bed sore

double arterial  pressure in 2 hours, therefore 2nd hourly posture change.

new lap app

supra-umbilical 4 cm incision.
gauze and artery used to clear the tissue. 2 retractors
2 arteries used to pick up umbilicus. incised. artery pushed through and dilated.
rod put.
manipulator used to pick up app.
harmonic pressed to full n tissue grasped.
2 loops placed and harmonic used to divide app.
app extracted thru 10 mm port with 5 mm camera.
instruments put and ports extracted to make sure nothing enters.
rectus with 1 vicryl.