Setup for a Laparoscopic Hemicolectomy (Kingsborough Community College, Brooklyn, NY)

CHAPTER 1

Hello, my name is Professor Gina Forsyth, and I am a college lab technician at Kingsborough Community College. Today I am going to be showing you how I set up for a laparoscopic hemicolectomy.

CHAPTER 2

I have already verified my instruments with the circulating nurse, so we have already confirmed sterility with the sterimeters that are in the tray, or also known as chemical indicators. As I'm setting up my forceps, I am separating the traumatic from the atraumatic.

CHAPTER 3

Now I'm going to do my initial count with the circulating nurse. We count in sequence of softs, sharps, and then instruments. Lap sponges come with or without rings, and they also come in packs of five. Laps without rings, one, two, three, four, five. Ray-Tec sponges come in packs of 10. Ray-Tecs, one, two, three, four, five, six, seven, eight, nine, 10. Marking pen, which is not required to count at all facilities, but for learning purposes, I will show you. The marker is counted as two pieces. One, two. Sutures, I have one, two. Blades, one, two. Hypodermic needles, one, two. I have a Bovie on my Mayo. Bovie tip, one. Scratch pad, one. Instruments, mosquitoes, one, two, three, four. Curved criles, one, two, three, four. Kelly, one. Allis, one, two. Kochers, one, two. Right angles, one, two. Babcocks, one, two. Needle holders, one, two, three. Sponge stick, one, two. Straight Mayo, one. Curved Mayo, one. Metzenbaum, one. Knife handles, one, two. Forceps, Adsons with teeth, one, two. Tissue forceps with teeth, one. Adsons smooth, one, two. Retractors, I have Senns, one, two. Army-Navy, one, two. S-retractors, one, two.

CHAPTER 4

I'm going to load my knife handles with the blades, putting a 10 blade on a number 3 handle. And a 15 blade on a number 7 handle.

CHAPTER 5

I already have medication that I have received from the nurse. My medicine cup is labeled with the dosage and the medication and the expiration date. It is 1% lidocaine with epinephrine expiring September 30th, 2025, as well as my syringe that is labeled with the medication.

CHAPTER 6

Some facilities don't count the laparoscopic instruments, but for learning purposes today, I'm going to count them and tell you what each of them are. So we have one, two, three, four, five, six. This is a Maryland dissector. Two atraumatic grasping forceps. One laparoscopic scissor. One hook cautery, or known as an L-hook cautery. And one biopsy grasper.

CHAPTER 7

On my Mayo, I have some of the other supplies that we would be using for the case. Light handle cover. A 10-millimeter, zero-degree scope, which is surgeon's preference. We have the camera head. The Bovie cord for the hook cautery. The light cord for the scope. And insufflation tubing. We have the Veress needle, which is also surgeon preference. We have various sizes of trocars. Again, a surgeon's preference. I have a 12-millimeter and two-five millimeter trocars. I have the scope warmer, which is used to eliminate fog on the scope during the case. This piece gets pulled out. You turn on the scope warmer by activating it with the button here, and the scope gets inserted inside of the scope warmer. There is also what we refer to as the Q-tip, which is used to clean inside of the trocars if it gets bloody.

CHAPTER 8

I also have a laparoscopic stapling device that may be used during this case, based on surgeon preference.

CHAPTER 9

In my ring stand, I have everything set for the surgeon and the rest of the surgical team. Their gown and gloves, and also the drapes that we would be using to proceed with the case. In order that they're going to be used, I have a half drape, four sticky towels, and the laparoscopy drape. Once the team comes in, we'll be ready to begin the case.