Post on 01-Sep-2018
Welcome to our service!
Here are a few tips and tricks to make it easier for you.
CSL
Kathy Deal 615-579-2907
Suzanne Harris 615-394-7253
Manager
Sonja Walsh 2-4160
Colorectal Surgery
Dr. Muldoon
Dr. Geiger
Dr. Cone
TIPS
They do not use the disposable bed cover provided in the kit.
Check VPIMS eORboard under comments for case notes.
There is a colorectal protocol in place for all patients; please see the
following page.
Bean bag used in robotic and laparoscopic case positioning with the
notch at the patient head.
COLORECTAL DIRTY BUCKETS
RIGHT COLECTOMY/ILEOCOLIC Hemostat x 2 3-0 PDS SH x 2 7 inch debakey x 2 Green towel x 3 Needledriver x 2 GIA 75 stapler Curved mayo scissor GIA 75 reload x 1 Needlebook, small Lap sponge x 1
LEFT COLECTOMY/SIGMOID/LAR Hemostat 2-0 Keith prolene needle Vanderbilt Anvil- 25 or 29 Curved mayo scissors Green towel x 3 Needle driver Purse string clamp Allis clamp x 3
General Surgery
Dr. Holzman
Doesn’t like cell phone use in his rooms
Dr. Sharp
Mixes his own local during MAC cases Injects his own Lymphazurin/Isosulfan blue after anesthesia induction HERNIA MESH--- SEE NEXT PAGE PICS Dr. Brandon Williams, Dr. English, Dr. Pierce, Dr. Spann Use “Endo I” for difficult angles Will often help with their patient positioning Dr. Williams tracks his staple loads on his dictation sheet and has additional timeout questions Dr. Poulose HERNIA MESH Bard soft 30 x 30 Ethion PVP Gora BioA
WHIPPLE Procedure
Specialized sutures on GGUR PMS suture caddies.
Have multiple pathology sheets available; multiple frozen sections possible. Dr. Idrees may occasionally use the CUSA .
The following picture will aid in counting Whipple Pans I and II. There are 13 box locks from Pan II in this picture. The two long Allis clamps remain in Pan II. The other box locks equal 13 from Pan I .
Pelvic Exenteration
If radioactive seeds are used, they are sewn into a mesh. Radiological oncology will need a small sterile field with supplies (from a list they provide.)
HIPEC
Start in and stay in lithotomy in case of rectal
involvement.
Dr. Idrees doesn’t use the warming blanket or machine. Dr. Idrees will notify the circulator if chemotherapy is needed; necessary instructions for disposal are on the DPC.
Penile Prosthesis
Spray bottle with ½ betadine, ½ saline in field; sterile peel packed in TVC core. Stainless steel implant tray; blue wrapped in TVC core. Must dwell with antibiotics in pre-op prior to entrance to OR.
Nephrectomy
Partial- special mini “time out” prior to clamping renal artery
Please reinforce importance of focus to all in room
Turn off music
Place signs on doors to limit traffic
No breaks/lunches/relief during this time
See DPC for full details
HOLEP (Holmium laser enucleation of prostate) Our staff will frequently finish these cases but just in
case…..
Have a Dornoch suction canister in room.
You may need two LOTS of fluids used here.
(i.e. 15-30 3L bags)
Percutaneous Nephrolithotomy (PERC)
Frequently start lateral or supine then flip prone mid-case. This depends on whether the patient has a nephrostomy tube. NO brown gel rolls from OZ (unable to use with radiology.)
Endo Uro Cart
The majority of urology specific supplies are on this cart. Laser fibers - sizes 200, 365, 550 Guide wires Sensor wire Dbl lumen catheters Uro-lock adaptor Used to connect cysto- tubing to scope
Cystoscopy/Ureteroscopy
Cysto tubing Level One Fluid Warmer Pressure bag during ureteroscopy; gravity otherwise
Interstim Insertion/Removal
Check with Kathy Deal. She communicates with the Medtronic rep (Kathy Kelley) to be present for these cases.
RALP Robotic Prostatectomy)/Hysterectomy
Position is steep Trendelenburg for majority of cases. Use blue egg crate with attached arm holders/straps to secure and pad patient. Use large donut to pad face under drape as robot arm may rest close to it. Put urine and specimens on ice. Research will take specimens when ready. Robot is positioned between the patient’s legs while in lithotomy position.
Equipment
GGUR has a storage room located in the back East corner of the OR behind OR 36. Stored there are:
Level One Fluid Warmer
Ultrasound
Laser machines (20,80,100 watts)
Keys are in the accu dose “keys”
Lateral positioning tools
Aquamantys
GYRUS- lives on 4S and is used for GYN cases as requested
STORZ towers- not needed in 36,37,38,39 (built into the boom along with CO2 canisters; otherwise they are located across from OR 30.
Slush machines
Caiman