1) Prepare an interpretation of the report for the patient or family, translating the report from medical to layman’s terminology.
2) “Translate” all of the medical terminology from this report into a written glossary, providing both definitions and a pronunciation guide. This should consist of a minimum of at least 25 medical terms.
Report:
TITLE OF OPERATION:
Cystourethroscopy, left retrograde ureteropyelogram and left dismembered pyeloplasty.
PREOPERATIVE DIAGNOSIS:
Left ureteropelvic junction obstruction.
POSTOPERATIVE DIAGNOSIS:
Left ureteropelvic junction obstruction.
ANESTHESIA:
General endotracheal anesthesia.
DESCRIPTION: The patient was brought to the operating room and underwent general anesthesia. He was placed in the dorsal lithotomy position. He was prepared and draped in the usual manner. The 9.5 pediatric cystoscope was placed in the bladder and a #3 ureteral catheter was placed through the torquing channel. A left retrograde ureteropyelogram was obtained. This showed a clear obstruction at the junction of the left ureteropelvic junction. The cystoscope and stent were then removed.
The patient was then placed in the left-flank-up position. An incision was made off the tip of the 12th rib with a #15 blade. Bleeding was controlled utilizing electrocautery. The muscle fibers were all incised in the flank with electrocautery. Two Richardson retractors were placed. Gerota’s fascia was opened in a vertical fashion and the kidney was delivered. The ureter was found in the retroperitoneal space and dissected out to the level of the renal pelvis. There was clear obstruction and kinking at the level of the ureteropelvic junction. Markings sutures were placed in the ureter and the renal pelvis with 6-0 Vicryl. The obstructive segment was excised and the tenth renal pelvis was then decompressed. An oblique anastomosis was then effected between the upper ureter which had been spatulated and the renal pelvis. This was accomplished with two sutures of 6-0 Vicryl at the apices and then running sutures on the anterior and posterior wall with 6-0 Vicryl. Prior to completing the anterior anastomosis, a 10-French Malecot catheter was used as a nephrostomy tube and brought with the nephrostomy needle through the substance of the kidney and was brought out through the flank, and it was sewn to the flank with 4-0 Prolene. The anterior aspect of the anastomosis was then completed after a #3 pediatric feeding tube was placed through the anastomosis and� to be watertight. The kidney was returned to the renal space. Gerota’s fascia was left open in the caudad portion. A Penrose drain was placed through a stab wound and brought down to the inferior portion below the anastomosis. This was sewn to the skin with 4-0 nylon. The muscle layers were then closed with running 3-0 Vicryl. The subcutaneous layer was closed with 4-0 Vicryl and the skin was closed with a running subcuticular 3-0 Prolene suture. There were no intraoperative complication. The patient was discharged to the recovery room in satisfactory condition.
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