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Surgical Mayo Setups, Second
Edition
Tammy Allhoff and Debbie
Hinton
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Chapter
1
Setup
Methods
Chapter 1 Setup Methods
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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.
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Examples of Basic Mayo Setups
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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
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Chapter 1 Setup Methods
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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
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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
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Chapter 1 Setup Methods
6
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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
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Figure 1-5 presents a variation of a basic
Mayo setup.
Figure 1-5: Variation of a basic Mayo setup
Chapter 1 Setup Methods
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Chapter 1 Setup Methods
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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
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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
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Chapter 1 Setup Methods
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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
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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
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Chapter 1 Setup Methods
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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
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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
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Chapter 1 Setup Methods
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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
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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
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15
Chapter 1 Setup Methods
Personal Notes
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16