General Surgery · Upper GI

Splenectomy (Laparoscopic)

DATE AND TIME: [Date and time]
URGENCY: Elective / Non-elective
SURGEON: [Name]
ASSISTANT: [Name / None]
ANAESTHETIST: [Name]

OPERATION: Laparoscopic Splenectomy
ANAESTHETIC: General anaesthesia
ANTIBIOTICS: [Drug and dose / Not indicated]
DVT PROPHYLAXIS: [Agent / mechanical / Not indicated]
PRE-OPERATIVE VACCINATIONS: Pneumococcal, Haemophilus influenzae type b, and meningococcal vaccines administered minimum 2 weeks pre-operatively.
POSITION: Right lateral decubitus, left side up at 60° angle, reverse Trendelenburg. Beanbag support. Left arm positioned as for left lateral thoracotomy. Orogastric tube inserted.

INDICATION:
[Idiopathic thrombocytopenic purpura (ITP) / haematological malignancy / haemolytic anaemia / symptomatic splenomegaly / trauma / incidental]. [Platelet and blood products available. Haematology review completed for ITP.]

PROCEDURE:
WHO Checklist performed. Abdomen prepared and draped.

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