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For my shoulder surgery that happened a week and a half ago, here's the write-ups.
Operative Report
Preopertative diagnosis: Soft tissue mass, left shoulder, upper left chest
Postopertative diagnosis: Soft tissue mass, left shoulder, upper left chest
Anesthesia: Total IV anesthesia and local 0.5% Marcaine plain mixed 1:1 with 2% Xylocaine with epinephrine
Procedure: Resection of soft tissue mass, left shoulder, left upper chest (12 x 10 cm).
Estimated blood loss: Negligible.
Complications: None.
Operative Specimen: Soft tissue mass of left shoulder consistent with a multilobulated lipoma.
Procedure in detail: The patient was taken to operating room #5 and placed supine. Total IV anesthesia was administered uneventfully. IV antibiotics were given. The left chest and shoulder area was prepped with ChloraPrep and draped sterilely. The large soft tissue mass on the anterior left shoulder and the upper lateral left chest was outlined with a marking pen and then a curvilinear incision in the natural skin line was outlined directly over this and them preemptively locally anesthetized. A 15 scalpel incision was carried down. Immediately in the relatively superficial adipose tissue, I encountered a multilobulated lipoma. This lipoma extended from the superficial subcutaneous space all the way down to the deltoid and pectoralis muscular fascia but did not involve it directly. The entire lipoma was resected using a combination of blunt and electrocautery dissection without any difficulty. The area was then further palpated and examined and a few additional small lobulations were noted which were removed separately. The are was then carried out copiously. The effluent was absolutely clear. There had been no bleeding or problems encountered. I encountered further local anesthetic preemptively in all deeper planes of dissection throughout the procedure and injected further deeper plane local anesthetic at this time once again. One final round of irrigation indicated all was cleared and on visualization and palpation, there was no further lipomatous lobulation. The specimen was certainly consistent with a benign multilobulated lipoma. It measured 12 x 10 cm in its length and width and was submitted to pathology for permanent section. The subcutaneous tissue was then reapproximated with interrupted simple 3-0 Vicryl. The skin was closed with running subcuticular 4-0 Vicryl, Mastisol, 1/2 inch Steri-Strips cut 1/3 length, and a sterile dressing was applied. The procedure was very well tolerated with no difficulties and sponge, instrument, and needle counts were correct. The patient was transported back to the recovery area in good condition.
*******
Surgical Pathology Report
Diagnosis: Soft tissue, left shoulder, lesion excision: Benign lipoma.
Microscopic description: A-D: Examination of the sections from the left shoulder lesion shows lobulated mature adipose tissue. There is no significant nuclear atypia. There is no diagnostic malignancy. The findings present are consistent with a benign lipoma.
Gross description [no shit]: Received in formalin labeled "lipoma of left shoulder" are at least ten disrupted, unoriented portions of tan-yellow to yellow-brown adipose tissue collectively measuring 14.2 x 9.7 x 4.5 cm. Due to the disrupted nature of the specimen, the outer surfaces are not inked. The cut surfaces are homogenous, golden yellow, soft, and lobulated. No distinct abnormality is noted grossly. There is a scant amount of unremarkable delicate interspersing membranous tissue. Representative sections are submitted as A-D.
Operative Report
Preopertative diagnosis: Soft tissue mass, left shoulder, upper left chest
Postopertative diagnosis: Soft tissue mass, left shoulder, upper left chest
Anesthesia: Total IV anesthesia and local 0.5% Marcaine plain mixed 1:1 with 2% Xylocaine with epinephrine
Procedure: Resection of soft tissue mass, left shoulder, left upper chest (12 x 10 cm).
Estimated blood loss: Negligible.
Complications: None.
Operative Specimen: Soft tissue mass of left shoulder consistent with a multilobulated lipoma.
Procedure in detail: The patient was taken to operating room #5 and placed supine. Total IV anesthesia was administered uneventfully. IV antibiotics were given. The left chest and shoulder area was prepped with ChloraPrep and draped sterilely. The large soft tissue mass on the anterior left shoulder and the upper lateral left chest was outlined with a marking pen and then a curvilinear incision in the natural skin line was outlined directly over this and them preemptively locally anesthetized. A 15 scalpel incision was carried down. Immediately in the relatively superficial adipose tissue, I encountered a multilobulated lipoma. This lipoma extended from the superficial subcutaneous space all the way down to the deltoid and pectoralis muscular fascia but did not involve it directly. The entire lipoma was resected using a combination of blunt and electrocautery dissection without any difficulty. The area was then further palpated and examined and a few additional small lobulations were noted which were removed separately. The are was then carried out copiously. The effluent was absolutely clear. There had been no bleeding or problems encountered. I encountered further local anesthetic preemptively in all deeper planes of dissection throughout the procedure and injected further deeper plane local anesthetic at this time once again. One final round of irrigation indicated all was cleared and on visualization and palpation, there was no further lipomatous lobulation. The specimen was certainly consistent with a benign multilobulated lipoma. It measured 12 x 10 cm in its length and width and was submitted to pathology for permanent section. The subcutaneous tissue was then reapproximated with interrupted simple 3-0 Vicryl. The skin was closed with running subcuticular 4-0 Vicryl, Mastisol, 1/2 inch Steri-Strips cut 1/3 length, and a sterile dressing was applied. The procedure was very well tolerated with no difficulties and sponge, instrument, and needle counts were correct. The patient was transported back to the recovery area in good condition.
*******
Surgical Pathology Report
Diagnosis: Soft tissue, left shoulder, lesion excision: Benign lipoma.
Microscopic description: A-D: Examination of the sections from the left shoulder lesion shows lobulated mature adipose tissue. There is no significant nuclear atypia. There is no diagnostic malignancy. The findings present are consistent with a benign lipoma.
Gross description [no shit]: Received in formalin labeled "lipoma of left shoulder" are at least ten disrupted, unoriented portions of tan-yellow to yellow-brown adipose tissue collectively measuring 14.2 x 9.7 x 4.5 cm. Due to the disrupted nature of the specimen, the outer surfaces are not inked. The cut surfaces are homogenous, golden yellow, soft, and lobulated. No distinct abnormality is noted grossly. There is a scant amount of unremarkable delicate interspersing membranous tissue. Representative sections are submitted as A-D.
