Miller

OR case preferences

Always see patients before his surgeries, whether in preop or onn the floor.

Bariatrics pain meds: 5mg oxycodone moderate pain q4h PRN, oxycodone 10mg severe pain q4h PRN

Unless he tells you otherwise, most patients will be sent home with 28 pills of oxycodone 5mg

Open inguinal hernia

mark ASIS and pubic tubercle
uses #15 blade to incise external oblique
usually uses permanent plug and patch for indirect hernias
anchors mesh with prolene sutures
closes with vicryl

Laparoscopic Ventral/umbilical Hernia

veres access subxiphoid
left side 12mm low 5mm high ports
right side 12mm high, 5mm low ports
uses microporous permanent mesh and 5mm tacker
anchors 4 edges of mesh first with ethibond suture and suture passer in 4 small incisions

Laparoscopic Cholecystectomy

12mm supraumbilical incision dissected down w kocher to grasp fascia
veress to insufflate
12mm epigastric port, 5mm midline port, 5mm right subcostal port, 12mm umbilical port
umbilical port is always first with a bladed trocar, no optiview
maryland for dissection, Hook for peeling
clips 2 down and 1 up artery and duct

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