STUDENTS’ PROFILE STUDENT NURSES’ NAME YEAR / SECTION / GROUP SCHOOL ID NUMBER CONTACT NUMBER OFFICIAL EMAIL ADD HOSPITALS’ NAME AREA OF DUTY SHIFT DATE / DAY CLINICAL INSTRUCTOR GONZALES, MARY MARGARETH E. 4NC-GROUP 2 20180014134 0975-045-2394 20180014134@my.xu.edu.ph MRXUH OPERATING ROOM PM SHIFT FEBRUARY 5, 2022 SIR JOHN IAN AMIGO Official Website: http://www.xu.edu.ph/college-of-nursing Official Email Address: nursing@xu.edu.ph Official Phone Number: (088) 853-9800 local 9817, 9446, 9447, 9448, 9449 LAPAROSCOPIC APPENDECTOMY INSTRUMENTATION INSTRUMENT NAME A. Consumables 10x10 gauze swabs Tonsil swabs Sharps pad Scratch pad PICTURE FUNCTION Control bleeding. Facilitate hemostasis. Where discarded sharps are placed. Keep instruments clean of charred tissue or debris. Official Website: http://www.xu.edu.ph/college-of-nursing Official Email Address: nursing@xu.edu.ph Official Phone Number: (088) 853-9800 local 9817, 9446, 9447, 9448, 9449 Swab counting bag Anti-fogging agent Filtered needles w/ syringes Gallipots Convenient counting, handling and disposal of contaminated swabs Applied directly onto the laparoscope lens tp condense steam into larger droplets, so as not to obscure the camera view. This is to aspirate solutions. Containers for liquids as well as specimen. Official Website: http://www.xu.edu.ph/college-of-nursing Official Email Address: nursing@xu.edu.ph Official Phone Number: (088) 853-9800 local 9817, 9446, 9447, 9448, 9449 Kidney dishes Laparoscope warmer Sterile camera cover Wound dressing For safe collection of medical waste. Sterile, single-use wrap that applies instant heat to warm scopes, preventing fog and condensation on distal lens. Placed around camera attachment to maintain sterility. Cover trocar sites at the end of the procedure. Official Website: http://www.xu.edu.ph/college-of-nursing Official Email Address: nursing@xu.edu.ph Official Phone Number: (088) 853-9800 local 9817, 9446, 9447, 9448, 9449 Steristrips Size 1 absorbable braided suture Size 4-0 monofilament absorbable synthetic suture (bigger) Sterilized surgical tape, used for wound closure. Used as stay sutures for Hasson port. With Jneedles for this particular case. Passed to surgeon in needle holders. These sutures are used to close the skin incisions. B. Infiltration Bupivacaine 0.25% with Adrenaline 1:200,000 A local anesthetic and should be aspirated with the filtered needle. This is used at the end of the surgery to create a transversus abdominis plane (TAP) block. Official Website: http://www.xu.edu.ph/college-of-nursing Official Email Address: nursing@xu.edu.ph Official Phone Number: (088) 853-9800 local 9817, 9446, 9447, 9448, 9449 Lidocaine A local anesthetic and should be aspirated into syringe with filtered eedle. Used for infiltration at the trocar sites during skin closure. However, depending on the surgeon’s preference, they may choose to infiltrate before trocar insertion. C. Port Insertion Number 15 blade Handheld diathermy / Electrocautery Pen / Monopolar Small curved cutting edge, used to make short and precise incisions; used to incise the skin and anterior fascia for port insertion. The blade must be placed into the blade holder, using forceps, before use. Cuts and coagulate modes. Soft tissue can be cut using the heat generated from high voltage output. Small vessels can be cauterized using a lower voltage output. This can be used to incise skin for port insertion. Official Website: http://www.xu.edu.ph/college-of-nursing Official Email Address: nursing@xu.edu.ph Official Phone Number: (088) 853-9800 local 9817, 9446, 9447, 9448, 9449 Langenbeck retractor Right angled retractor, which can come in various sized; used to retract skin and subcutaneous tissue. (2) Two Langenbeck retractors can be used to expose the anterior fascia. Allis forceps Have teeth at tips of the jaws to hold soft tissue; Used to grasp the peritoneum on either side of the midline during