGENERATIVE JOINT DISEASE. ...
+ wav
Tue Jun 19 21:51:03 2018 wav
Preoperative Diagnosis:
RIGHT KNEE DEGENERATIVE JOINT DISEASE.

Procedure:
CEMENTED TOTAL KNEE ARTHROPLASTY, RIGHT.

Prior to punching the tibia, we trialed with our size #5 femur and our size #4 tibia. We had excellent stability in flexion and extension with a size 7 mm bearing.

All trials were removed. The joint was copiously irrigated as we prepared for cementation. Simplex _____ cement with tobramycin was then mixed on the back table. This was then applied to the tibia as well as the femur, and the real implants were then cemented appropriately.

** • P - poi
Tue Jun 19 21:54:36 2018 poi

**** • Thanks a lot. - guy-
Tue Jun 19 21:57:48 2018 guy-


• Patient status post hemiarthroplasty
+ tlh
Tue Jun 19 19:15:10 2018 tlh
X-ray examination of the right shoulder in Grashey, Y and axillary views demonstrates a well-fit-and-positioned press-fit right shoulder hemiarthroplasty, which is concentrically located about the ______[s/l nay-dum] glenoid in all 3 views. There is a well-maintained subacromial space. ______[s/l Sternal] wires are noted again.
** • THANK YOU, poi! :) - a n e a j g
Tue Jun 19 19:24:31 2018 a n e a j g

** • native glenoid? - poi
Tue Jun 19 19:23:18 2018 poi

** • yes to sternal wires - poi
Tue Jun 19 19:21:58 2018 poi

**** • just as a qualifier-- it is not uncommon to see the pt's sternum + poi
Tue Jun 19 19:25:31 2018 poi
on shoulder films.

• Postoperative Diagnosis: CLINICALLY SEVERE OBESITY, BODY MASS INDEX O ...
+ wav
Tue Jun 19 19:10:13 2018 wav
Postoperative Diagnosis: CLINICALLY SEVERE OBESITY, BODY MASS INDEX OF 50, STATUS POST ADJUSTABLE GASTRIC BAND PLACEMENT IN JUNE 2011, OBSTRUCTIVE SLEEP APNEA, HYPERTENSION, HYPERLIPIDEMIA, HISTORY OF TRANSIENT ISCHEMIC ATTACK, NONALCOHOLIC STEATOHEPATITIS, OSTEOARTHRITIS, VITAMIN D DEFICIENCY.

Operations:
1. LAPAROSCOPIC REMOVAL OF ADJUSTABLE GASTRIC BAND, PORT, AND TUBING.
2. LAPAROSCOPIC CONVERSION TO ROUX-EN-Y GASTRIC BYPASS.
3. LYSIS OF ADHESIONS.
4. EGD.


FINDINGS: Multiple adhesions between the omentum and the anterior abdominal wall _____ vicinity of the patients prior open cholecystectomy incision.
** • especially in the - poi
Tue Jun 19 19:14:05 2018 poi

**** • Thanks a lot. - guy
Tue Jun 19 19:26:17 2018 guy


• Subsequently, _______________, she also began noting to have some symptoms of clickin
+ mp3 posted
Tue Jun 19 18:17:30 2018 mp3 posted
We discussed proceeding with a right trigger thumb release. Subsequently, _______________, she also began noting to have some symptoms of clicking to the left thumb.
** • since our last visit with her, - poi
Tue Jun 19 18:26:03 2018 poi

**** • Thank you, poi - mp3 posted
Tue Jun 19 18:57:35 2018 mp3 posted


• Preoperative Diagnosis: FOURNIER'S GANGRENE. Procedure: R ...
+ wav
Tue Jun 19 17:37:22 2018 wav
Preoperative Diagnosis:
FOURNIER'S GANGRENE.

Procedure:
RIGHT VERTICAL PROFUNDA ARTERY PERFORATOR FLAP ADVANCEMENT.

