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Bowel Resection (Colectomy/Hemicolectomy) mayo stand and back table surgery setup

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setup author

Surgery setup images for Bowel Resection (Colectomy/Hemicolectomy)

Bowel Resection (Colectomy/Hemicolectomy) surgery instruments

Clamping & Occluding instruments

Hemostatic Clip Applier
Hemostatic Clip Applier
Curved Hemostat
Curved Hemostat
Right Angle Clamp
Right Angle Clamp
Kocher Forceps
Kocher Forceps
Kelly Forceps
Kelly Forceps
Straight Hemostat
Straight Hemostat
Babcock
Babcock
Allis Forceps
Allis Forceps

Cutting & Dissecting instruments

#3 Knife Handle
#3 Knife Handle
Metzenbaum Scissor
Metzenbaum Scissor
Curved Mayo Scissor
Curved Mayo Scissor
Straight Mayo Scissor
Straight Mayo Scissor

Grasping & Holding instruments

Toothed Forcep
Toothed Forcep
Smooth Adson
Smooth Adson
Adson Forceps
Adson Forceps
Russian Tissue Forceps
Russian Tissue Forceps
Forester Sponge Forceps
Forester Sponge Forceps
Ferris Smith Tissue Forceps
Ferris Smith Tissue Forceps
Non toothed Pickup
Non toothed Pickup
Debakey Forceps
Debakey Forceps

Retracting & Exposing instruments

Bookwalter Retractor
Bookwalter Retractor
Balfour Retractor
Balfour Retractor
Tessier Malleable Retractor
Tessier Malleable Retractor
Army-Navy Retractor
Army-Navy Retractor
Richardson Retractor
Richardson Retractor
Deaver Retractor
Deaver Retractor

Suctioning instruments

Yankauer Suction
Yankauer Suction
Poole Suction Probe
Poole Suction Probe

Suturing & Stapling instruments

Mayo-Hegar Needle Holder
Mayo-Hegar Needle Holder

What to expect during Bowel Resection (Colectomy/Hemicolectomy)

A bowel resection surgery is a procedure where a part of the small intestine is removed and the remaining parts are reconnected. This is done to treat conditions such as cancer, Crohn’s disease, and diverticulitis, among others. The surgery is performed under general anesthesia and requires specialized instruments and a skilled surgical team to ensure its success.

Extra Equipment
ESU, suction 

Drapes
Folded towels, laparotomy drape

Step 1: Incision and Mesentery Dissection
The first step in a bowel resection surgery is making an incision to gain access to the small bowel. A 10 blade is typically used for this purpose. Once the incision is made, the mesentery is cut into and dissected. It is important to maintain hemostasis throughout this process to prevent excessive bleeding.

Step 2: Identification and Removal of Affected Small Bowel
After the mesentery is dissected, the affected part of the small bowel is identified and removed. This is typically done using either a TA or GIA stapler to connect the two ends of small bowel back together. The resected piece of small bowel should be handed off as a specimen for further analysis.

Step 3: Closure
Once the affected section of small bowel has been removed, closure begins in layers. The first layer of closure is typically the peritoneum, which is closed using a running absorbable suture. Next, the fascia is closed with interrupted non-absorbable sutures. Finally, the skin is closed using either a running subcuticular suture or staples.

Tips and tricks
Have long instrument trays available, as well as a Balfour and Bookwalter retractor. Always have different size clips easily accessible. The resected part of the bowel being removed should be kept separate in order to avoid contaminating the rest of the sterile setup. Any instruments that become contaminated with bowel contents should also be taken off of the sterile field. A separate sterile field may be requested for the end of the case for closing, containing extra gowns, gloves, and a minor procedure tray.

Scar after Hemicolectomy surgery

The Surgery Sparknotes

  1. Make incision with 10 blade to access small bowel.
  2. Cut and dissect mesentery while maintaining hemostasis.
  3. Identify and remove affected small bowel using TA or GIA stapler.
  4. Hand off resected piece as specimen.
  5. Closure begins in layers: peritoneum, fascia, skin.

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