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Surgical Mayo Setups, Second Edition Tammy Allhoff and Debbie Hinton Vice President, Editorial: Dave Garza Director of Learning Solutions: Matthew Kane Senior Acquisitions Editor: Tari Broderick Managing Editor: Marah Bellegarde Senior Product Manager: Juliet Steiner Editorial Assistant: Nicole Manikas Vice President, Marketing: Jennifer Baker Marketing Director: Wendy Mapstone Senior Marketing Manager: Michele McTighe Marketing Coordinator: Scott A. Chrysler Production Director: Wendy Troeger Production Manager: Andrew Crouth Content Project Management: PreMediaGlobal Senior Art Director: Jack Pendleton Licensed to: CengageBrain User Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Licensed to: CengageBrain User Chapter 1 Setup Methods Chapter 1 Setup Methods Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 1 Licensed to: CengageBrain User Chapter 1 Setup Methods 2 Introduction There are many variations in regard to setting up a Mayo. The variations used will depend on specialty, procedure, facility, and OR layout. Some variations will also depend on personal preference. Setups are further dependent upon the site of surgery and the side on which the surgery is to be done. Most sterile setups are done farthest from the OR door, to reduce traffic in and around the sterile setup. The following photos show different ways that you may choose to set up your instruments and back table. The photos are not meant to suggest that these are the only ways for you to set up, but instead are to be used as a guide for variations to make your setup easier to work from. Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Licensed to: CengageBrain User Examples of Basic Mayo Setups Delmar Cengage Learning Figure 1-1 shows the basic Mayo setup for exploratory laparotomy. Instrumentation can be adjusted according to the procedure being performed. Figure 1-1: Basic Mayo setup for exploratory laparotomy Chapter 1 Setup Methods Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 3 Licensed to: CengageBrain User Chapter 1 Setup Methods 4 Delmar Cengage Learning Figure 1-2 presents the basic Mayo setup including back table and ring basin. Scrubbed personnel would stand within the sterile area and have access to all instrumentation and supplies on the back table. The ring basin could be used for instrumentation that is no longer usable or needed, for sterile trash, or when breaking down the setup. It could also be used for large specimens. During the initial setup, the draping supplies (in order of usage) may be stacked here with the surgeon’s gown and gloves on top. Figure 1-2: B asic Mayo setup including back table and ring basin Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Licensed to: CengageBrain User Delmar Cengage Learning Figure 1-3 shows the basic back table setup with “working end” to be pulled up to a sterile field that includes the Mayo setup and the draped patient. Figure 1-3: Basic back table setup with “working end” Chapter 1 Setup Methods Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 5 Licensed to: CengageBrain User Chapter 1 Setup Methods 6 Delmar Cengage Learning Figure 1-4 shows a basic Mayo setup with the loaded sponge sticks and dissectors placed so that there will be room for other instrumentation to be added to the Mayo. The loaded scalpels are placed in a protective device for safety. The scrubbed personnel would stand near the end where the scalpels are located. Figure 1-4: B asic Mayo setup with the loaded sponge sticks and dissectors, allowing room for a ­ dditional instrumentation Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Licensed to: CengageBrain User Delmar Cengage Learning Figure 1-5 presents a variation of a basic Mayo setup. Figure 1-5: Variation of a basic Mayo setup Chapter 1 Setup Methods Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 7 Licensed to: CengageBrain User Chapter 1 Setup Methods 8 Delmar Cengage Learning Figure 1-6 shows a basic Mayo setup with a second Mayo setup for large retractors. This variation can be used when there is a need for additional large ­retractors, as for procedures requiring multiple sizes and types of retractors. Figure 1-6: B asic Mayo setup with a second Mayo setup for large retractors Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Licensed to: CengageBrain User Delmar Cengage Learning Figure 1-7 shows a basic Mayo setup with roll towel for instrumentation placed at the end. This layout variation is sometimes used for different specialties, and instrumentation will also vary according to the specialty instrumentation required. The scrubbed personnel would stand at the opposite end of the roll towel and face the instrumentation on the roll towel. Figure 1-7: B asic Mayo setup with roll towel for instrumentation Chapter 1 Setup Methods Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 9 Licensed to: CengageBrain User Chapter 1 Setup Methods 10 Delmar Cengage Learning Figure 1-8 presents the basic Mayo setup with the roll towel of instrumentation on the end of the Mayo stand. The second Mayo stand holds large retractors and is also sometimes used for specialty items, depending on the procedure. This basic setup includes large handheld retractors. Figure 1-8: B asic Mayo setup with the roll towel for instrumentation at the end Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Licensed to: CengageBrain User Delmar Cengage Learning Figure 1-9 shows a basic back table with the retractors left in the pan for organization and counting. Figure 1-9: B asic back table with retractors left in the pan for ­organization and counting Chapter 1 Setup Methods Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 11 Licensed to: CengageBrain User Chapter 1 Setup Methods 12 Delmar Cengage Learning Figure 1-10 demonstrates a basic Mayo setup for arm/wrist procedures. A back table can be used for the setup and pulled up to the sterile field, or a Mayo stand can be used with the back table pulled up along the back of the Mayo setup. Figure 1-10: Basic Mayo setup for arm/wrist procedures Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Licensed to: CengageBrain User Delmar Cengage Learning Figure 1-11 presents a basic Mayo setup for arm/hand/wrist procedures. Instrumentation will be adjusted accordingly. This shows the Mayo setup with the back table pulled up to the sterile field. Figure 1-11: B asic Mayo setup for arm/hand/wrist procedure Chapter 1 Setup Methods Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 13 Licensed to: CengageBrain User Chapter 1 Setup Methods 14 Delmar Cengage Learning Figure 1-12 shows a basic setup working from the back table. This layout may be utilized for urology, gynecology, or some orthopedic procedures. The instrumentation would be changed accordingly. This layout is utilized depending on the site of surgery and when there is limited space or no need for a traditional Mayo stand. Figure 1-12: Basic setup working from the back table Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Licensed to: CengageBrain User Conclusion There are many different variations and techniques for setting up your Mayo stand and back table for different procedures. New or inexperienced scrub personnel will need to find a method they are most comfortable with and that will facilitate the setup and passing of instruments and supplies in the most efficient way during the procedure. Depending on the specialty, there is not always a need for the traditional Mayo stand setup. In some situations, a back table setup will be utilized for instrumentation and supplies without a Mayo setup. This may be done in such cases as cystoscopy, OB/GYN procedures, and hand, wrist, or arm procedures. Scrub persons will want the Mayo stand setup and/or the back table setup to be organized so that they can reach all instrumentation and supplies. The most commonly used items are traditionally placed on the Mayo stand, whereas the less commonly used items are left on the back table. Instrumentation and supplies must be organized so the surgical count can be performed at the appropriate times. The scrub person will need to multitask at different times during the procedure, so he or she will need to be able to see and reach all instrumentation and supplies. Having an organized setup will be more beneficial to the patient, as it enables the scrub person to meet the needs of the surgeon and expedite the timely and efficient passing of instruments and supplies. It also decreases the risk of losing an item and facilitates the transition when a team member needs to be relieved during a procedure. Every scrub person should find his or her own method of setting up the sterile field. In doing so, remember that most facilities have standard protocol that must be followed. Also keep in mind the layout of the OR, the surgeon’s preference, and basic technique. Chapter 1 Setup Methods Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 15 Chapter 1 Setup Methods Personal Notes Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 16