smoh/medical-transcriptions huggingface dataset:
Phacoemulsification & Lens Implantation - 5  ( Surgery)
Description:  Phacoemulsification with IOL, right eye.  Cataract, right eye.  A lid speculum was placed in the right eye after which a supersharp was used to make a stab incision at the 4 o'clock position through which 2% preservative-free Xylocaine was injected followed by Viscoat.

PREOPERATIVE DIAGNOSIS:,  Cataract, right eye.,POSTOPERATIVE DIAGNOSIS:,  Cataract, right eye.,OPERATION PERFORMED: , Phacoemulsification with IOL, right eye.,ANESTHESIA:,  Topical with MAC.,COMPLICATIONS,:  None.,ESTIMATED BLOOD LOSS: , None.,PROCEDURE IN DETAIL:  After appropriate consent was obtained, the patient was brought to the operating room and then prepared and draped in the usual sterile fashion per Ophthalmology.  A lid speculum was placed in the right eye after which a supersharp was used to make a stab incision at the 4 o'clock position through which 2% preservative-free Xylocaine was injected followed by Viscoat.  A 2.75-mm keratome then made a stab incision at the 2 o'clock position through which an anterior capsulorrhexis was performed using cystotome and Utrata.  BSS on blunt cannula, hydrodissector, and spun the nucleus after which phacoemulsification divided the nucleus in 3 quadrants each was subsequently cracked and removed through phacoemulsification I&A.  Healon was injected into the posterior capsule and a XXX lens was then placed with a shooter into the posterior capsule and rotated into position with I&A, which then removed all remaining cortex as well as viscoelastic material.  BSS on blunt cannula hydrated all wounds, which were noted to be free of leak and lid speculum was removed.  Under microscope, the anterior chamber being soft and well formed.  Pred Forte, Vigamox, and Iopidine were placed in the eye.  A shield was placed over the eye.  The patient was followed to recovery where he was noted to be in good condition.
Phacoemulsification & Lens Implantation - 4  ( Surgery)
Description:  Phacoemulsification of cataract and posterior chamber lens implant, right eye.

OPERATION PERFORMED:, Phacoemulsification of cataract and posterior chamber lens implant, right eye., ,ANESTHESIA:, Retrobulbar nerve block, right eye, ,DESCRIPTION OF OPERATION: ,The patient was brought to the operating room where local anesthetic was administered to the right eye followed by a dilute drop of Betadine and a Honan balloon.  Once anesthesia was achieved, the right eye was prepped with Betadine, rinsed with saline, and draped in a sterile fashion.  A lid speculum was placed and 4-0 silk sutures passed under the superior and inferior rectus muscles stabilizing the globe.  A fornix-based conjunctival flap was prepared superiorly from 10 to 12 o'clock and episcleral vessels were cauterized using a wet-field.  A surgical groove was applied with a 69 Beaver blade 1 mm posterior to the limbus in a frown configuration in the 10 to 12 o'clock position.  A lamellar dissection was carried anteriorly to clear cornea using a crescent knife.  A stab incision was applied with a Superblade at the 2 o'clock position at the limbus.  The chamber was also entered through the lamellar groove using a 3-mm keratome in a beveled fashion.  Viscoat was injected into the chamber and an anterior capsulorrhexis performed.  Hydrodissection was used to delineate the nucleus and the phacoemulsification tip was inserted into the chamber.  A deep linear groove was dissected through the nucleus vertically and the nucleus was rotated 90 degrees with the assistance of a spatula through the side-port incision.  A second groove was dissected perpendicular to the first and the nucleus was fractured into quadrants.  Each quadrant was emulsified under burst power within the capsular bag.  The epinuclear bowl was manipulated with vacuum, flipped into the iris plane, and emulsified under pulse power.  I&A was used to aspirate cortex from the capsular bag.  A scratcher was used to polish the capsule, and Viscoat was injected inflating the capsular bag and chamber.  The wound was enlarged with a shortcut blade to 5.5 mm.  The intraocular lens was examined, found to be adequate, irrigated with balanced salt, and inserted into the capsular bag.  The lens centralized nicely and Viscoat was removed using the I&A.  Balanced salt was injected through the side-port incision.  The wound was tested, found to be secure, and a single 10-0 nylon suture was applied to the wound with the knot buried within the sclera.  The conjunctiva was pulled over the suture, and Ancef 50 mg and Decadron 4 mg were injected sub-Tenon in the inferonasal and inferotemporal quadrants.  Maxitrol ointment was applied topically followed by an eye pad and shield.  The patient tolerated the procedure and was taken from the operating room in good condition.
Phacoemulsification & Lens Implantation - 3  ( Surgery)
Description:  Cataract, right eye.  Phacoemulsification with intraocular lens placement, right eye.

