benzoin and steri strps were then applied.
we then used 4-0 vicryl sutures to close the skin in a subcuticular fashion. we then irrigated with saline solution and closed the subcutaneious tissue with 3-0 vicryl interrupted and running sutures. the lesion was excised in its entirety and electrocautery was used to control hemostasis. as we continued to dissect circumferentially around it without sharp dissection, it was noted that it did go down to a muscle but no evidence of hernia was identified. we then anesthetized with 1% lidocaine with epinephrine and sodium bicarbonate, made a 4 cm incision, and used sharp dissection to dissect circumferentially around this soft tissue lesion, being careful to make sure that we were not entering any kind of hernia sac secondary to spigelian hernia. the patient then underwent sedation with a sterile prep and drape. OPERATIVE PROCEDURE: the patient was brought into the operating room after informed consent was obtained. OPERATIVE FINDINGS: large soft tissue lesion measuring about 6 cm in greates dimension. consequently, the procedure, risks, benefits, and alternatives of excision of this lesion were discussed with the patient,and she understood and wished to proceed with the excision. However, it was not reducible and did not appear to be consistent with a hernia. OPERATIVE INDICATIONS: this is a pleasant female who comes in with a soft tissue lesion in the left lank over what appeared to be a spigelian hernia site as well. OPERATIONS: Excision of left flank soft tissue mass with layered closure measuring 4 cm, with margins,prior to excision.ĪNESTHESIA: sedation with 1% lidocaine with epinephrine and sodium bicarbonate. Postoperative Diagnosis: left flank soft tissue mass Preoperative diagosis: Left flank soft tissue mass "You've started your first day at Venture Outpatient Surgery Center.