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

CHAPTER 1

Hi, my name is Ana Anilmis and I'm a surgical technologist. Today, we're here at Eastwick College and I will show you my setup for a laparoscopic hemicolectomy.

CHAPTER 2

We will be starting by showing you my Mayo stand, which was previously draped. I have here all the laparoscopic cords, starting with the light cord, the camera cord, the insufflation cord, as well as the cautery cord.

CHAPTER 3

Moving onto my back table, I have set up my laparoscopic instruments. On the right side of the tray, I have my atraumatic forceps, and in this side of the tray I have my traumatic forceps. I have my string set up, my retractors, Veress needle, which is used for insufflation at the beginning of the case. We have our trocars, which we have a 12 millimeters, blunt, that is used for the cameras as well as the five-millimeter trocars, which they're used for the laparoscopic instruments.

CHAPTER 4

We also have our softs, or sponges as we call them. We have a pack of laps and a pack of Ray-Tecs. Here I have a bulb syringe that is usually used for saline. I have a medication cup and I'm just going to make a note saying that prior to receiving the medication into the field, the circulator and I will be both checking the names, strength, and the expiration date of the medication and promptly after receiving the medication, the cup as well as the syringe will be properly labeled. I also have an 11-blade, which is used as a puncture blade to be able to insert the trocars. I have my marking pens alongside with a ruler. Alongside we have the sutures, usually surgeon prefers for skin closure or 4-0 Monocryl. I also have a hypo needle for the medication.

CHAPTER 5

And now on this side of the setup, I have my two basins, which they were sterilely draped prior. We have our light handle. I have a skin prep. I have the surgeon's gown. We have the towels and the double gloves alongside with the drapes and the four towels for squaring off the surgical site. After the whole setup was done, I will be proceeding for the surgical counts alongside my circulator.

CHAPTER 6

Today, I have with me, my circulator, Aliany Villalona, and she will be assisting me in the surgical count. We will be starting by counting the softs, sponges. We have laps, and I'm just gonna make a side note. The laps, they come with rings, because the rings, they will be left outside the patient's incision to be able to know how many sponges that are inside the cavity. So laps, 1, 2, 3, 4, and 5. Ray-Tecs, we have 1, 2, 3, 4, 5, 6, 7, 8, 9, 10. I just wanna mention that in all cases when you do a count, your circulator should be able to see everything that you're counting, including softs, instruments, sharps, just to make sure that you're both confirming the right count. Moving into the sharps, we have blades. One, I have one hypo needle. I have sutures, 1, 2. We're gonna move now to the stringer, and we have towel clips, which they're atraumatic, we have 1, 2. We have cryos, 1, 2. We have Kellys, 1, 2. Kochers, 1, 2. Aliss, 1, 2. Babcock, 1, 2. Needle holder, 1, 2. And I have one straight Mayo and one Metzenbaum alongside with sponge sticks, 1, 2. Going into my laparoscopic instruments, we're gonna have one biopsy cup. We have Babcocks, 1, 2. We have one Maryland dissector. We have graspers, Maryland graspers, 1, 2, 3. We have Aliss, 1, 2. We have one David, one Yag, and we also have a laparoscopic needle holder. The atraumatic forceps, we have 1, 2. Gerald, 1, 2. We have the traumatic forceps, which we have Adsons, 1, 2, and pickup with teeth, 1 and 2. Moving to the retractors, I have here Army-Navy, 1, 2, Loop 1, 2, and 1 Senn. In the center of my table, I have one Veress needle, which will be used for the insufflation. I also have trocars available in two sizes. Depends on the facility, count could be different. In my facility, we count all the parts that they come in, apart from the trocar, we're gonna be starting with the 12 millimeters, which is used in conjunction with the zero-degree scope and the 30-degree scope that they are available, but they're not countable items. So we have trocars, 1, 2, 3, and 4. 5, 6, 7, 8. I have one knife handle. I have marking pens, 1, 2, 3, 4, and one ruler.

CHAPTER 7

Now that the initial count is complete and confirmed with the circulator, I just wanted to add a side note that if the surgeon decides to convert from a laparoscopic procedure to an open procedure, we will have the trays available in the room for the circulator to assist. Next, we will be proceeding to assist the surgeon into gowning, gloving, and draping the patient.