PREOPERATIVE DIAGNOSIS: , Cataract, right eye.,POSTOPERATIVE DIAGNOSIS:,  Cataract, right eye.,PROCEDURE:,  Phacoemulsification with intraocular lens placement, right eye.,ANESTHESIA: , Monitored anesthesia care,ESTIMATED BLOOD LOSS: , None,COMPLICATIONS:,  None,SPECIMENS:,  None,PROCEDURE IN DETAIL: , The patient had previously been examined in the clinic and was found to have a visually significant cataract in the right eye.  The patient had the risks and benefits of surgery discussed.  After discussion, the patient decided to proceed and the consent was signed.,On the day of surgery, the patient was taken from the holding area to the operating suite by the anesthesiologist and monitors were placed.  Following this, the patient was sterilely prepped and draped in the usual fashion.  After this, a lid speculum was placed, preservative-free lidocaine drops were placed, and the SuperSharp blade was used to make an anterior chamber paracentesis.  Preservative-free lidocaine was instilled into the anterior chamber, and then Viscoat was instilled into the eye.,The 3.0 diamond keratome was then used to make a clear corneal temporal incision.  Following this, the cystotome was used to make a continuous tear-type capsulotomy.  After this, BSS was used to hydrodissect and hydrodelineate the lens.  The phacoemulsification unit was used to remove the cataract.  The I&A unit was used to remove the residual cortical material.  Following this, Provisc was used to inflate the bag.  The lens, a model SA60AT of ABCD diopters, serial #1234, was inserted into the bag and rotated into position using the Lester pusher.,After this, the residual Provisc was removed.  Michol was instilled and then the corneal wound was hydrated with BSS, and the wound was found to be watertight.  The lid speculum was removed.  Acular and Vigamox drops were placed.  The patient tolerated the procedure well without complications and will be followed up in the office tomorrow.
Phacoemulsification & Cataract Extraction - 4  ( Surgery)
Description:  Cataract extraction with phacoemulsification and posterior chamber intraocular lens implantation.  Cataract, right eye.

PREOPERATIVE DIAGNOSIS:  ,Cataract, right eye.,POSTOPERATIVE DIAGNOSIS: , Cataract, right eye.,PROCEDURE: , Cataract extraction with phacoemulsification and posterior chamber intraocular lens implantation.  ME 30, AC 25.0 diopter lens was used.,COMPLICATIONS:  ,None.,ANESTHESIA: , Local 2%, peribulbar lidocaine.,PROCEDURE NOTE:  ,Right eye was prepped and draped in the normal sterile fashion.  Lid speculum placed in his right eye.  Paracentesis made supratemporally.  Viscoat injected into the anterior chamber.  A 2.8 mm metal keratome blade was then used to fashion a clear corneal beveled incision temporally.  This was followed by circular capsulorrhexis and hydrodissection of the nucleus would be assessed.  Nuclear material removed via phacoemulsification.  Residual cortex removed via irrigation and aspiration.  The posterior capsule was clear and intact.  Capsular bag was then filled with Provisc solution.  The wound was enlarged to 3.5 mm with the keratoma.  The lens was folded in place into the capsular bag.  Residual Provisc was irrigated from the eye.  The wound was secured with one 10-0 nylon suture.  The lid speculum was removed.  One drop of 5% povidone-iodine prep was placed into the eye as well as a drop of Vigamox and TobraDex ointment.  He had a patch placed on it.  The patient was transported to the recovery room in stable condition.
Phacoemulsification & Lens Implantation - 2  ( Surgery)
Description:  Phacoemulsification with intraocular lens placement.  A wire speculum was placed in the eye and then a clear corneal paracentesis site was made inferiorly with a 15-degree blade. 

