Surgery setup images for Carpal Tunnel & Ulnar Nerve Decompression at Wrist (Dr. Hanlon)

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Clamping & Occluding

  • Allis Forceps

    Allis Forceps

  • Penetrating Towel Clamp

    Penetrating Towel Clamp

Cutting & Dissecting

  • Bandage Scissor

    Bandage Scissor

  • Stevens Tenotomy Scissor

    Stevens Tenotomy Scissor

  • Straight Mayo Scissor

    Straight Mayo Scissor

Grasping & Holding

  • Adson Forceps

    Adson Forceps

Retracting & Exposing

  • Heiss Self-Retaining Retractor

    Heiss Self-Retaining Retractor

Suctioning

  • Yankauer Suction

    Yankauer Suction

The patient is Supine with their arm on the tourniquet hand table. The arm will be lifted & held as the circulator preps it. The tech will place a blue towel under the arm once they’re done so they can set the patient’s arm down on the table. (may or may not be done) they may continue to hold the arm & pass it off to the surgeon to do their prep.

Here is the order our surgeon does this procedure:
1- Hand split drape to the circulator
2- Gown & glove the surgeon
3- Hand surgeon stockinette
4- Hand surgeon a folded blue towel with a towel clip (they’ll wrap it around the forearm & clip it)
5- Hand surgeon large drape (goes under patient’s arm)
6- Hand surgeon peds drape (goes over patient’s arm-take off stickies & help place it)
7- Hand surgeon large drape (goes over patient’s body)
8- Hand surgeon Allis, cautery bucket & another Allis
9- Leave a stack of 2 blue towels on Mayo Stand for the surgeon to place under the patient’s wrist for support
10- Grab cords & secure them to drapes. Place light handles.

The procedure:
1- Skin marker to mark incision
2- “Sharp Skin Knife” (#15 blade) with pickups to make incision
3- Heiss “cricket” retractors
4- “Sharp deep skin knife” (new #15)
5- Tenotomy scissors
6- Basin & irrigation. Bring up pitcher so he can refill
7- Dump irrigation into a large basin
8- Suture & pickups to surgeon & suture scissors to assistant. (suture: 4-0 Ethilon 1662G & 2-0 Vicryl J269 (Ulnar)
9- Clear most instruments off Mayo Stand
10- Get a count from the circulator
11- Bring up dressings: wet & dry (throw off reset of Raytecs), Adaptic on 3×3, fluff 2 fluffs, 2 webril, conform, plaster for a splint if it’s the non-dominant hand, Ace bandage. Don’t forget bandage scissors!

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