Setup for a Laparoscopic Hemicolectomy (Eastwick College, Ramsey, NJ)

Laparoscopic hemicolectomy is a minimally invasive surgical intervention requiring careful organization and clear setup procedures. A systematic approach to this setup ensures all necessary equipment is available, and it supports optimal surgical outcomes and patient safety. This educational video provides a demonstration of a setup for a laparoscopic hemicolectomy including back table organization, Mayo stand preparation, instrument arrangement, and the initial count with a circulator.

Laparoscopic hemicolectomy is performed for various colorectal pathologies, including colon cancer, diverticular disease, inflammatory bowel disease, and benign polyps not amenable to endoscopic removal.^1–3 This minimally invasive technique has demonstrated significant advantages over open colectomy, including reduced postoperative pain, shorter hospital stays, faster return to normal activities, and improved cosmetic outcomes.^4–6 Studies indicate that laparoscopic hemicolectomy results in comparable oncologic outcomes to open surgery while offering superior short-term recovery parameters. The procedure involves removal of either the right or left portion of the colon with subsequent anastomosis, using laparoscopic instruments and energy devices.

The surgical technologist's role in establishing a properly organized sterile field is fundamental to procedural success, improved surgical workflow, and patient safety.

Following sterile draping procedures, all laparoscopic connection cords are positioned on the Mayo stand. The back table is organized with atraumatic (smooth) forceps positioned on the right side of the tray and traumatic (toothed) forceps positioned on the left side. The retractors and Veress needle for insufflation are arranged centrally. Trocars include one 12-millimeter blunt trocar designated for camera insertion and multiple 5-millimeter trocars for laparoscopic instrument insertion. Laparoscopic instruments are arranged by function.

Soft goods are packaged in standardized quantities: one pack of five laparoscopic sponges (laps) and one pack of ten Ray-Tec sponges. A bulb syringe is positioned alongside a medication cup. Prior to medication administration, both the circulating nurse and surgical technologist verify the medication name, strength, and expiration date. Following receipt of medication onto the sterile field, the medication cup and syringe are immediately labeled appropriately.

A blade scalpel, used for trocar insertion incisions, is placed in the sharps container, along with a hypodermic needle for medication administration, and suture for skin closure. Additional sterile supplies include a marking pen, ruler, basins, a light handle cover, and skin prep solution. Sterile gowns and gloves for the surgical team are placed alongside towels, as well as drapes for squaring off the surgical site after the skin prep. The initial count is performed collaboratively between the surgical technologist and the circulating nurse (circulator). All items are counted verbally and must be visible to both people to ensure accuracy. The implementation of such rigorous counting protocols is a critical safety mechanism, meant to prevent adverse events such as retained foreign bodies, which can result in serious patient harm.

Supplemental instrument trays are available within the operating room should the need arise to convert quickly to an open procedure. After completion of the setup and initial count, the surgical team is gowned and gloved, and begins to drape the patient. Educational materials demonstrating proper surgical setup procedures are invaluable for training surgical technologists and operating room personnel. Having standardized protocols establishes consistent practices across institutions, promotes adherence to best practices, and ensures that all team members understand their roles in maintaining sterile technique and patient safety.

Nothing to disclose.