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Pre-operative
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Post-operative
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Operation procedures
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Specimen removed:
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Device selection:
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Procedure Indication
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Anesthesia Type
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Anesthesiologist:
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Anesthesiologist:
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Estimated Blood Loss
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Estimated Blood Loss:
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Procedure description (abdominal)
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Procedure description (buttock)
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Entrance catheter level
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Entrance catheter level
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Tip of Catheter level
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Tip of Catheter level
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Scar revision? (midline)
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Midline incision dressing (abdominal)
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Pocket creation
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Scar revision? (pocket)
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Regular Abdominal pocket
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Subfascial pocket
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Tunneling side (abdominal)
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Midline and Pocket incision dressing (buttocks)
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Pump filled with? (abdominal)
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Pump filled with? (buttocks)
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Pocket closure dressing and discharge
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Condition Post-Operative
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Condition post-op (Complications)
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