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Holding Reference :
Holding Reference :
HBP (Endo)
HBP (Endo)
Dr's Preference
Dr's Preference
1。 如果用Retractor, e.g. Omnitract, 不用墊藍紙
1。 如果用Retractor, e.g. Omnitract, 不用墊藍紙
2。 Dr. Sunny Use S502C scissors in Whipple
2。 Dr. Sunny Use S502C scissors in Whipple
3。 Lap +/- open whipple case，當用完支endoeye, 走鏡後，要數走一次short raytec, confirm 沒有short raytec missing. (7/11/2023)
3。 Lap +/- open whipple case，當用完支endoeye, 走鏡後，要數走一次short raytec, confirm 沒有short raytec missing. (7/11/2023)
4。 Dr Janet Kung prefer needle holder: a. Ryder 225 mm (BM76R) in S502C; b. Ryder 200 mm (08-0051) in S001A. （NOV/2023）
4。 Dr Janet Kung prefer needle holder: a. Ryder 225 mm (BM76R) in S502C; b. Ryder 200 mm (08-0051) in S001A. （NOV/2023）
5。 Dr. E Lo CUSA Clarity setting: Amplitide: proportional. foot pedal 左腳。下面墊小布防冼走。
5。 Dr. E Lo CUSA Clarity setting: Amplitide: proportional. foot pedal 左腳。下面墊小布防冼走。
Practice in HBP
Practice in HBP
Basic HBP theatre setting
Basic HBP theatre setting
SUPINE
SUPINE
E.g. For hepatectomy, Lap Chole, Open RFA/ Microwave ......
E.g. For hepatectomy, Lap Chole, Open RFA/ Microwave ......
- Please Leave patent's Left thigh FREE, standby for RFA pad
- Please apply TWO diathermy PAD on patient's Right thigh
- Please apply SCD
- Please apply heel gel
Lap HBP position and theatre setting
Lap HBP position and theatre setting
Drain :
Drain :
REF 2231
REF 2231
Blake Fr. 19
Blake Fr. 19
pre packed with trocar x 1
pre packed with trocar x 1
Cut Half from black dot
Please confirm with surgeon before CUT
REF 2234
REF 2234
Blake Fr. 24
Blake Fr. 24
Cut Left 20 cm from black dot
Please confirm with surgeon before CUT
Medication in HBP
Medication in HBP
- Methylene blue for Dr. K. Ng case
Methylene blue mixture
Methylene blue mixture
1 ml Methylene blue in 100 ml injectable NS
1 ml Methylene blue in 100 ml injectable NS
- Sandostatin 0.2 mg s.c. on call to OT; 6 hours after 1st dose for Whipple's operation.
- ICG IndoCyanine Green, 2.5 mg on call to OT for lap liver cyst deroofing operation .
- Wound infiltration : application of EASY PUMP in HBP case
EASY PUMP
EASY PUMP
Tachosil
Tachosil
TachoSil_PI_Jun2018.pdfTechnique
Technique
Rummel touniquet preparation
Rummel touniquet preparation
- Fr. 24 foley 如圖分成五份。
將中間的部份套入stillette 備用。
將中間的部份套入stillette 備用。
2。 要配合nylon tape 6 mm (W277) 或 6.4 mm cotton tape 使用。
2。 要配合nylon tape 6 mm (W277) 或 6.4 mm cotton tape 使用。
Surgeon 會將預備好的rumel snare, 利用stillette (in S502C) 將6 mm nylon tape or 6.4 mm cotton tape 穿過foley, 再用foley 和 Robert (strong curve) 將hepatoduodenal ligament 如下圖束緊。
Surgeon 會將預備好的rumel snare, 利用stillette (in S502C) 將6 mm nylon tape or 6.4 mm cotton tape 穿過foley, 再用foley 和 Robert (strong curve) 將hepatoduodenal ligament 如下圖束緊。
Pringle maneuver using a rumel tourniquet
Pringle maneuver using a rumel tourniquet
Pringle manoeuvre
Pringle manoeuvre
The Pringle maneuver is a surgical maneuver used in some abdominal operations. A large atraumatic hemostat is used to clamp the hepatoduodenal ligament (free border of the lesser omentum) interrupting the flow of blood through the hepatic artery and the portal vein and thus helping to control bleeding from the liver. More commonly, in the absence of soft clamp, manual compression of the hepatoduodenal ligament is performed.
