DATE OF PROCEDURE: MM/DD/YYYY
PREOPERATIVE DIAGNOSIS: Left neck lipoma.
POSTOPERATIVE DIAGNOSIS: Left neck lipoma.
PROCEDURE PERFORMED: Excision of deep neck lipoma.
SURGEON: John Doe, MD
ANESTHESIA: General endotracheal.
ESTIMATED BLOOD LOSS: Minimal.
COMPLICATIONS: None.
INDICATIONS FOR PROCEDURE: The patient is a (XX)-year-old woman with a history of a large mass growing in the neck. On MRI, this was consistent with a lipoma. Fine needle aspiration did not reveal any significant pathology. The patient is presenting for definitive diagnosis as well as excision.
DESCRIPTION OF PROCEDURE: After obtaining informed consent, the patient was taken from the holding area to the operating room by the anesthesia and surgery teams. She was placed on the operating table in the supine position. After adequate general endotracheal anesthesia by the anesthesia team, the table was turned 90 degrees. A shoulder roll was placed below the patient, and the patient was prepped and draped in the usual sterile fashion.
A curvilinear incision was made in the neck, in a skin crease. Subplatysmal flaps were elevated superiorly and inferiorly. The sternocleidomastoid muscle was retracted laterally. The lipoma was then immediately encountered. By gently dissecting around this, the carotid sheath was preserved. The carotid artery, vagus nerve and internal jugular vein were all isolated away from this. The facial vein was elevated up and away from the mass and ultimately ligated, as it was very adherent. The mass was then able to be elevated away from the adjacent structure of the submandibular gland by gentle blunt dissection.
Once this was done, the mass could easily be elevated from its superior aspect and elevated down in the wound. Gentle blunt dissection was then done to elevate it away from the other contents of the carotid sheaths. The mass separated easily, and there was no significant adherence. It was fully removed and sent off for permanent specimen.
The wound was copiously irrigated. The 7 French flat Jackson-Pratt drain was placed. The wound was closed in layers. The patient was allowed to awaken from anesthesia, was extubated without incident, and returned to the recovery room in stable condition.
