Case No.

: Major Scrub 1
Name of Student: Mary Edella Acob
Year and Section: III-I

Name of Patient: Amanda Brual Evangelista Age: 67 Sex: Female Civil Status: Married
Date of Admission: September 30, 2019 Time Started/Ended: 8:10 A.M./10:15 A.M.
Date of Surgery: October 1, 2019
Bed #: 4077 Hospital No.:19-050000234596 Admissions No.:19I00990

Surgeon: Dr. Wilhelmina A. Mercado

Assistant Surgeon: Dr. Raymundo
Anesthesiologist: Dr. M. Jatico/Dr. Guerrero
Scrub Nurse: Emy Grace M. Mangosing
Circulating Nurse: Chelsi Anne Y. Abolencia

Chief Complaint: Hypogastric pain

Rationale/Definition: The admitting diagnosis was right ovarian new growth. Most cysts don’t cause
symptoms, but a large ovarian new growth can cause pelvic pain which is a dull or
sharp pain in the lower abdomen on the side of the cyst.
Pathophysiology:

Predisposing factors: Etiology:

• Age (67 years old) Unknown Precipitating factors:
• Hormonal imbalance • smoking

abnormal overgrowth of
cells within the ovary

Arising from
epithelial lining

Diagnostic test: Signs and Symptoms:

•
• Ultrasound Benign epithelial cell
Hypogastric pain
• Constipated
• transvaginal sonograms tumor
• Abdominal fullness

If treated If not treated

Continuous proliferation
Surgical Treatment: of cells growth
- Right oophorectomy with
frozen section followed by
total abdominal hysterectomy Exposure to carcinogens
with bilateral salpingectomy Increase in size of tumor
and left oophorectomy
•
Development of malignant tumor

Result:
- Right mucinous
cystadenoma Uncontrolled proliferation of cells in the tumor

Reduction likelihood Increase in size

of regrowth

ovarian CANCER

Continues increase in size

 OVARIAN CANCER

Continues increase in size

Metastasis of cancer cells in

other organs

Proliferation of cancer cells

in that area

Formation of new tumor

Complications occur

Post-Op Diagnosis: Right mucinous cystadenoma

Rationale/Definition: Right mucinous cystadenoma is a benign cystic tumor lined by a mucinous
epithelium.

Surgical procedure: Right oophorectomy with frozen section followed by total abdominal hysterectomy
with bilateral salpingectomy and left oophorectomy
Definition: “Abdominal” is the surgical technique that will be used in which there will be an
incision through the abdomen. This is also the surgical removal of the uterus, ovary,
fallopian tubes, and cervix.
Indication: This is done to the patient because if the ovarian new growth is not removed it can
cause further severe pain to the patient if the cyst ruptures.

Type of anesthesia: GETA

Specific technique: Inhalation
Main anesthetic agent: Sevoflurane
Mechanism of action: These work by reducing the activity of the body's central nervous system
temporarily. It is a clear colorless liquid, that becomes a gas when put into a special anesthetic machine.
It causes a dose-dependent vasodilation of cerebral vasculature, thereby increasing cerebral blood flow
and intracranial pressure. Sevoflurane reduces the cerebral metabolic rate
Position: Supine
Equipment used for Positioning: Pillow, safety strap (upper thigh)
Incision: Midline vertical incision carried down to peritoneum
Skin preparation: Abdomen down to peritoneum
Disinfectant used: Betadine and cutasept-F
Draping: Lap sheet, towel (4)

Sutures and Needles:

Tissue Layer Needle Name of Suture Used Suturing Technique

• Skin • Cutting • Vicryl • Interrupted Suture

• Subcutaneous Fat • Round • Vicryl • Subcutaneous Suture
• Anterior Fascia • Round • PDS Plus • Deep Suture
• Muscle • Intestinal • Mersilk • Spiral Interrupted Suture
• Peritoneum • Round • Vicryl OCT 1 • Continuous suture
Instruments:
Clamping Retracting Grasping Cutting Others

• Kelly • Malleable • Thumb Forcep • Knife Handle • Bowl

• Allis • Army Navy • Tissue Forcep • Mayo • Kidney Basin
• Peritoneal • Richardson • Russian Straight • Medicine Cup
• Ochsner • Self- • De Bakey • Mayo Curve • Cautery
Straight Retaining • Adson • Metzenbaum • Needle Holder
• Ochsner Retractor
curve • Bladder
• Bobcock Retractor
Long • Deaver
• Bobcock
Short
• Towel
Clips
• Sponge
Holder
• Kelly Mayo