its incision and during the placement of stay sutures. Curved mayo scissors Have curved blades for cutting heavy fascia or muscle; use to incise the anterior fascia during Hasson port insertion. Needle holder Have ratchets to allow instrument to lock the suture in its jaws. The jaws of the needle holder are short and cross hatched should grasp the needle on its body; All sutures are Official Website: http://www.xu.edu.ph/college-of-nursing Official Email Address: nursing@xu.edu.ph Official Phone Number: (088) 853-9800 local 9817, 9446, 9447, 9448, 9449 passed to the surgeon in needle holders. Metzenbaum Have curved blades too but thinner and more delicate than the mayo; To cut and dissect delicate tissue. Hasson port Has a blunt tip and wings to anchor the stay sutures. 30 degrees laparoscope: Uses angled lens; more commonly used laparoscopes; laparoscopes are inserted into the Hasson port prior to the insertion of additional trocars, to perform an abdominal laparoscopy. Official Website: http://www.xu.edu.ph/college-of-nursing Official Email Address: nursing@xu.edu.ph Official Phone Number: (088) 853-9800 local 9817, 9446, 9447, 9448, 9449 Two 5mm Trocars Atraumatic grasper Atraumatic fenestrated graspers Disposable hook Used in this procedure. Larger trocars may be used depending on surgeon’s preference. Have serrated jaws. Used to handle soft tissue. Similar to atraumatic graspers; has window along the length of the jaws. Similar function above and are used to handle soft tissue. Has right angled tip; used to cut or coagulate using different voltage outputs; commonly used as general dissection instrument in laparoscopic appendectomies Official Website: http://www.xu.edu.ph/college-of-nursing Official Email Address: nursing@xu.edu.ph Official Phone Number: (088) 853-9800 local 9817, 9446, 9447, 9448, 9449 Another energy device Laparoscopic clip applicator Loops Laparoscopic scissors An optional instrument to grasp, cut, dissect, and seal tissue and vessels. Introduce and close a clip around a vessel; Used to ligate the appediceal artery during mesoappendix dissection or to ligate the appendix at the base. Used to ligate the appendix at the base. Divide the appendix at the base between loops Official Website: http://www.xu.edu.ph/college-of-nursing Official Email Address: nursing@xu.edu.ph Official Phone Number: (088) 853-9800 local 9817, 9446, 9447, 9448, 9449 Suction irrigation cannula Specimen retrieval bag Connected to a suction pump and irrigation solution; used to perform a wash. Enclosed within the cannula of this instrument and can be released once inside the abdominal cavity. Inserted in the Hasson port and a 5mm port. After the appendix is amputated, it is replaced in the bag and removed. D. Additional Equipment Compression boots Leg straps To aid in patient’s legs’ circulation Straps are designed to prevent patient’s leg from moving or falling from a surgical table. Official Website: http://www.xu.edu.ph/college-of-nursing Official Email Address: nursing@xu.edu.ph Official Phone Number: (088) 853-9800 local 9817, 9446, 9447, 9448, 9449 A standard disposable single-use patient return electrode forms a resistive circuit and the direct electrical connection relies on good contact with the patient. Diathermy pad References Korndorffer JR, Fellinger E, Reed W. SAGES guideline for laparoscopic appendectomy. Surgical endoscopy. https://www.sages.org/publicati ons/guidelines/guidelines-for-laparoscopic appendectomy/.2010; 24 (4):757-61. Accessed on Mar. 11, 2019. WebMD. Appendicitis. WebMD Website. https://www.webmd.com/ digestive-disorders/digestive-diseases-appendicitis. Accessed Nov. 19, 2020. Rutherford CJ. Differentiating surgical instruments. 2nd ed. Philadelphia,PA: FA Davis Company; 2011. Official Website: http://www.xu.edu.ph/college-of-nursing Official Email Address: nursing@xu.edu.ph Official Phone Number: (088) 853-9800 local 9817, 9446, 9447, 9448, 9449