General

General Oncology

Urology

Robotics

Resource Guide

Welcome to our service!

Here are a few tips and tricks to make it easier for you.

CSL

Kathy Deal 615-579-2907

Suzanne Harris 615-394-7253

Manager

Sonja Walsh 2-4160

General

Surgery

Colorectal Surgery

Dr. Muldoon

Dr. Geiger

Dr. Cone

TIPS

They do not use the disposable bed cover provided in the kit.

Check VPIMS eORboard under comments for case notes.

There is a colorectal protocol in place for all patients; please see the

following page.

Bean bag used in robotic and laparoscopic case positioning with the

notch at the patient head.

COLORECTAL DIRTY BUCKETS

RIGHT COLECTOMY/ILEOCOLIC Hemostat x 2 3-0 PDS SH x 2 7 inch debakey x 2 Green towel x 3 Needledriver x 2 GIA 75 stapler Curved mayo scissor GIA 75 reload x 1 Needlebook, small Lap sponge x 1

LEFT COLECTOMY/SIGMOID/LAR Hemostat 2-0 Keith prolene needle Vanderbilt Anvil- 25 or 29 Curved mayo scissors Green towel x 3 Needle driver Purse string clamp Allis clamp x 3

General Surgery

Dr. Holzman

Doesn’t like cell phone use in his rooms

Dr. Sharp

Mixes his own local during MAC cases Injects his own Lymphazurin/Isosulfan blue after anesthesia induction HERNIA MESH--- SEE NEXT PAGE PICS Dr. Brandon Williams, Dr. English, Dr. Pierce, Dr. Spann Use “Endo I” for difficult angles Will often help with their patient positioning Dr. Williams tracks his staple loads on his dictation sheet and has additional timeout questions Dr. Poulose HERNIA MESH Bard soft 30 x 30 Ethion PVP Gora BioA

Endo “I”

Mesh - Dr. Sharp

Surgical

Oncology

WHIPPLE Procedure

Specialized sutures on GGUR PMS suture caddies.

Have multiple pathology sheets available; multiple frozen sections possible. Dr. Idrees may occasionally use the CUSA .

The following picture will aid in counting Whipple Pans I and II. There are 13 box locks from Pan II in this picture. The two long Allis clamps remain in Pan II. The other box locks equal 13 from Pan I .

13 instruments from box locks in Whipple pan II Whipple Pan I

CUSA Machine

CUSA Pack 1

CUSA Pack 2

CUSA Pack 3

CUSA Pan

Pelvic Exenteration

If radioactive seeds are used, they are sewn into a mesh. Radiological oncology will need a small sterile field with supplies (from a list they provide.)

Mesh for Rad Onc

HIPEC

Start in and stay in lithotomy in case of rectal

involvement.

Dr. Idrees doesn’t use the warming blanket or machine. Dr. Idrees will notify the circulator if chemotherapy is needed; necessary instructions for disposal are on the DPC.

BK Ultrasound

Argon

Aquamantys

Sump Drain - Dr. Idrees

Open Cases – Dr. Idrees

Ask Core staff

UROLOGY

Penile Prosthesis

Spray bottle with ½ betadine, ½ saline in field; sterile peel packed in TVC core. Stainless steel implant tray; blue wrapped in TVC core. Must dwell with antibiotics in pre-op prior to entrance to OR.

Nephrectomy

Partial- special mini “time out” prior to clamping renal artery

Please reinforce importance of focus to all in room

Turn off music

Place signs on doors to limit traffic

No breaks/lunches/relief during this time

See DPC for full details

HOLEP (Holmium laser enucleation of prostate) Our staff will frequently finish these cases but just in

case…..

Have a Dornoch suction canister in room.

You may need two LOTS of fluids used here.

(i.e. 15-30 3L bags)

Percutaneous Nephrolithotomy (PERC)

Frequently start lateral or supine then flip prone mid-case. This depends on whether the patient has a nephrostomy tube. NO brown gel rolls from OZ (unable to use with radiology.)

Endo Uro Cart

The majority of urology specific supplies are on this cart. Laser fibers - sizes 200, 365, 550 Guide wires Sensor wire Dbl lumen catheters Uro-lock adaptor Used to connect cysto- tubing to scope

EndoUrology Cart

See inside door of cart for POU scanning and item location.

Middle section of cart

Right section of cart

Stents - Sizes

Guide Wires

Sensor Wires

Dbl Lumen Catheters

Uro-lock Adaptor

Used to connect cysto-tubing to scope

Blue Light procedures only.

Turn scope on after plug wires in.

Laser

Robot Core Implant Cart

Cystoscopy/Ureteroscopy

Cysto tubing Level One Fluid Warmer Pressure bag during ureteroscopy; gravity otherwise

Level One Fluid Warmer

Interstim Insertion/Removal

Check with Kathy Deal. She communicates with the Medtronic rep (Kathy Kelley) to be present for these cases.

Robotics

RALP Robotic Prostatectomy)/Hysterectomy

Position is steep Trendelenburg for majority of cases. Use blue egg crate with attached arm holders/straps to secure and pad patient. Use large donut to pad face under drape as robot arm may rest close to it. Put urine and specimens on ice. Research will take specimens when ready. Robot is positioned between the patient’s legs while in lithotomy position.

There is a steel guide you can place on the floor

to direct the robot.

Equipment

GGUR has a storage room located in the back East corner of the OR behind OR 36. Stored there are:

Level One Fluid Warmer

Ultrasound

Laser machines (20,80,100 watts)

Keys are in the accu dose “keys”

Lateral positioning tools

Aquamantys

GYRUS- lives on 4S and is used for GYN cases as requested

STORZ towers- not needed in 36,37,38,39 (built into the boom along with CO2 canisters; otherwise they are located across from OR 30.

Slush machines

Caiman