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    1. The document describes the procedures for abdominal herniorrhaphy including defining hernias, types of hernias, patient preparation, skin preparation, and surgical steps. 2. The types of hernias discussed are inguinal (direct and indirect), femoral, umbilical, and incisional. 3. Key responsibilities of the circulator are outlined such as setting up monitors and equipment, adjusting insufflator settings, and ensuring proper connections for suction, irrigation and electrosurgery.

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    1. The document describes the procedures for abdominal herniorrhaphy including defining hernias, types of hernias, patient preparation, skin preparation, and surgical steps. 2. The types of hernias discussed are inguinal (direct and indirect), femoral, umbilical, and incisional. 3. Key responsibilities of the circulator are outlined such as setting up monitors and equipment, adjusting insufflator settings, and ensuring proper connections for suction, irrigation and electrosurgery.

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    1. The document describes the procedures for abdominal herniorrhaphy including defining hernias, types of hernias, patient preparation, skin preparation, and surgical steps. 2. The types of hernias discussed are inguinal (direct and indirect), femoral, umbilical, and incisional. 3. Key responsibilities of the circulator are outlined such as setting up monitors and equipment, adjusting insufflator settings, and ensuring proper connections for suction, irrigation and electrosurgery.

    Copyright:

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    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    3 views1 page

    Img 0043

    Uploaded by

    O'jays Navarro
    1. The document describes the procedures for abdominal herniorrhaphy including defining hernias, types of hernias, patient preparation, skin preparation, and surgical steps. 2. The types of hernias discussed are inguinal (direct and indirect), femoral, umbilical, and incisional. 3. Key responsibilities of the circulator are outlined such as setting up monitors and equipment, adjusting insufflator settings, and ensuring proper connections for suction, irrigation and electrosurgery.

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    66

    Surgicol Procedures lncluding Minimol Access Procedures

    Abdominol Extroiniestinol Surgery o

    $/

    Blades (1) No. 10, (1) No. 15 or (1) No. 11 Suction tubing

    Clip cartiidges

    fte

    , Epigastric. Defect in the abdominal waII between

    SpeciolNotes After the patient is in the room, position monitors. Following draping, the scrub person will pass off camera cable, light cord, suction tubing, and electrocautery cord. The circulator adjusts the insufflator. First adjust to low flow (between 5 and 7 mm Hg), then high ffow according to surgeon's direciions. Connect and turn on light source and white balance
    camera. The circulator will turn on the VCR (to record) if requested.

    ftpmtmdes. Ineisional (Ventral). A defect within the scar of a mgical incision (abdominal).
    ltrscussion

    xiphoid process and the umbilicus through which

    The circulator checks CO,

    level. '

    Hernias are either reducible or irreducible, that is, inmerated. The contents of an incarcerated hernia may lbeeome strangulated, compromising the viability of frapped tissue and necessitating their resection in addtion to the herniorrhaphy. Flocedures
    Several techniques are employed for each of these hernia types. Usually an incision is made over the site of tre defect. Blunt and sharp dissection are employed to erpose the hernia sac and surrounding musculofascial defect. With incisional hernias, the peritoneal cavity may be entered. The hernia sac may be allowed to retract, sutured over (imbricated), or excised. The musculofascial defect may be closed employing a wide variety of techniques and suture materials, and occasionally a mesh prosthesis. The subcutaneous tissue and skin are approximated.

    Recheck position of monitors so they can be easily viewed.

    The circulator conYrects remaining items: irrigation tubing, suction tubing, and electrosurgical cord.
    Keep lens clean as necessary. The circulator positions the electrosurgical unit.

    ABDOMINAT HERNIORRHAPHY Definiiion Repair of a musculofascial defect, through which various organs or tissues may present.

    Types

    Reporotion of the Potient The patient is supine with the arm on the affected side extedded on an armboard. Apply electrosurgical dispersive pad. Iflocal anesthesia is employed, see circulator responsibilities, pp. 34-35.
    Skin Preporotion

    bilicus: paraumbilical) most often seen in children or


    obese adults.

    The musculofascial defect is in the groin, the herniated tissues presenting through the posterior inguinal wall medial to the deep inferior epigastric vessels (direct); or through the deep inguinal ring and inguinal canal, emerging at the superficial inguinal ring (indirect); or through the femoral canal (femoral). Umbilical. Within the umbilicus (or about the um-

    Inguinal (Direct, Indirect) and Fernoral.

    Inguinal and Femoral. Begin'at the incision extending from umbilicus to midthigh (including a wide margin beyond the midline), and down to the table on the sides; external genitalia are prepped last. Umbilical. Begin at the incision extending from the nipples to upper thighs, and down to the table at the
    sides.

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