Operative Report for Amanda Jenkins
OPERATIVE REPORT
Jenkins, Amanda
2967898
Hal Russo, MD
June 29.
SURGEON: Hal Russo, MD
FIRST ASSISTANT: Wendy Quimby, MD
SECOND ASSISTANT: Justin Don, MD
PREOPERATIVE DIAGNOSIS
Medically refractory seizures.
POSTOPERATIVE DIAGNOSIS
Medically refractory seizures.
PROCEDURE
Insertion of left vagal nerve stimulator.
ANESTHESIA
General Endotracheal
HISTORY
This is a 6 year old white female, who has had medically refractory seizures for most of her life. She arrives here after failing multiple medical therapies for insertion of a vagal nerve stimulator in the palliative treatment of her seizures.
PROCEDURE IN DETAIL
The patient was brought to the operating room, intubated and placed in supine position with her head turned to the left, and a shoulder roll placed under left shoulder. The anterior portion of her neck, left pectoral and left axillary area were prepared with iodine solution and draped in the sterile fashion. First, a horizontal incision was made in the midportion of the neck from the midline extending to the left anterior border of the sternocleidomastoid muscle and dissection carried down through the platysma, exposing the sternocleidomastoid and paratracheal fascia. Then, this fascial plane was opened and this eventually exposed the carotid sheath. The carotid sheath was incised sharply revealing the internal jugular vein superficially, the carotid artery more medially and the vagus nerve in the postural lateral part of the sheath. A 3.0 cm segment of vagus nerve was isolated from its connective tissue and the bipolar electrode array of the stimulator (Cyberonics Model 101) was inserted on the nerve as according to the manufacturer. Then, a double strand release loop was created with the tie downs provided by the manufacturer, the ascending loop attached to the fascia of the medial sternocleidomastoid and the descending loop attached to the external fascia of the sternocleidomastoid. Attention was then
Jenkins, Amanda
2967898
Hal Russo, MD
June 29.
SURGEON: Hal Russo, MD
FIRST ASSISTANT: Wendy Quimby, MD
SECOND ASSISTANT: Justin Don, MD
PREOPERATIVE DIAGNOSIS
Medically refractory seizures.
POSTOPERATIVE DIAGNOSIS
Medically refractory seizures.
PROCEDURE
Insertion of left vagal nerve stimulator.
ANESTHESIA
General Endotracheal
HISTORY
This is a 6 year old white female, who has had medically refractory seizures for most of her life. She arrives here after failing multiple medical therapies for insertion of a vagal nerve stimulator in the palliative treatment of her seizures.
PROCEDURE IN DETAIL
The patient was brought to the operating room, intubated and placed in supine position with her head turned to the left, and a shoulder roll placed under left shoulder. The anterior portion of her neck, left pectoral and left axillary area were prepared with iodine solution and draped in the sterile fashion. First, a horizontal incision was made in the midportion of the neck from the midline extending to the left anterior border of the sternocleidomastoid muscle and dissection carried down through the platysma, exposing the sternocleidomastoid and paratracheal fascia. Then, this fascial plane was opened and this eventually exposed the carotid sheath. The carotid sheath was incised sharply revealing the internal jugular vein superficially, the carotid artery more medially and the vagus nerve in the postural lateral part of the sheath. A 3.0 cm segment of vagus nerve was isolated from its connective tissue and the bipolar electrode array of the stimulator (Cyberonics Model 101) was inserted on the nerve as according to the manufacturer. Then, a double strand release loop was created with the tie downs provided by the manufacturer, the ascending loop attached to the fascia of the medial sternocleidomastoid and the descending loop attached to the external fascia of the sternocleidomastoid. Attention was then