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Farwaniya Urology — OT Cases
Operative Theatre Registry
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Case Info
Date Done
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Case Type
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Elective
Emergency
OT Consult
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Patient Info
Patient Name
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Civil ID / File Number
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Phone Number
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Age
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Gender
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Male
Female
Diagnosis
Category
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Stone
Prostate
Bladder
Urethra
Testis
Kidney
Ureter
Scrotal
Other
Stone Details
Location (select all that apply)
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Kidney
Ureter
Bladder
Kidney — which calyx/area
Upper calyx
Middle calyx
Lower calyx
Pelvis
Multiple
Ureter — which level
Upper
Mid
Lower
Number of stones
Total burden (mm)
HU value
Sub-type
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Surgery
Procedure
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— Select procedure —
PCNL
Mini-PCNL
FURS / RIRS
URS — Ureteroscopy
ECIRS
TURP
HoLEP
TURBT
Nephrectomy
Partial Nephrectomy
Urethrotomy
Orchidectomy
Hydrocelectomy
Varicocele Surgery
Cystoscopy + DJ stent
Other
Sub-type
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Approach
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Supine
Prone
Lithotomy
Flank
Other
Specify procedure
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Remarks / Comments
Surgical Team
Consultant in charge
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Senior assisting
Surgical team members
Operative Details
Side
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Rt
Lt
B/L
N/A
Operative approach
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Endo
Open
Lap
Robotic
DJ Stent
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Yes
No
Cancer / Histopath
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Yes
No
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