Time-out was completed verifying correct patient, procedure site, laterality, positioning, allergies, perioperative antibiotics, DVT prophylaxis, fire risks, and surgical and postoperative plan. Anesthesia was administered and endotracheal tube was placed. The patient was then _____ inferiorly on the table and placed in the lithotomy position with well-padded stirrups. The perineum was then prepped with Betadine and draped in a standard sterile fashion.
** • The patient was then slid inferiorly on the table - Jeannine
Tue Jun 19 18:18:04 2018 Jeannine

**** • Thanks a lot. - guy
Tue Jun 19 18:19:07 2018 guy


• Preoperative Diagnosis: HISTORY OF LEFT CHOLESTEATOMA. Proce ...
+ WAV
Tue Jun 19 16:47:38 2018 WAV
Preoperative Diagnosis:
HISTORY OF LEFT CHOLESTEATOMA.

Procedures:
1. SECOND LOOK PROCEDURE.
2. TYMPANOPLASTY.
3. OSSICULAR CHAIN RECONSTRUCTION WITH 0.5 MM _____.
4. FACIAL NERVE MONITORING.

** • *something* prosthesis -- I'm still searching for what kind might fit here. - taco
Tue Jun 19 16:53:56 2018 taco

**** • I'm finding "piston prosthesis" but I can't hear "piston"... hmmm - t
Tue Jun 19 16:58:28 2018 t

****** • can it be FrisbBEE - guy
Tue Jun 19 17:07:49 2018 guy

******** • Frisbee? - guy
Tue Jun 19 17:08:04 2018 guy

********** • Yes ! I think you solved it, guy. - taco
Tue Jun 19 17:15:44 2018 taco

************ • Thanks a lot. - guy
Tue Jun 19 17:37:30 2018 guy

****** • Thanks a lot. - guy
Tue Jun 19 17:06:49 2018 guy


• also by the patient _____________. We discussed
+ wav
Tue Jun 19 16:26:45 2018 wav
This was noted bilaterally, but the right side was slightly worse and also by the patient _____________. We discussed to proceed with a right carpal tunnel release.


** • I think he says "and also bothered the patient worse." - taco
Tue Jun 19 16:30:18 2018 taco

**** • no, wait, it is "...also bothered the patient more, so..." - taco
Tue Jun 19 16:31:01 2018 taco

****** • THanks, taco! - wav
Tue Jun 19 17:18:07 2018 wav


• initiate __________ and mobility of the thumb
+ wav
Tue Jun 19 15:38:04 2018 wav
We will allow the wound to fully heal and remove the sutures, initiate __________ and mobility of the thumb likely at the 1st postoperative visit.
** • scar massage - taco
Tue Jun 19 15:42:26 2018 taco

**** • Gee! Thank you taco :) - wav
Tue Jun 19 15:46:13 2018 wav


• s/l aynum
+ n m l e f g
Tue Jun 19 15:34:34 2018 n m l e f g
history of poorly differentiated squamous cell carcinoma of the s/l aynum and has been getting concurrent chemotherapy and radiation. He says this very clearly.
** • IS this an ESL possibly meaning "anus"? Are there no other clues in the report? - nm
Tue Jun 19 15:42:05 2018 nm

**** • yes he's ESL. I'm thinking he means anus too. Thanks so much! - n m l e f g
Tue Jun 19 15:45:48 2018 n m l e f g


• Urogenital Gynecology
+ Rose
Tue Jun 19 10:47:05 2018 Rose
She has primary immune deficiency, hypothyroidism, hypoglycemia, Epstein-Barr virus, Barretts esophagus, s/l theopenia asthma
** • Osteopenia was correct.. I listened again and this time it was clear a ... + f h g l n g
Tue Jun 19 11:09:38 2018 f h g l n g
Osteopenia was correct.. I listened again and this time it was clear as a bell so thank you very much!!
** • thank you ... + m c d l o a
Tue Jun 19 11:04:53 2018 m c d l o a
thank you
** • ? maybe "osteopenia, asthma" - g o m g c l
Tue Jun 19 11:03:33 2018 g o m g c l

** • Barrett's esophagus with eosinophilia? - wag- taco
Tue Jun 19 11:03:08 2018 wag- taco


• The patient was discussed with general surgery, Dr. *** by Dr. *** from the ED. sm
+ wav :)
Tue Jun 19 03:40:20 2018 wav :)
_____ and the patient will be kept overnight under observation with a HIDA scan and repeat labs.
** • She recommended the patient be kept - ~C
Tue Jun 19 14:55:11 2018 ~C

** • She was ??? and the patient . . . I kind of hear she was brought in, not sure - sea
Tue Jun 19 09:05:46 2018 sea

** • in the ED (I dont hear "Dr" in there at all. - b o l b o m
Tue Jun 19 08:03:29 2018 b o l b o m


• Preoperative Diagnosis: INCARCERATED LEFT INGUINAL HERNIA. P ...
+ wav
Mon Jun 18 21:02:24 2018 wav
Preoperative Diagnosis:
INCARCERATED LEFT INGUINAL HERNIA.

