Setup for an Open Cholecystectomy (Kingsborough Community College, Brooklyn, NY)

CHAPTER 1

Hello, my name is Dana Donovan. I'm an adjunct lecturer here at Kingsborough Community College. Today, I will be showing you the setup for an open gallbladder procedure.

CHAPTER 2

As of now, my back table, Mayo stand, and basin have already been opened. Before I put these instruments onto the back table, I verified with my circulating nurse that my external and internal chemical indicators met the proper parameters to confirm sterility.

CHAPTER 3

We also have medication on our field that I verified with the circulating nurse for the dosage, the name of the medication, and the expiration date. Everything has been properly labeled with all the necessary information.

CHAPTER 4

First we're gonna start off by setting up this major tray right here. I'm going to take a blue towel and make my instrument roll. Some institutions have rolls already made for you. If not, you need to learn how to make your own. You take your stringer of instruments and place them as so. Okay. While setting up my forceps, I separate non-penetrating from penetrating. Penetrating on the right side, non-penetrating on the left side. I place my knife handles here in an isolated area. When setting up your instruments, you wanna make sure that all your instrumentation is visible. So then when you count with the circulating nurse, everything runs nice and smooth.

CHAPTER 5

First thing I'm gonna do is load my blades. We have a 10 blade that we're going to load onto a number three knife handle, and a 15 blade on a number three knife handle. Okay? Always load your blades with a needle holder.

CHAPTER 6

Now I'm going to place my light handle cover on my Mayo stand, as well as my Bovie, or my electrocautery, my suction tubing with my Yankauer tip, as well as my drapes needed for this procedure. And the surgeon's gown and gloves will be placed right here. Everything that will be used first for the procedure, I've placed on the Mayo stand.

CHAPTER 7

Now we will begin our initial count. First we start with softs, then we move to sharps, and then we move to instrumentation. I'm gonna start with my Ray-Tecs. Always wait to take the paper off before you count with your circulating nurse. It should always be in packs of 10, and laparotomy pads should always be in packs of five. Ray-Tecs: one, two, three, four, five, six, seven, eight, nine, 10. Laparotomy pads with no rings: one, two, three, four, and five. We also count our marker, which comes in two pieces: one, two. Our suction tip, which is a Yankauer, we have one. Now we'll move on to sharps. We have two sutures on the field: one and two. And you always have to make sure that the needle is visible to your nurse. We have hypodermic needles: one, two. Blades: one, two. Bovie tip, we have one, and scratch pad, we have one. Now we'll move on to our instrumentation. I'm just gonna use a non-loaded knife handle. Mosquitoes: one, two, three, four. Crile: one, two, three. Straight Crile: one, two. Kelly clamp: one, two, three, four. Large Kelly: one, two, three. Allis: one, two. Babcock: one, two. Kocher: one, two, three. Right angle: one, two, three. Tonsil: one, two. Large needle holder: one. Small needle holder: one, two. Large curved Mayo: one. Metzenbaum: one. Curved Mayo: one. Straight Mayo: one. Forceps, we have DeBakeys: one, two. Smooth dressing: one, two. Adson without teeth: one, two. Adson with teeth: one, two. Pickups with teeth: one, two. Bulldog: one, two. Green loop: one, two. Parker: one, two. Senn retractors: one, two. Weitlaner: one. And our Poole suction comes with two pieces, so will be counted one, two. This is our retractor tray. We have a Balfour, which comes with one, and then each screw is counted: one, two. And then the bladder blade as well. So altogether, one, two, three, four pieces. Then we have Richardson: one, two, three, four. Rakes: one, two. Army-Navy: one, two. Double-ended Rich: one, two, three, four. Malleable: one, two. Deavers: one, two, three. And a sweetheart: one. Our initial count is complete and we are ready to gown and glove the surgical team.