PROCEDURE PERFORMED: , Phacoemulsification with intraocular lens placement.,ANESTHESIA TYPE:  ,Topical.,COMPLICATIONS: , None.,DESCRIPTION OF PROCEDURE:  ,The patient was brought to the operating room after the eye was dilated with topical Mydriacyl and Neo-Synephrine eye drops.  Topical anesthetic drops were applied to the eye just prior to entering the operating room.  The eye was then prepped with a 5% Betadine solution injected in the usual sterile fashion.  A wire speculum was placed in the eye and then a clear corneal paracentesis site was made inferiorly with a 15-degree blade.  Lidocaine 1% preservative-free, 0.1 cc, was instilled into the anterior chamber through the clear corneal paracentesis site and this was followed with viscoelastic to fill the chamber.  A 2.8-mm keratome was used to create a self-sealing corneal incision temporally and then a bent capsulotomy needle was used to create an anterior capsular flap.  The Utrata forceps were used to complete a continuous tear capsulorrhexis, and hydrodissection and hydrodelineation of the nucleus was performed with BSS on a cannula.  Phacoemulsification in a quartering and cracking technique was used to remove the nucleus, and then the residual cortex was removed with the irrigation and aspiration unit.  Gentle vacuuming of the central posterior capsule was performed with the irrigation and aspiration unit.  The capsular bag was re-expanded with viscoelastic, and then the wound was opened to a 3.4-mm size to accommodate the intraocular lens insertion using an additional keratome blade.,The lens was folded, inserted into the capsular bag and then unfolded.  The trailing haptic was tucked underneath the anterior capsular rim.  The lens was shown to center very well.  The viscoelastic was removed with the irrigation and aspiration unit and one 10-0 nylon suture was placed across the incision after Miochol was injected into the anterior chamber to cause pupillary constriction.  The wound was shown to be watertight.  Therefore, TobraDex ointment was applied to the eye, an eye pad loosely applied, and a Fox shield taped firmly in place over the eye.,The patient tolerated the procedure well and left the operating room in good condition.
Phacoemulsification & Cataract Extraction - 3  ( Surgery)
Description:  Cataract, right eye.  Phacoemulsification with intraocular lens insertion, right eye.  A wire lid speculum was inserted to keep the eye open and the eye rotated downward.

PREOPERATIVE DIAGNOSIS: , Cataract, right eye.,POSTOPERATIVE DIAGNOSIS:,  Cataract, right eye.,TITLE OF OPERATION:  ,Phacoemulsification with intraocular lens insertion, right eye.,ANESTHESIA: , Retrobulbar block.,COMPLICATIONS: , None.,PROCEDURE IN DETAIL:  ,The patient was brought to the operating room where retrobulbar anesthesia was induced.  The patient was then prepped and draped using standard procedure.  A wire lid speculum was inserted to keep the eye open and the eye rotated downward with a 0.12.  The anterior chamber was entered by making a small superior limbal incision with a crescent blade and then entering the anterior chamber with a keratome.  The chamber was then filled with viscoelastic and a continuous-tear capsulorrhexis performed.  The phacoemulsification was then instilled in the eye and a linear incision made in the lens.  The lens was then cracked with a McPherson forceps, and the remaining lens material removed with the phacoemulsification tip.  The remaining cortex was removed with an I&A.  The capsular bag was then inflated with viscoelastic and the wound extended slightly with the keratome.  The folding posterior chamber lens was then inserted in the capsular bag and rotated into position.  The remaining viscoelastic was removed from the eye with the I&A.  The wound was checked for watertightness and found to be watertight.  Tobramycin drops were instilled in the eye and a shield placed over it.  The patient tolerated the procedure well.
Phacoemulsification & Cataract Extraction - 5  ( Surgery)
Description:  Cataract extraction via phacoemulsification with posterior chamber intraocular lens implantation.  An Alcon MA30BA lens was used.   A lid speculum was placed into the right eye.  Paracentesis was made at the infratemporal quadrant. 

