129 GYNECOMASTIA EXCISION with or without LIPOSUCTION

This operation is done for males as young as 13 years.

Note differences when liposuction included

modified March 4, 2013

 

OPERATIVE TIME 2 hours

USUAL LOCATION(S): Pres Main, Pres Day, ASC

FREQUENCY: 4/YEAR

ASSISTANT: GWEN

ICD9: 611.1 GYNECOMASTIA

CPT:19140 EXC GYNECOMASTIA, 15877 LIPOSUCTION

 

ANESTHESIA

General, ETT or LMA, Kefzol 1 gm IV

PATIENT POSITION | SETUP

Supine, arms out on boards, green towel, tattoo kit: 22g needle, kelly clamp, 3cc syringe 18g needle, 4x4, gloves

TABLE POSITION

Normal

ROOM SETUP

Pre-warm room and bed,

for liposuction: pressure bags for tumescent solution

 

EQUIPMENT

Baer Hugger, seq teds

for LIPOSUCTION

for liposuction: Liposuction machine and [1] cannister, flow sheet, Test and connect machine

SPECIALS

Headlight and 2] light sources

Metric weighing scale

PREP

CHG prep set

DRAPING

plastic pack w/Lap drape, mag pad, [2] half sheets, [1] 3/4 sheet, [1] mayo stand cover, [6] sticky paper drapes, extra gown

CAUTERY

Bovie 50/50 pure, flat silver tip, Valleylab extended silver coated long blade bovie E1450, Saf-T-Vac

SUCTION

[2] suctions: regular with plastic Yankauer and Saf-T-Vac

[2] suction tubing

 

SOLUTIONS | IRRIGATION

Normal saline [3] liters

NEEDLES | SYRINGES

Solution “C” 200cc - Mix 2% lidocaine w/epi 50cc +

                          0.5%Marcaine w/epi 50cc + NS 100cc

■draw up separate Marcaine 0.25% with epi - 60cc

LOCAL ANESTHETIC

[ 2] 20cc syringes, [2] long Quincke 22g spinal needles

for LIPOSUCTION

for liposuction: [2] liters tumescent Solution “A”

MEDICATIONS

Bacitracin ointment 2 oz [hold], methylene blue

 

STERILE SUPPLIES

Marker pen, Asepto,

for liposuction: [2] BSS tubing for tumescent infiltration

SPONGES

Lap sponges

NON-STERILE SUPPLIES

 

129 GYNECOMASTIA EXCISION with or without LIPOSUCTION

page 2

 

SETS TO OPEN

Special plastic set

INSTRUMENTS USED (ON MAYO STAND)

     FORCEPS

01- 03 - 05 Adson, Debakey, Long Adson-Brown

     SCISSORS

Metz, short and long serrated Rees Mayo, str Mayo, str metz, Reynolds

     NEEDLE HOLDERS

Crile Wood, Webster

     RETRACTORS

Army Navy, Senn, Breast, small facelift, gold double breast

KNIFE | BLADES

[2] No. 15

      LIPOSUCTION CANNULAS

for liposuction:

Black Infiltration holder with wrench

Hundstadt infiltration needle long blunt

3mm 4mm 5mm liposuction cannulas

     OTHER

Allis clamps, Lahey clamps

Liposuction flow sheet

 

 

No

Type

SN

status

SUTURES 

[ 2 ]

4-0 Monocryl PS-2

Y214

open

 

[ 2 ]

5-0 Monocryl P-3

Y426

open

 

[ 2 ]

3-0 Nylon PS-1

1663

 

hold

[ 4 ]

5-0 plain P-3

1915G

open

 

[ 1 ]

dermabond

 

open

 

 

DRAINS

[2] 15 Fr. Round Blake drains with connectors and reservoir bulbs - 2188

DRESSINGS

[2] each: 4x4, drain sponge, ABD, 6" Ace, kerlix, safety pins

[2] small tegaderm or dermabond - hold

 

POSTOPERATIVE

wrapping board

NOTES

 

 

COMMENTS

.

DATE MODIFIED

July 2006, March 2008, July 2008, May 2010, Mar 2013