Removal of a Lipoma from the Lower Back

Popaholics I'd fast forward to the 7:35 mark and for those interested in just suturing, that starts around the 11:00 mark. For those trying to learn the procedure, the teaching points I would make are the following. First, the lower back, in and of itself is a bit challenging when you go looking for lipomas (especially) and likewise for cysts. There can be an enormous amount of subcutaneous tissue and you can 'lose' your target fairly easily. For this reason, many physicians opt to start with an elliptical incision as they have a greater chance of localizing their target. I did not do so here as a linear incision is less traumatic and seals up a bit simpler in the end. However, had I had difficulty localizing the lipoma, I would have felt very comfortable extending my incision into a broader elliptical one. Second, if you simply cannot find the cyst or lipoma there is nothing wrong with suturing the patient closed and sending them to someone with more experience. I realize that this is not something anyone, the patient included, wants to hear but it isn't the end of the world either. As opposed to simply digging and digging, if you are out of your depth then simple suture the patient closed and send them along. The reality is that this will almost never happen and even if it did, the next surgeon would likely incorporate your incision into his process without creating a much more significant scar. At any rate, this procedure went fairly smoothly and I must apologize again for my hand getting in the way at times. I have been working on this lately and hopefully the newer videos will be of a higher quality. Thanks and take care.