PREOPERATIVE DIAGNOSIS: , Cataract, right eye.,POSTOPERATIVE DIAGNOSIS:  ,Cataract, right eye.,PROCEDURE PERFORMED:  ,Cataract extraction via phacoemulsification with posterior chamber intraocular lens implantation.  An Alcon MA30BA lens was used, * diopters, #*.,ANESTHESIA: ,Topical 4% lidocaine with 1% nonpreserved intracameral lidocaine.,COMPLICATIONS:, None.,PROCEDURE: , Prior to surgery, the patient was counseled as to the risks, benefits and alternatives of the procedure with risks including, but not limited to, bleeding, infection, loss of vision, loss of the eye, need for a second surgery, retinal detachment and retinal swelling.  The patient understood the risks clearly and wished to proceed.,The patient was brought into the operating suite after being given dilating drops.  Topical 4% lidocaine drops were used.  The patient was prepped and draped in the normal sterile fashion.  A lid speculum was placed into the right eye.  Paracentesis was made at the infratemporal quadrant.  This was followed by 1% nonpreservative lidocaine into the anterior chamber, roughly 250 microliters.  This was exchanged for Viscoat solution.  Next, a crescent blade was used to create a partial-thickness linear groove at the temporal limbus.  This was followed by a clear corneal bevel incision with a 3 mm metal keratome blade.  Circular capsulorrhexis was initiated with a cystitome and completed with Utrata forceps.  Balanced salt solution was used to hydrodissect the nucleus.  Nuclear material was removed via phacoemulsification with divide-and-conquer technique.  The residual cortex was removed via irrigation and aspiration.  The capsular bag was then filled with Provisc solution.  The wound was slightly enlarged.  The lens was folded and inserted into the capsular bag.,Residual Provisc solution was irrigated out of the eye.  The wound was stromally hydrated and noted to be completely self-sealing.,At the end of the case, the posterior capsule was intact.  The lens was well centered in the capsular bag.  The anterior chamber was deep.  The wound was self sealed and subconjunctival injections of Ancef, dexamethasone and lidocaine were given inferiorly.  Maxitrol ointment was placed into the eye.  The eye was patched with a shield.,The patient was transported to the recovery room in stable condition to follow up the following morning.
Phacoemulsification & Cataract Extraction - 2  ( Surgery)
Description:  Cataract, right eye.  Phacoemulsification with intraocular lens insertion, right eye.  The patient was then prepped and draped using standard procedure.  An additional drop of tetracaine was instilled in the eye, and then a lid speculum was inserted.

PREOPERATIVE DIAGNOSIS: , Cataract, right eye.,POSTOPERATIVE DIAGNOSIS: , Cataract, right eye.,TITLE OF OPERATION: , Phacoemulsification with intraocular lens insertion, right eye.,ANESTHESIA: , Topical.,COMPLICATIONS: , None.,PROCEDURE IN DETAIL:  ,The patient was brought to the operating room where tetracaine drops were instilled in the eye.  The patient was then prepped and draped using standard procedure.  An additional drop of tetracaine was instilled in the eye, and then a lid speculum was inserted.,The eye was rotated downward and a crescent blade used to make an incision at the limbus.  This was then dissected forward approximately 1 mm, and then a keratome was used to enter the anterior chamber.  The anterior chamber was filled with 1% preservative-free lidocaine and the lidocaine was then replaced with Provisc.  A cystotome was used to make a continuous-tear capsulorrhexis, and then the capsular flap was removed with the Utrata forceps.  The lens nucleus was hydrodissected using BSS on a cannula and then removed using the phaco.  This was aided by cracking the lens nucleus with McPherson forceps.  The remaining cortex was removed from the eye with the I&A.  The capsular bag was then polished with the I&A on capsular bag.  The bag was inflated using viscoelastic and then the wound extended slightly with a keratome.  A folding posterior chamber lens was inserted and rotated into position using McPherson forceps.  The I&A was then placed in the eye again and the remaining viscoelastic removed.  The wound was checked for watertightness and found to be watertight.  TobraDex drops were instilled in the eye and a shield was placed over it.,The patient tolerated the procedure well and was brought to recovery in good condition.
Phacoemulsification & Cataract Extraction  ( Surgery)
Description:  Phacoemulsification and extracapsular cataract extraction with intraocular lens implantation, right eye.

DIAGNOSIS:,  Nuclear sclerotic and cortical cataract, right eye.,OPERATION:,  Phacoemulsification and extracapsular cataract extraction with intraocular lens implantation, right eye.,PROCEDURE:,  The patient was taken to the operating room and placed on the table in the supine position.  Cardiac monitor and oxygen at 5 liters per minute were connected by the nursing staff.  Local anesthesia was obtained using 2% lidocaine, 0/75% Marcaine, 0.5 cc Wydase with 6 cc of this solution used in a paribulbar injection, followed by ten minutes of digital massage.  The patient was then prepped and draped in the usual sterile fashion for eye surgery.  With the Zeiss operating microscopy in position, a lid speculum was inserted and a 4-0 black silk bridal suture placed in the superior rectus muscle.  With Westcott scissors, a fornix-based conjunctival flap was made.  The surgical limbus was identified and hemostasis obtained with wet-field cautery.  With a 57-Beaver blade, a corneoscleral groove was made and shelved into clear cornea.  A stab incision was made at 2 o'clock with a 15-degree blade.  With a 3.0 mm keratome, the shelved groove was attended into the anterior chamber.  Viscoelastic was inserted into the anterior chamber and anterior capsulotomy was performed in a continuous-tear technique.  Hydrodissection was performed with Balanced Salt Solution.  Phacoemulsification was performed in a two-headed nuclear fracture technique.  The remaining cortical material was removed with irrigation and aspiration handpiece.  The posterior capsule remained intact and vacuumed with minimal suction.  The posterior chamber intraocular lens was obtained.  It was inspected, irrigated, inserted into the posterior chamber without difficulty.  Inspection revealed the intraocular lens to be in good position with intact capsule and well-approximated wound.  There was no aqueous leak even with digital pressure.  The conjunctiva was pulled back into position with wet-field cautery.  A subconjunctival injection with 20 mg Gatamycine and 0.5 cc Celestone was given.  Tobradex ointment was instilled into the eye, which was patched and shielded appropriately, after removing the lid speculum and bridle suture.  The patient tolerated the procedure well and was sent to the recovery room in good condition, to be followed in attending physician office the next day.
Perlane & Restylane Injection  ( Surgery)
Description:  Perlane injection for the nasolabial fold.  Restylane injection for the glabellar fold.

