Mayo stand and back table instruments for Sacral Neuromodulation Stage 1 surgery setup

Clamping & Occluding

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  Kelly Forceps

Cutting & Dissecting

• 

  Metzenbaum Scissor

• 

  Straight Mayo Scissor

Grasping & Holding

• 

  Adson Forceps

• 

  Cushing Debakey Tissue Forceps

Retracting & Exposing

• 

  Army-Navy Retractor

• 

  Senn Retractor

Suctioning

• 

  Yankauer Suction

What to expect during Sacral Neuromodulation Stage 1

The patient will be draped. Cords will be put up. The c-arm will be draped. Everyone will be wearing lead. The rep will hand you their supplies & let you know how to put them together & which ends of the wires to hand to them. They’ll also let you know when the surgeon’s going to use them. They’ll hand you two foramen needles, which you will add to your hypo count!

The surgeon will start off with a marking pen & may use an Army-Navy or the wire to figure out where they need to make their marks to insert the foramen needle. Once they figure that out they’ll use the local. After that comes the foramen needle. The leads will be tested to see if the needle is properly placed. This part may take a while. They will be looking for toe flexion & bellow. Once it’s properly placed they’ll remove the core of the needle & hand it back. They’ll place the leads & then test the leads. They’ll take out the needles to deploy the leads & test again. Once they’re satisfied they’ll insert the long wire that has marks on it. After that comes the introducer which our rep calls “the grey cross thing”. After that, they’ll insert this wire that has about 4 sets of electrodes at the bottom. The surgeon will want a marker to mark the other side. They may also ask for a ruler. Next will be the knife, cautery, pickups, Senn, or Army-Navy retractors. They will make a pocket for the battery. Then they’ll use the tunneler that has the sharp tip. They’ll unscrew the tip, feed the wire through, pull the lead through, attach the battery with the mini screwdriver & then suture it up with Vicryl & then close the skin with Monocryl. Dressings will be steri-strips or surgeon’s preference.