Mayo stand and back table instruments for Hemorrhoidectomy surgery setup

Clamping & Occluding

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  Curved Hemostat

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  Pennington Forceps

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  Straight Hemostat

Cutting & Dissecting

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  #3 Knife Handle

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  Metzenbaum Scissor

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  Curved Mayo Scissor

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  Straight Mayo Scissor

Grasping & Holding

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  Toothed Forcep

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  Adson Forceps

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  Forester Sponge Forceps

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  Non toothed Pickup

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  Debakey Forceps

Retracting & Exposing

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  Pratt Rectal Speculum

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  Sawyer Retractor

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  Hill Ferguson Rectal Retractor

Suctioning

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  Yankauer Suction

Suturing & Stapling

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  Mayo-Hegar Needle Holder

What to expect during Hemorrhoidectomy

Hemorrhoids are enlarged, swollen veins around the anus and rectum. They usually aren’t dangerous, but do cause discomfort. Some people don’t know that they have them. They usually pop up from too much straining while going to the restroom. This surgery will take less than an hour. It is not considered sterile since the hemorrhoids are in a dirty area of the body…the anus.

Surgery Steps: The hemorrhoids will either be suture ligated and then removed with cautery, or they will simply be viewed with a rectal speculum, or a hill ferguson retractor, and grasped with a toothed pickup, DeBakey, or Pennington clamp, and be removed with a scalpel and cautery. A laser is used less often. Packing gauze may be used for dressings. After the hemorrhoids are removed, the surgeon may also decide to use suture to close the incisions. It depends on how deep, and how much skin was removed. 

Extra Equipment:

ESU, suction 

Drapes:

Lithotomy: Leggings, under buttocks drape, lithotomy drape

Prone: Towels, universal drape

Notes: Lubricant needs to be used when inserting retractors. Hemorrhoids will be sent as specimens. Most of the time suture is not used. I always make sure to suction all of the bovie plume that goes into the air. It is really bad to breathe in, and plus, it smell terribly. Usually, the patient is either positioned in prone or lithotomy. On very rare occasions, jackknife position may be utilized, but that isn’t a position that is used often anymore.