Procedure:
OPEN LEFT INGUINAL HERNIA REPAIR WITH MESH.

FINDINGS: Incarcerated left indirect inguinal hernia containing sigmoid colon and small bowel. Small bowel was edematous with small hemorrhagic areas. There was a large mesenteric hematoma with _____ performed that revealed viability of the bowel throughout. The sigmoid colon was a sliding hernia.
** • never mind. Thanks to anyone who tried. - guy-
Mon Jun 18 22:17:41 2018 guy-


• Preoperative Diagnosis: LARGE NEUROENDOCRINE MEDIASTINAL MASS. ...
+ wav
Mon Jun 18 19:30:03 2018 wav
Preoperative Diagnosis:
LARGE NEUROENDOCRINE MEDIASTINAL MASS.

Procedure:
BRONCHOSCOPY, ROBOTIC LEFT VATS, STERNOTOMY, RESECTION OF MEDIASTINAL MASS.

We then carefully began dissecting free this mass. It did require opening the pericardium, dissecting it off the main pulmonary artery and the upper lobe pulmonary artery as well as an aorta. There was a portion of it that was adhesed to the innominate vein, so we did have to, after gaining vascular control, resected the portion of the innominate vein, maintaining its patency and closing this and performing a venoplasty would _____ a 4-0 Prolene suture.
** • I think he's stumbling and just saying "venoplasty with a 4-0 " etc - sea
Mon Jun 18 19:44:48 2018 sea

**** • yep, he started to say "with a zero" then changed it to 4-0... - b o l b o m
Mon Jun 18 20:34:13 2018 b o l b o m

****** • Thanks a lot everybody - guy
Mon Jun 18 21:03:01 2018 guy

** • never mind. Thanks to anyone who tried. - guy
Mon Jun 18 19:35:51 2018 guy


• Preoperative Diagnosis: RIGHT HIP DEGENERATIVE JOINT DISEASE. ...
+ wav
Mon Jun 18 18:15:38 2018 wav
Preoperative Diagnosis:
RIGHT HIP DEGENERATIVE JOINT DISEASE.

Procedure:
RIGHT TOTAL HIP ARTHROPLASTY WITH NAVIGATION.

Next, the acetabular rim was cleared of all soft tissue including the labrum. Next, the acetabulum was reamed in sequential fashion starting with a #51 reamer. Prior to reaming, we used fluoroscopy to help determine our position and _____ medialization. Fluoroscopy was used throughout the reaming process.
** • amount of - poi
Mon Jun 18 18:18:56 2018 poi

**** • Thanks a lot. - guy
Mon Jun 18 18:22:25 2018 guy


• The patient tolerated the procedure well, was extubated uneventfully, ...
+ wav
Mon Jun 18 17:35:58 2018 wav
The patient tolerated the procedure well, was extubated uneventfully, and transported to the recovery room in stable condition.

POSTOPERATIVE PLAN: The patient will begin dangling _____ between day #3 to #5 depending on how the flap progresses. In the meantime, for the next 72 hours to maintain strict bedrest and leg elevation.

** • sometime - taco
Mon Jun 18 17:43:00 2018 taco

**** • Thanks a lot. - guy
Mon Jun 18 18:15:59 2018 guy

** • never mind. Thanks to anyone who tried. - guy
Mon Jun 18 17:40:29 2018 guy


• Preoperative Diagnosis: RIGHT FOOT SARCOMA. Procedure: RI ...
+ wav
Mon Jun 18 17:21:18 2018 wav
Preoperative Diagnosis:
RIGHT FOOT SARCOMA.

Procedure:
RIGHT FOOT RECONSTRUCTION WITH LEFT ANTEROLATERAL THIGH FREE FLAP.

