surgeon name: hypospadias or protocols template for: hypospadias there are explanations of each...
TRANSCRIPT
Surgeon Name:
OR Protocols Template for: HYPOSPADIAS
There are explanations of each template - how it will look when
finished and how to correctly complete each template. Please fill
each section out and return to [email protected]
1. OR Checklists
2. Procedure Sequence Guide
3. Room Arrangement
4. Instrument Labels
Byron Joyner, MD, MPA
Surgeon Name:
Glove Size:
OR Protocols - General Checklist
Please use the line shape below to cross out items on the example checklist that you do not wish to have included on your personal checklist.
If you wish to add additional items not listed here, please use the following slides to add them to the appropriate section.
Copy, paste and move this line as many times as required.
Byron Joyner, MD, MPA
7.5 Sensicare
Done N/A
1. Pre-Flight (Preparations) ChecklistPlease add any items you wish to include on your list.General: For All Cases
Anesthetic plan established, type of regional block
Preoperative antibiotics established
Fellow or resident participating in case established
Pagers removed from self and placed on counter
Site marked
Time out performed
Sutures: 4-0 PDS on ann RB1, 5-0 Monocryl on a P3
Dressing: Dermabond
Done N/A
Please add any items you wish to include on your list.2. In-Flight (Procedure) ChecklistGeneral: For All Cases
Done N/A
Please add any items you wish to include on your list.
Done N/A
Done N/A
NEXT Case Preparations:
THIS Case Preparations:
3. Landing (Post-Procedure) ChecklistGeneral: For All Cases
Determine location of next patient
Need for H/P or consent of next patient
Safety sign out performed
Parents notified
PACU orders written
Postoperative antibiotics and pain medication plan established
Postoperative orders written
Disposition established
Equipment issues
Improvements
Surgeon Name:
Procedure:
Glove Size:
OR Protocols – Procedure Checklist
Please use the line shape below to cross out items on the example checklist that you do not wish to have included on your personal checklist.
If you wish to add additional items not listed here, please use the following slides to add them to the appropriate section.
Copy, paste and move this line as many times as required.
Hypospadias
Byron Joyner, MD, MPA
7.5 Sensicare
Done N/A
1. Pre-Flight (Preparations) ChecklistPlease add any items you wish to include on your list.Hypospadias-Specific
Sutures: 4-0 pds on RB1 , 5-0 monocryl on P3
Needle tip on bovie electrocautery
Done N/A
Please add any items you wish to include on your list.2. In-Flight (Procedure) ChecklistHypospadias-Specific
Done N/A
Please add any items you wish to include on your list.
Done N/A
Done N/A
NEXT Case Preparations:
THIS Case Preparations:
3. Landing (Post-Procedure) ChecklistHypospadias-Specific
OR Protocols – Procedure Sequence Guide
Here is an example of the procedure sequence guide. It contains components and steps for each part of the surgery. The 3rd column lets the nurse or scrub tech know what instrument to have ready.
Please use the following slides to create your procedure sequence guide with the specifics of how you perform the surgery.
Components Steps Instruments / Scrub Tech
Surgical Procedure: HYPOSPADIAS
Mark Incision 1. Mark 2 cm incision along Langerhans lines 1 finger breadth medial to ASIS and 1 finger lateral to semi-lunaris
1. Marking pen2. Raytec
Incision and Dissection 1. Make incision at skin2. Incise dermis with electrocautery3. Use Jake clamp to dissect through
Scarpa’s fascia 4. Divide Scarpa’s and develop plane to
external oblique fascia5. Define shelving edge and superficial
inguinal ring
1. 15 blade scalpel2. Adson x 23. Jake4. Electrocautery with needle tip5. S retractors x 2
Open Fascia and Expose Cord 1. Place right angle in external ring2. Incise external ring and reposition clamp
superficially3. Incise fascia proximally4. Sweep nerve off fascia and transpose5. Separate cremasteric fibers
1. Right angle clamp2. Electrocautery3. Debakey forceps x 24. Mosquito
Dissect Out Hernia Sac and Ligate
1. Deliver entire sac with cord out of incision
2. Identify and isolate hernia sac3. Identify spermatic cord vessels and vas
deferens4. Dissect hernia sac off cord proximally5. Suture ligate hernia sac and place
second tie proximal to suture
1. Debakey forceps x 22. Mosquito clamp3. Raytec4. Straight snap x 25. Tenotomy scissors6. 4-0 PDS
Close Fascia and skin 1. Close external oblique fascia2. Close Scarpa’s fascia3. Close skin 4. Pull on testicle
1. 4-0 PDS2. Debakey forceps3. 5-0 Monocryl4. Adson forceps x 25. Mastisol, steri strips, Oasis dressing,
Tegaderm
Components Steps Instruments / Scrub Tech
Components Steps Instruments / Scrub Tech
OR Protocols – Room Arrangement
This section shows how the room should be arranged for each procedure and where each staff member generally stands.
On the following slide, move the objects around to position them correctly for your hypospadias procedure. If you need more objects, simply copy and paste one, then double click the text to change the name of the item.
IV Pole
Foot Pedal
Room Arrangement:Hypospadias
Please use the shapes below as shortcuts for any new items.
OR Table
Surgeon
Assistant
Scrub
Video Bovie
Back table
IV Pole
Anesth
Door to OR
Circulator’s Computer
Mayo
Circulator
FootPedal
Patient’s headText
Text
Text
ExtraText
OR Protocols – Instrument Labels
This section shows how to correctly set up the mayo stand or back table. It also shows the names of each instrument so that mistakes are avoided.
On the following slide, please insert your own photo of your mayo stand or back table.
Then use the blank labels to type in the correct names and position the labels appropriately.
Mayo Stand | Hypospadias
Copy/Paste to re-use. The shape will change to fit the amount of text. Text Label
Metzenbaum (2)
Debakey (4)Adson (2)
Mosquito, Straight Snap,
Right Angle
Jake
Bipolar
Electrocautery with Needle Tip
Raytec
S Retractor (2)
Peanut on Curved
Hemostats (2) Light Handles