No.

MR

42

40

04

RUMAH SAKIT UMUM UKI

SMF OBSTETRI GINEKOLOGI
Jl. Mayjen Sutoyo no. 2, Cawang, Jakarta Timur, 13630
Tel. 021 8092317 ext. 108 / 205

SURGERY REPORT
Name : Mrs. Diyah ayu utami
Sex : Female
Operator
Prof. Dr. H.I.O Marsis, SpOG
Anesthetic
Assitant 1
Dr. Benhur Sibuea
Instrumentator
Assitant 2
Medianto T Sinabutar
Observer
Pre-surgical Diagnose : Breech labour at 37th weeks in gestation with
G2P0A1

Age : 27 Years
Dr. Veronica, SpAn
Zr. Franco
Gabriel Hutabarat

Post-surgical Diagnose : Breech labour at 37th weeks in gestation with

G2P0A1

Surgery Date : May 5th 2014

Duration time of surgery : 2 hours 10
minutes (7.30-9.40)
Type of surgery
Emergency
Minor
Policlinic
Medium
Major
Elective

Tehnique of operation :
1. Transperitoneal Cesarean Section
2.
3.

Operation Procedures:
I.

Patient slept in supine position with spinal anastesia

II.

Aplied inside the dower catether

III.

Aseptic and antiseptic on abdomen adjacent regio until 1/3 proximal upper leg and the operation field
was limited with steril doek

IV.

The abdomen was prepped and draped and tested for analgesia. When found to be adequate, a
Pfannenstiel incision was made around fibritio tissue and the skin fold in down abdomen regio was
thrown, the incision was made deeper slice by slice from cutis, subcutis, fascia with sharp technique.
Then rectus abdominis muscles were separated to lateral with dull technique, bleeding was taken care off.

V.

Peritoneum parietal was opened tipside and downside so we can see uterine gravidarum, and the 2
curavor were put inside the right and left abdomen cavity for sperating the uterine and the other organ

VI.

Plica vesicouterine was opened and incision was made to left and right.

VII.

Transversal incision was made on lower segment of uterus. Once incision was opened, the incision was
extended by cutting laterally and slightly upward with bandage scissors.

VIII.

Once incision was made, the fetal membrane was broken and amniotic fluid flowed. Fluid was cleaned
by suctioning, the infant wasnt still showed.

IX.

The operator step into the uterus and we could see the babys hand and we continued the incision from
left to right lateral. The operator pulled back the babys hand into uterus and then looking for babys feet.
After that the operator was give mild pressure on the fundus uterine. Then delivered step by step
extremitas inferior, breech, trochanter posterior, trochanter anterior, back shoulder, front shoulder.

X.

Placenta was removed manually and the uterine cavity was cleaned from shred of membranes, vernix,
clots, and other debris. Bleeding was taken care off.

XI.

After that the uterine tissue was sewed and over hecting:
- Suture was done on lower segmen of uterine at two pole with Vicryl no. 2 and then the
myometrium tissue was sutured by running-locked suture.
- First slice of myometrium tissue with Chromic cat gut no. 2 by continuous suture.
- Second slice of myometrium tissue and serosum was sutured with Chromic cat no. 2 by
continuous suture.
- Plica vesicauterine was sutured with chromic cat gut no. 2.0 by continuous suture.

XII.

XIII.

After there was no bleeding abdomen cavity was sutured slice by slice
-

Parietoperitoneum was sutured with plain cat gut no 2.0 by continous suture

Rectus abdominis muscles were sutured with chromic plain gut no 2.0 by continous suture

Fascia was sutured with vicryl no 2 by continous suture

Subcutis was sutured with plain cat gut no 0 by simple suture

Cutis was sutured with" chromic cat gut " no . 3.0 by subcuticuler.

Bleeding was approximately 800cc .

The operation wound was cleaned by cleaning stole cell from the vagina, the operation wound was
cleaned with NaCl 0,9 % and then it was given antibiotic zalf and then was closed by sufratulle, sterill
cassa and tegaderm.

XIV.

The operation finished.

The condition of patient post operation:

General condition

: Look mild sick

Consciouness

: Compos Mentis

Blood pressure

100/70 mmHg

Pulse rate

74 x/minute

Respiration

22 x/minute

Temperature

36,3 oC

Tissue to Pathology of Anatomy :

Yes

: Type of tissue ..........................................

No

Operator,

(Prof. dr. H.I.O Marsis, SpOG)