The Pringle maneuver is a surgical maneuver used in some abdominal operations. A large atraumatic hemostat is used to clamp the hepatoduodenal ligament (free border of the lesser omentum) interrupting the flow of blood through the hepatic artery and the portal vein and thus helping to control bleeding from the liver. More commonly, in the absence of soft clamp, manual compression of the hepatoduodenal ligament is performed.
= To minimize blood loss.
= To minimize blood loss.
計時
計時
當進行 pringle maneuver 時，需要計 clamp and release 的時間
當進行 pringle maneuver 時，需要計 clamp and release 的時間
通常是 clamp 15 分鐘再 release 5 分鐘。（請跟從醫生指示）。
通常是 clamp 15 分鐘再 release 5 分鐘。（請跟從醫生指示）。
最多 4 個cycle.
最多 4 個cycle.
請清楚計算時間及 cycle，將紀錄紙條交給醫生。
請清楚計算時間及 cycle，將紀錄紙條交給醫生。
Timer 存 HBP cupboard.
Timer 存 HBP cupboard.
ESU Setting
ESU Setting
CUSA diathermy nosecone CEM
CUSA diathermy nosecone CEM
With CUSA Clarity 23 kHz
With CUSA Clarity 23 kHz
compatible to diathermy machine (with CEM)
compatible to diathermy machine (with CEM)
FORCE IC
FORCE IC
FORCE IX
FORCE IX
FORCE FX-8C
FORCE FX-8C
FORCE FX-8CS
FORCE FX-8CS
Not compatible:
Not compatible:
VALLEYLAB FX8
VALLEYLAB FX8
TissueLink set up
TissueLink set up
ESU Setting:
ESU Setting:
CUT: BLEND 1
CUT: BLEND 1
COAG: 60 FULG
COAG: 60 FULG
Need an independent diathermy (TWO diathermy pad)
Need an independent diathermy (TWO diathermy pad)
OR
OR
Share use with monopolar in FT 10
Share use with monopolar in FT 10
TissueLink consumble
TissueLink consumble
Open or Lap type
Open or Lap type
Connect to 1L room temp NS, using infusion pump from RR, drip rate at 120 ml / hour and adjust upon request.
Connect to 1L room temp NS, using infusion pump from RR, drip rate at 120 ml / hour and adjust upon request.
調較好 drip rate 後，只需夾實近 tip 的 clamp 便可。
調較好 drip rate 後，只需夾實近 tip 的 clamp 便可。
surgeon 使用時會自行放 clamp.
surgeon 使用時會自行放 clamp.
Olympus ESG 400 USG 400
Olympus ESG 400 USG 400
set up for Thunderbeat
set up for Thunderbeat
Start up setting
Start up setting
Monopolar Hand : 30/30
Monopolar Hand : 30/30
Monopolar foot: 30/30
Monopolar foot: 30/30
Bipolar: coag 80
Bipolar: coag 80
Thunderbeat: 1/3
Thunderbeat: 1/3
Quick Reference of Equipment used in HBP
Quick Reference of Equipment used in HBP
Quick reference for set up ERBE bipolar
Quick reference for set up ERBE bipolar
Easy spray Quick reference guide for Open surgery
Easy spray Quick reference guide for Open surgery
tisseel_hcp_easyspray-qrg_v1-07-15.pdfCool-Tip RFA Quick Reference
Cool-Tip RFA Quick Reference
Cool tip E-series quick reference.pdfCUSA Clarity Quick Reference
CUSA Clarity Quick Reference
CUSA Clarity Quick Guide -Full version 4.pdfMicrowave SOLERO Quick Reference
Microwave SOLERO Quick Reference
Microwave SOLERO Quick Reference.docxPage updated
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