Setup for an Open Pancreatectomy (Eastwick College, Ramsey, NJ)

CHAPTER 1

Hello, my name is Michael Alfieri, and I'm a surgical technologist. Today, we're here at Eastwick College, and I'm going to demonstrate to you how to set up for an open pancreatectomy.

CHAPTER 2

So as you can see, I already have my back table double-draped, as well as my Mayo stand is already double-draped.

CHAPTER 3

I already have my blades all secured over here inside of my needle box. I've already received my saline and medication on the field. Together, my circulator and I have confirmed name, strength, and expiration. I've also appropriately labeled my bulb syringe, my syringe, and my medication cup.

CHAPTER 4

Moving on to my basin set, in this ring basin, I have two gowns, two sets of towels, and two sets of gloves. That's gonna be for my surgeon and whoever their assistant might be. I have my four sticky towels to square off the incision site, and I also have all of my patient drapes in order of usage. In this ring basin, I have four extra towels, a light handle cover, a skin prep stick, and suction tubing.

CHAPTER 5

So at this time, I'm gonna call my circulator over to grab my instrument sets. This is going to be my circulator today, Aliany Villalona. At this time, she's just going to be verifying sterility inside the set itself. No moisture, no strikethrough. No moisture, no strikethrough. No moisture, no strikethrough. No moisture, no strikethrough. So now I'm going to grab my chemical indicator and confirm with my circulator that it has gone through the sterilization process. And she's going to show it back to me. Now I hand off my count sheet and grab my instruments.

CHAPTER 6

So now I'm gonna start setting up my instrument tray. When you're doing this, you know there is no one way to set up your tray. Everybody likes to set up their tray differently. So, I'm going to check under my blue meshwork, make sure there's no hidden instruments or moisture at the bottom of the tray. We're all good. So, I like to start with setting up my forceps and the way that I like to do so. So, I always put my Geralds on this side. I like my DeBakeys over here. My pickups with teeth, I like putting over here. Smooth pickups in the middle. And then my Adson pickups. Over here. So next I'm gonna set up my retractors.

CHAPTER 7

So at this time, once I complete my setup, I'm gonna call over my circulator and we're going to begin our initial count. Ready? So we start with sponges. Laparotomy sponges, one, two, three, four, five. Ray-Tecs, one, two, three, four, five, six, seven, eight, nine, ten. Next we move on to our sharps. Blades, one, two, three. Hypodermic needles, one. One Bovie with tip and scratch pad. And sutures, one, two. So now I'm going to count my stringer. I like to use an empty knife handle. It helps to count the instruments using the knife handle, so that the circulator can see every single tip to ensure that every single instrument is there when I'm counting. So, starting with Mosquitoes, one, two, three, four. Criles, one, two, three, four, five, six. Kellys, one, two, three, four, five, six. Peans, one, two. Tonsils, one, two. Right-angle Mixter, one, two, three, four. Allis, one, two, three, four. Kocher, one, two. Babcocks, one, two. Needle holder, one, two. Curved Metzenbaum, one. Curved Mayo, one. Straight Mayo, one. Sponge stick, one, two, three, four. So now moving on to my forceps. I have my DeBakeys, one, two. Adsons with teeth, one, two. Smooth pickups, one, two. Pickups with teeth, one, two. Geralds, one, two. Now moving on to our retractors. We have one Balfour with one wing nut and two attachments. Army-Navys, one, two. Farabeufs, one, two. Weitlaner, one. Now moving on to our Yankauer suction. This is based off hospital policy how you count these. My hospital, since the tip comes off, we count it as two separate. So, Yankauer, one, two. And then we have one #3 knife handle, and then, again, based off hospital policy, however you count these, our hospital, it comes apart, so we count it as two separate. One, two. So at this time you confirm with your circulator that the initial count is complete. Count complete.

CHAPTER 8

So now I'm gonna take my stringer off my instruments, and I'm gonna start setting up my Mayo stand. So, the first thing you're going to do when you take the actual stringer off is you're going to grab a needle holder and the knife handle and you're going to load on a #10 blade. So when you're doing this, you always need to ensure sharps safety. That's very key. So you're always going to load the blade over your needle box and place that on the towel that was preplaced on the Mayo stand. I also like to throw two laparotomy sponges up here as well, also two Army-Navy retractors. So, I like to put in order on my Mayo stand how I know my surgeon is going to need the instruments. So, always pickups with teeth first. Then he will need smooth pickups. I'm going to throw two Criles up on the stand. This is for hemostasis, clamping off any blood vessels. I'm going to put two Allis graspers on to manipulate tissue and organs when you're inside the abdominal cavity. And then I'm also going to put one curved Metzenbaum scissor. This is for blunt dissection of any soft tissue. Now that I have my back table and Mayo stand all set up, I'm ready to gown and glove the surgeon and assistant, and prepare to begin our procedure.