Back Table Setup for an Open Umbilical Hernia Repair

CHAPTER 1

So, setting up for an open hernia repair. This is an open umbilical hernia repair. So we just have a standard basic pack right here. Just open front, open back, take your gown off the top. And now, there's different types of blue here. So the dark blue, you don't want to touch 'cause that's all considered sterile. The light blue is considered non-sterile. So that's the part you touch. You can just open up like that. Now this table is a little bigger, so you're gonna have some of the light blue on the table, but it's okay. It's all sterile still. And as you're opening, you don't want to get too close to your table, but you also don't wanna be far enough to where when you open things it just bounces off. Some things are a little more difficult to open than others, but luckily for this case, there's nothing too big. I was always taught open your smaller stuff first 'cause if you open the big stuff first and then try to open the small stuff, it'll just end up bouncing off. Just to get the closeup view of it. I can't use that. And if a package rips on you while you open it, just throw it away and get a new one. It's not worth risking the contamination or anything like that. And that's pretty much all the sterile supplies that you'll need to open. The size, the actual tray itself, which is this guy. And for opening pans, just pop your tags, take them off. Don't touch the inside because the inside is considered sterile. Check your filter, make sure no holes or anything like that. There'll be another one in the bottom. So once I take it out, the circulator will actually check it for me. And, that's about it.

CHAPTER 2

So, now that every, all the stuff is open, kind of gotta organize it, so it's not a complete mess. Luckily for this case, there's not too much stuff. So organizing it takes half a second. Kind of wanna reinforce the table with a towel just in case something gets dropped on it, something slams on it. That way you have an extra layer of protection. When you go in for your tray, just lift it at the handles. Let the circulator check the bottom of the filter. No holes. You're good. And you're good to go. Now for setups, it's always doctor preference. So if it's your first time working with a doctor, it's gonna be a little - not too correct. But as you work with the doctor more and more, you'll get more accustomed to what they like, what they want, what they need, all that good stuff. If you don't know what you need, I had a technician tell me he has a little method called it the KPAK method. So you just set up your Kelly, Peans, Allis, and Kocher clamps. I'll show you here in a little bit. Create a little roll for your stringed instruments, so that way they're not flying all over the place. I like to take out my handheld retractors just in case they might need one or the other. Sometimes they'll use one, might want another one. Happens pretty often. And just like the back table, I like to reinforce the Mayo because this is what they'll actually be setting things down on, putting things down on. So if this rips, then all your stuff becomes unsterile. Always good to have an extra layer of protection. So now I've set up my Kellys, my Peans, my Allis', and my two Kochers. So that's a little setup I like to do for these general cases. You'll always want some Adsons. Adson with Brown or Adson-Brown or Adson with teeth. Either is nice. I believe she has a fellow, so I'm gonna put up all those just to have it available. All right. Just gonna change out. This is the Bovie tip. So the Bovie usually comes with a non-guarded tip. However, usually doctors prefer the guarded tip. It's more of a finer point. Reminds them more of a blade. More accurate. Put that guy up. I like to start with Army-Navy's, but just in case have the Goelets available or any other retractors that you may have. If you have a lot of retractors, you can leave them in the tray. As long as you just remember where they are. The easier it is to get, the better. That's pretty much that. Set up the doctor's gloves and her gown. Fellow and his gown. All that. If you have meds, that's why you have the stickers and a pen. If there's meds, which there more than likely is. And then for the Rays, just lay them out. And you could throw one on the Mayo for good luck. Knife. I'll switch this one out. So there are multiple types of Bovie tips that you can have. It's always gonna come with this one. This one is your guarded one, which they use sometimes. And there's also a more of a finer needle point one that we'll use for this case. And I'm sure there are many more. I like to set out a needle driver and a straight Mayo 'cause every time you use a needle driver, they're always gonna need to cut it. Local? 1% with epi. Cool. And 0.25% marcaine... Gotcha. If you have a Telfa, just cut it up into pieces. I like thirds. Depending on the case, you might need more. You might not need it at all. But it's always nice to have a few cut up in preparation. 1% lidocaine with Epi. Expiration 3/25. Here's 20 cc. Thank you. And 0.25% marcaine. 3/26 expiration. This is 10 cc. We'll get some more. Marcaine, 0.25, 3/26. Gotcha. Okay. Thank you. And after they hand it off, that's when you label it. You said 0.25%? 0.25%. And always get some water. Water. Water or saline. Okay. Let's do it. Start with Rays. 1, 2, 3, 4, 5, 6, 7, 8, 9, 10. Hypos - two. One blade. I got three Bovie tips. No sutures yet. No laps. No. Should I get a pack? No. Okay. Yeah, that's it.