DATE OF PROCEDURE: MM/DD/YYYY
PREOPERATIVE DIAGNOSIS: Acute left testicular pain.
POSTOPERATIVE DIAGNOSES:
1. Acute left testicular pain.
2. Acute left testicular torsion.
PROCEDURE PERFORMED: Scrotal exploration, left orchiectomy, and right orchiopexy.
SURGEON: John Doe, MD
ANESTHESIA: General.
SPECIMEN: Included the left testis.
DRESSINGS: Included bacitracin, Telfa, fluffs, and jockstrap.
DRAINS: None.
DESCRIPTION OF PROCEDURE: The patient was brought on urgent basis in the main operating room. He was placed in the supine position. After adequate instillation of general anesthesia, the scrotal pubic hair was clipped. He was prepped and draped in the usual sterile fashion.
A midline scrotal incision measuring approximately 4 mm was established with a knife. The dartos was incised with electrocautery. The tunica vaginalis was open. The left testis and cord were delivered from the left hemiscrotum. The left testis was dark blue in color. The left spermatic cord was twisted 720 degrees. After detorsion, left testis was wrapped in a warm towel.
Attention was turned to the right hemiscrotum. The dartos muscle was incised with electrocautery. The tunica vaginalis was opened sharply. The right testis was returned to the right hemiscrotum, and the tunica albuginea was fixed to the dartos muscle of the scrotum medially, laterally, and inferiorly with a 3-0 nylon suture.
Attention was turned to the left testis. The decision was made to proceed with left orchiectomy. The left vas deferens was separated from the lymphatic and blood vessel, and each of the bundles was cross-clamped and transected. The left testis was sent to the pathology department in anatomically labeled container. The left vas deferens, the remaining cord structures were secured with 2-0 silk suture.
The wound was vigorously irrigated. Hemostasis was obtained. The dartos was closed with running 2-0 Vicryl suture. The scrotal skin was closed with 4-0 chromic suture. Bacitracin and a piece of Telfa were placed over the scrotal wound, and in addition fluffs were placed inside a jockstrap. The patient tolerated the procedure well. He was awoken in the operating room and accompanied to the recovery room in stable condition. The estimated blood loss was negligible. The procedure was performed with approximately 650 ml of IV fluids. The procedure was performed without transfusion. The procedure was performed without complications.
PLAN: The plan for this patient includes routine postoperative care. Norco one tablet every four to six hours as needed for postoperative pain is recommended. The patient is encouraged to contact the office with questions and/or problems. He was asked to return to the office in one to two weeks for postoperative evaluation. The disposition for this patient depends on his clinical course.
