Setup for an Open Incisional Hernia Repair (Ivy Tech Community College, Indianapolis, IN)

Operating room preparation for an open incisional hernia repair requires careful planning to provide surgical efficiency and patient safety. This video serves as a learning resource for those, such as surgical technologists, who are responsible for setting up the OR before the start of a case. Topics covered include the arrangement of instrumentation, how to prepare for and complete an initial count before the surgery, and optimal placement of essential equipment and supplies. These back table setup methods enhance surgical workflow efficiency while maintaining sterility.

Incisional hernias represent a significant complication following abdominal surgery, occurring in approximately 4–30% of patients who undergo laparotomy procedures.^1–4 These hernias develop when the fascial layers fail to heal properly, creating abdominal wall weakness through which internal organs or tissues can protrude. Open incisional hernia repair remains the gold standard for complex cases, particularly those involving large defects, recurrent hernias, or significant comorbidities that preclude minimally invasive approaches.^5–7 The procedure typically involves mobilization of hernia contents, excision of the hernia sac, and reinforcement of the abdominal wall using synthetic mesh or primary tissue repair techniques. Recurrent incisional hernias present additional challenges, with rates ranging from 8–32% depending on repair technique and patient factors.⁸ Given this complexity and potential for complications, perioperative protocols are essential for optimizing surgical outcomes and minimizing postoperative morbidity.

As with any surgery, it is essential to create and maintain sterile conditions. Efficient operating room setup procedures help to reduce the  procedure time and improve surgical outcomes.

This video discusses the importance and creation of the sterile field. Surgical instrumentation should be placed in such a way as to provide operational efficiency for all members of the surgical team. Topics covered include efficient arrangement of the back table and what to put on the Mayo stand for the start of the case. Placement of sharps, sponges, and containers for medication and irrigation fluid (normal saline) is also covered.

The initial surgical count is another important step in the perioperative process. This video demonstrates how to prepare for and complete the initial surgical count of all soft goods, sharps, and instruments with a licensed professional to provide a baseline of all countable items, decrease the possibility of retained items, and promote patient safety.

Nothing to disclose.