Hellstrom Circumcision Dictation Template

OPERATIVE NOTE

 

Pre-op Dx: balanitis

 

Post-op Dx: same

 

Procedure: circumcision

 

Surgeon: Wayne Hellstrom, MD

 

Assistant(s): Hoang Minh Tue Nguyen, MD

 

Anesthesia: LMA

 

Indications for Procedure:

 

yo WM referred to Urology for balanitis. He has been dealing with recurrences

for years. He is usually treated with a topical medication but is ready for a

circumcision. Not a diabetic, not on anticoagulation therapy. After poor results

with medical management via topical steroids and

antifungals, the patient elected to proceed with a circumcision. The risks and

benefits of surgery were discussed with the patient prior to signing an informed

consent.

 

Operation in Detail:

 

 

The patient was seen in the preoperative unit and informed consent was obtained.

He was taken to the OR and placed in a supine position on the OR table. After a

smooth and uneventful induction of anesthesia, the patient was prepped and

draped in a sterile fashion.

 

A WHO timeout was performed and all were in agreement.

 

We began by using kocher clamps at the 12 o'clock position of the prepuce and

clamped a few times. We then repeated the same procedure at the 6 o'clock, 9

o'clock, and 3 o'clock position.

 

We used a curved mayo to excise the excess skin along the clamped kocher. The

specimen was then passed off and sent for pathology.

 

Hemostasis was achieved with bovie electrocautery. Once

hemostasis was achieved, we reapproximated the penile skin using 3-0 monocryl

suture in an interrupted fashion.

 

The skin was then covered with dermabond. The penis was wrapped with a cling

dressing and a coban.

 

The patient was then awoken from anesthesia and taken to the PACU in good

condition.

 

Dr. Wayne Hellstrom was scrubbed and present for the entirety of the

procedure.

 

Findings: balanitis

 

EBL: minimal

 

Implants: none

 

Specimens: foreskin

 

Drain: none

 

Complications: none