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Hemorrhoidectomy mayo stand and back table surgery setup

Diana Lei-aloha Avatar

setup author

Surgery setup images for Hemorrhoidectomy

Hemorrhoidectomy surgery instruments

Clamping & Occluding instruments

Curved Hemostat
Curved Hemostat
Pennington Forceps
Pennington Forceps
Straight Hemostat
Straight Hemostat

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
Adson Forceps
Adson Forceps
Forester Sponge Forceps
Forester Sponge Forceps
Non toothed Pickup
Non toothed Pickup
Debakey Forceps
Debakey Forceps

Retracting & Exposing instruments

Pratt Rectal Speculum
Pratt Rectal Speculum
Sawyer Retractor
Sawyer Retractor
Hill Ferguson Rectal Retractor
Hill Ferguson Rectal Retractor

Suctioning instruments

Yankauer Suction
Yankauer Suction

Suturing & Stapling instruments

Mayo-Hegar Needle Holder
Mayo-Hegar Needle Holder

What to expect during Hemorrhoidectomy

Hemorrhoidectomy is a surgical procedure that is performed to remove hemorrhoids, which are swollen and inflamed veins in the rectum and anus. The procedure is typically recommended when non-surgical treatments, such as dietary changes or medication, have been unsuccessful in treating hemorrhoids. Hemorrhoidectomy is performed under general anesthesia and involves the removal of the hemorrhoids using various surgical techniques. While the procedure can be effective in providing long-term relief from hemorrhoids, it is also associated with some risks and potential complications, including bleeding and infection.

Extra Equipment
ESU, suction 

Drapes
Lithotomy: Leggings, under buttocks drape, lithotomy drape

Prone
Towels, universal drape

Step 1: Visualizing the Hemorrhoids
To begin the Hemorrhoidectomy, the surgeon will need to visualize the hemorrhoids. This can be done using a rectal speculum or a hill ferguson retractor, which will provide a clear view of the area.

Step 2: Grasping the Hemorrhoids
Once the hemorrhoids are visualized, the surgeon will need to grasp them using a toothed pickup, DeBakey clamp, or Pennington clamp. These instruments will allow the surgeon to firmly grasp the hemorrhoids and manipulate them as needed.

Step 3: Removing the Hemorrhoids
After the hemorrhoids are grasped, they will be removed using a scalpel and cautery. In some cases, a laser may be used instead of a scalpel. The surgeon will carefully cut away the hemorrhoids while using cautery to control bleeding.

Step 4: Dressing the Wound
After the hemorrhoids have been removed, the surgeon may decide to use sutures to close the incisions. This will depend on the depth of the incisions and how much skin was removed. Once the incisions are closed, the wound will be dressed with packing gauze to promote healing.

Tips and tricks
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.

The Surgery Sparknotes

  1. Visualize hemorrhoids using rectal speculum or hill ferguson retractor.
  2. Grasp hemorrhoids with toothed pickup, DeBakey clamp, or Pennington clamp.
  3. Remove hemorrhoids with scalpel and cautery or laser.
  4. Dress wound with packing gauze and potentially suture incisions.

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