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MEDICAL FACULTY OF CHRISTIAN UNIVERSITY OF INDONESIA

HOSPITAL
DEPARTMENT OF OBSTETRY AND GINECOLOGY
JL. Mayjen Sutoyo No. 2 Cawang, Jakarta Timur 13630
Telp.8099217 ext. 108 / 205

37

GENERAL

SURGERY REPORT
Name: Mrs. Hartati. T
Sex: Female
Age: 45 years old
Operator
Prof.dr.I.O.Marsis, SpOG
Anestetic
Dr. Veronica, SpAn
Asistant 1
Dr.Benhur Sibuea
Instrumentator
Zr. Sumarni
Asistant 2
Ferji Rhenald
Observer
Meri Octavia
Pre-surgery diagnose: Cyst Ovarium Suspect Malignancy + Myoma Utery Dextra
Post- surgery diagnose: Cyst Ovarium Dextra Suspect Malignancy +
Myoma Utery + Adhesi
Technique of operation
1. Total hysterectomy
2. Salpingo-oophorectomy bilateral
3. Adhesiolysis

Surgery date: March 14th 2016

Duration time of surgery:3 hours 30
minutes
Type of surgery
emergency
minor
policlinic
medium
elective
major

Operation Procedures:
I.

Patient in supine position with general anesthetic

II.

Applying methylene blue in to introitus vagina and installing dower catheter

III.

Asepsis and antisepsis in abdomen region and surrounding the 1/3 distal of
posterior extremity, field of view narrowed by steril doek.

IV.

Median incision on abdomen was made around fibritio tissue, 15 cm length,

the incision was made deeper sliece by sliece from cutis, subcutis, fascia then
it seperated to lateral section with sharp technique. musculus rectus abdominis
seperated with dull technique, bleeding was taken care off.

V.

Explored the abdominal and pelvic cavity

a. Identified:
-

The uterine as big as babys head

Left ovary were found brown ovarium cyst

Right and left fallopian were adhesion

Conclusion: -Uterine myoma

-Brown ovarium left cyst
-Adhesion

b. Total hysterectomy was planned

c. Salfingooverectomy Bilateral + Adhesiolysis
VI.
a.

Operative procedures of total hysterectomy as follows

Fixation uterus by drill
b. The round ligament clamped on two side, approximately 1 cm and 1,5
cm from uterus and then cut both two clamp, ligated at medial and
lateral dissection, then sutured it by Vicrylno.1. The same procedure
is done on both sides.
c. Opened plica vesikouterina and continued incision to the left and right
lateral and put aside to lower.
d. The proximal of left fallopian tube was clamped on two side, cut both
two clamped ligated on medial and lateral dissection and then sutured
with Vicrylno.1. The same procedure is done on the right fallopian
tube.
e. The left broad ligament clamped on two side, cut both two clamped,
ligated, then sutured. The same procedure is done on the right broad
ligament.
f. The left uterosacral ligament clamped on two side, approximately 1 cm
and 1,5 cm from uterus, cut between two clamped, ligated on medial
and lateral dissection then sutured with Vicrylno.1. The same
procedure is done on the right uterosacral ligament.
g. The left and right vasa uterin clamped, cut and ligated with
Vicrylno.1
h. The left cardinale ligament clamped on two side, cut between two
clamped, ligated on medial and lateral dissection, then sutured. The
same procedure is done on the right cardinale ligament.
i. Cut off the upper vagina and sutured with Vicryl no.1 by overhecting
suture. And hanged with the right and left round ligament, the right and
left uterosacral ligament and the proximal of right and left fallopian
tube.
j. Reperitonealitation by sutured plica vesikouterin with Chromic Cat
Gut no.2.0

VII. Operative procedures of adhesiolysis of tuba fallopies

Adhesion of tuba fallopies was evacuated with cauterization
VIII. Operation procedures of salphingoovorectomy :
a. Attachment trocar and continue the suction fluid cyst amount 100 cc. Texture
of the fluid cyst is mucin. And then, doing hecting with cromic cat gut no. 2
b. Clipped, cutting and bundle of right ovarii propium ligament with thread of
Chromic cat gut no. 2
c. The continue of clipped, cutting and bundle of left ovarian base with thread
Chromic cat gut no. 2
d. Taking of right and left ovarian to examination of pathology anatomy
e. Spulling and suction with NaCl 0,9%. Input of Hidrokortison 10 cc to cavum
abdomen

IX. After the reperitonealitation had been done abdominal wall was closed, the
peritoneum cavity was cleared from the blood cloth and after sure its no
bleeding then it was sutured slice by slice.
a. Peritoneum parietal was sewed bastes with Plain cat gutno.2.0
b. M.Rectusabdominis was sutured with Chromic cat gut no.2.0
c. Fascia was sutured with Polysorbno.1 by continue
d. Subcutis was sutured with Plain cat gut no.0 by simple suture
e. Cutis was sutured with Chromic cat gut no. 2.0 by subcuticuler
X.

Bleeding approximately 500 cc

XI.

Post surgical wound was cleaned by using Nacl + Betadine, and then it was
closed by using the curapor.

XII.

The abdomen was cleaned.

XIII. The surgery finished.

Post surgery condition:

General condition

: Moderate illness

Consciousness

: Somnolent

Blood pressure

: 130/80 mmHg

Pulse rate

: 72 x/mnt

Respiratory Rate

: 18 x/mnt

Temperature

: 36,5oC

Tissue to Anatomy Patological

 Yes: type of tissue : ovarium right, uterine, omentum, appendix (March 14th 2016)
No

Operator,

( Prof.dr.I.O.Marsis, SpOG )