No MR 19 74 02 00

MEDICAL FACULTY OF CHRISTIAN UNIVERSITY OF INDONESIA GENERAL

HOSPITAL
DEPARTMENT OF OBSTETRY AND GINECOLOGY
JL. Mayjen Sutoyo No. 2 Cawang, Jakarta Timur 13630
Telp.8099217 ext. 108 / 205

OPERATION REPORT
Name : Mrs. Devi Sinarti Sex : Female Age : 33 Years
Ronaldo Yusuf Pantas Sianturi
Operator Prof. Dr. H.I.O Marsis, SpOG Anesthetic
Nyoman Adhydeva Purusanti
Assistant 1 Yudhistira Herlambang Instrumentator Bd. Nancy
Assistant 2 Rina Dwi Indriyani Observer -
Pre-operation Diagnose : Primary Infertility
Date of operation : March 25th
Post-operation Diagnose : Patent Fallopian Tube 2013
Duration of operation : 10 minutes
Tehnique of operation : Type of operation
1. Hydrotubation Emergency Minor
2. - Poliklinik Medium
3. - Elektif Mayor

Operation Procedures :
I. Patient slept in supine on operational table with lithotomy position, O2 nasal 2 lpm
with ketalar 50 mg and valium 10 mg IV.
II. Aseptic and anti-septic at the external genital region and around.
III. Applied sims speculum at posterior and anterior vagina. Anterior portio clamped
with kohel tang at 12 oclock position
IV. Sondation 7,0 cm anteflexion uterine.
V. Uterine canul was inserted into uterine cavity and then 20 cc of aquabides +
Kanamycin 1 gr + Oradexon 5 mg was injected into the uterine cavity through the
uterine canul. There are light pressure in early action and have opened.
VI. The uterine canul had been released, the Kohel tang and sims speculum had been
released.
VII. Aseptic and anti-septic the vagina
The condition of patient post operation:

General condition : Mild illness

Consciouness : Composmentis
Blood pressure : 140/10 mmHg
Pulse rate : 90 x/minute
Respiration : 20 x/minute
Temperature : 36,2 oC
Operator,

(Prof. dr. H.I.O Marsis, SpOG)