After this was dissected out, we then made our back cut. Then, the flap was isolated on its perforator with an audible Doppler signal on the skin paddle. At this point, satisfied with our flap dissection, the posterior tibial vessels were exposed. The flap which had been isolated in addition to _____ the lateral femoral cutaneous nerve was divided and transferred down to the foot.
** • also carrying (?) - taco
Mon Jun 18 17:32:16 2018 taco

**** • Thanks a lot. - guy
Mon Jun 18 17:34:59 2018 guy


• I identified the right ureteric orifice with s/l "sit light". The left (etc.).
- mt (cysto)
Mon Jun 18 16:50:21 2018 mt (cysto)

** • I think it i a solution and not a light, but don't know how to spell - mt
Mon Jun 18 16:59:15 2018 mt


• Just a stumble, or is there a word? Thanks
+ wav
Mon Jun 18 16:37:51 2018 wav
0.5% Marcaine with epinephrine was injected for postoperative pain relief. The Hulka was removed. The patient was then placed supine _____ and transferred to the recovery room in stable condition.
** • awoken - mt
Mon Jun 18 16:50:41 2018 mt

**** • Thanks!! Is awoken correct, or is it rather awakened? - wav
Mon Jun 18 17:08:18 2018 wav


• ____ confirmation, the peritoneal cavity presence was confirmed, a pne ...
+ wav
Mon Jun 18 16:28:19 2018 wav
____ confirmation, the peritoneal cavity presence was confirmed, a pneumoperitoneum was achieved, after which
** • directed toward the fundus once confirmation of the peritoneal cavity presence - sea
Mon Jun 18 16:30:27 2018 sea

** • I think he is saying this, awkwardly said. Please someone agree or disagree. Thanks + wav
Mon Jun 18 16:30:25 2018 wav
Once confirmation of the peritoneal cavity presence was confirmed, a pneumoperitoneum was achieved,
**** • I think you got it right. Thanks so much! - wav
Mon Jun 18 16:36:19 2018 wav

**** • Agree, it's hard to tell from his inflection which way to go with the commas - sea
Mon Jun 18 16:35:03 2018 sea


• Next, the patients leg was brought out into full extension. Gentle e ...
+ mp3
Mon Jun 18 16:20:17 2018 mp3
Next, the patients leg was brought out into full extension. Gentle extension force was applied until the patients knee was brought to nearly full extension.

This concluded the procedure. Anesthesia was reversed and the patient was brought to PACU in good condition.

POSTOPERATIVE INSTRUCTIONS: We will need to continue with aggressive _____ postoperatively. This will include narcotic pain medication as well as an antiinflammatory in the form of Celebrex. CTA machine will be ordered for postop and at home.

** • multi-level pain strategy postoperatively - sea
Mon Jun 18 16:29:21 2018 sea

**** • Thanks a lot. - guy
Mon Jun 18 16:29:38 2018 guy


• Preoperative Diagnoses: 1. STATUS POST BILATERAL TOTAL KNEE ARTHRO ...
+ wav
Mon Jun 18 16:09:37 2018 wav
Preoperative Diagnoses:
1. STATUS POST BILATERAL TOTAL KNEE ARTHROPLASTY.
2. BILATERAL KNEE ARTHROFIBROSIS.

Procedure:
BILATERAL KNEE MANIPULATION UNDER ANESTHESIA.

The patient was subsequently brought back to the operating room and transferred to the operating table. Care was taken to pad all bony prominences and a safety strap was applied. Next, general anesthesia was induced and the patient was intubated.

A time-out was performed identifying the patient, procedure to be performed with laterality. _____ preoperative antibiotics were not used.

We began with the right knee.

** • As we were not making an incision? - isgal
Mon Jun 18 16:25:55 2018 isgal

**** • Thanks a lot. - guy
Mon Jun 18 16:26:03 2018 guy


• She now studies in Fordham University in New York for premed which is ____ biology.
- mp3
Mon Jun 18 15:35:20 2018 mp3

** • BS in (Bachelors of Science) - taco
Mon Jun 18 15:55:36 2018 taco

**** • ... + c i c i d m
Mon Jun 18 17:35:45 2018 c i c i d m

**** • ... - thanks
Mon Jun 18 16:24:03 2018 thanks




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