PREOPERATIVE DIAGNOSES:  ,1.  Nasolabial mesiolabial fold.,2.  Mid glabellar fold.,POSTOPERATIVE DIAGNOSES:  ,1.  Nasolabial mesiolabial fold.,2.  Mid glabellar fold.,TITLE OF PROCEDURES:  ,1.  Perlane injection for the nasolabial fold.,2.  Restylane injection for the glabellar fold.,ANESTHESIA:  ,Topical with Lasercaine.,COMPLICATIONS: , None.,PROCEDURE: , The patient was evaluated preop and noted to be in stable condition.  Chart and informed consent were all reviewed preop.  All risks, benefits, and alternatives regarding the procedure have been reviewed in detail with the patient.  This includes risk of bleeding, infection, scarring, need for further procedure, etc.  The patient did sign the informed consent form regarding the Perlane and Restylane.  She is aware of the potential risk of bruising.  The patient has had Cosmederm in the past and had had a minimal response with this.  Please note Lasercaine had to be applied 30 minutes prior to the procedure.  The excess Lasercaine was removed with a sterile alcohol swab.,Using the linear threading technique, I injected the deep nasolabial fold.  We used 2 mL of the Perlane for injection of the nasolabial mesiolabial fold.  They were carefully massaged into good position at the end of the procedure.  She did have some mild erythema noted.,I then used approximately 0.4 mL of the Restylane for injection of the mid glabellar site.  She has a resting line of the mid glabella that did not respond with previous Botox injection.  Once this was filled, the Restylane was massaged into the proper tissue plane.  Cold compressors were applied afterwards.  She is scheduled for a recheck in the next one to two weeks, and we will make further recommendations at that time.  Post Restylane and Perlane precautions have been reviewed with the patient as well.
Peritoneal Dialysis Catheter Insertion  ( Surgery)
Description:  A 14-year-old young lady is in the renal failure and in need of dialysis.

PREOPERATIVE DIAGNOSIS: , Renal failure.,POSTOPERATIVE DIAGNOSIS:,  Renal failure.,OPERATION PERFORMED: , Insertion of peritoneal dialysis catheter.,ANESTHESIA: , General.,INDICATIONS:  ,This 14-year-old young lady is in the renal failure and in need of dialysis.  She had had a previous PD catheter placed, but it became infected and had to be removed.  She, therefore, comes back to the operating room for a new PD catheter.,OPERATIVE PROCEDURE:  ,After the induction of general anesthetic, the abdomen was prepped and draped in the usual manner.  A small transverse right upper quadrant incision was made and carried down through the skin and subcutaneous tissue with sharp dissection.  The fascia was divided and the posterior fascia and peritoneum were identified.  A hole was made in the posterior fascia through the peritoneum and into the peritoneal cavity.  The omentum came up through the hole and so therefore the omentum was actually brought up and a small portion of it removed, which could easily be brought up through the incision.  A PD catheter was then placed into the pelvis over a guidewire.  At this point, the peritoneum and posterior fascia was closed around the catheter.  The anterior fascia was then closed over the top of the cuff leaving the cuff buried in the fascia.  The second incision was then made lateral and the catheter brought out through a second incision and the subcutaneous cuff then positioned at that site.  The catheter was then connected and two runs of a 150 mL of fluid were made with a good inflow and a good clear return.  The skin was closed with 5-0 subcuticular Monocryl.  Sterile dressings were applied and the young lady awakened and taken to the recovery room in satisfactory condition.