DATE OF OPERATION: MM/DD/YYYY
PREOPERATIVE DIAGNOSES:
1. Right spermatocele.
2. Left epididymitis.
3. Left spermatocele.
POSTOPERATIVE DIAGNOSES:
1. Right spermatocele.
2. Left epididymitis.
3. Left spermatocele.
OPERATIONS PERFORMED:
1. Exploration of scrotal contents.
2. Right spermatocelectomy.
3. Left spermatocelectomy.
4. Left epididymectomy, partial.
SURGEON: John Doe, MD
DESCRIPTION OF OPERATION AND FINDINGS: The patient was brought to the operating room, and he was put in the supine position. After satisfactory general anesthesia, the skin of the external genitalia and the lower abdomen was prepped with Betadine and draped in a sterile manner. An incision was carried out right of scrotum, along the skin crest, incising through the dartos there, all the way down to the tunica vaginalis, and the vaginalis was opened, and exploration of the right hemiscrotal content was then performed.
The right testicle appeared to be in normal shape; however, there was evidence of spermatocele in the upper part of the epididymis area, and this was congested and very full. Throughout on exploration, it showed that this structure was very tight and full of fluid. Dissection was carried to the parietal layer of the tunica vaginalis. Sharp dissection was performed to free the cyst from the testicle and epididymis, all the way to the root of the epididymal cyst.
The root was fulgurated with Bovie, and the cyst was then removed completely and sent for pathological studies. Upon examination, it showed no evidence of tumor or masses. Epididymis appeared to be normal, and the patient had previous vasectomy, so there was some congestion of the epididymal area, but there was no evidence of tumor or masses or bleeding points. The testicle was then put back into the scrotum. The tunica vaginalis was closed with 3-0 chromic running locking suture, the dartos muscle was then closed with 3-0 chromic running locking suture, and skin by 4-0 chromic running mattress suture.
The same procedure was performed on the left side. After incising the skin, the dartos muscle, all the way down to the tunica vaginalis, the tunica vaginalis was opened and left hemiscrotal content was explored. Upon exploration of the left hemiscrotal content, it showed evidence of spermatocele and also has chronic epididymitis, which was affecting the epididymal area with cystic formation. The testicle appeared to be normal. There was no evidence of tumor, masses, bleeding points, or any lesions. Sharp dissection was performed. Partial epididymectomy was performed. Some bleeding from the epididymis was then cauterized and the cystic structure was also removed, and the epididymal cyst was then blocked and removed and sent for pathological study.
Upon completion of the procedure, irrigation was performed, and fulguration showed no evidence of abnormal bleeding points. Upon closure, the tunica vaginalis was closed with 2-0 chromic running locking suture, the dartos muscle was closed with 3-0 chromic running locking suture, and skin with 4-0 chromic running mattress suture. The patient tolerated the operative procedure well. Upon completion of the procedure, the scrotal supporter was applied, and the patient was then sent to the recovery room in good condition.
