Laparoscopic
Partial Nephrectomy

-OT3 Ceiling TV / Uro 3D TV / URO HDTV 3 (OT10)

-Olympus ESG410

-Suction machine x 2

-BK5000 USG machine with Lap. Probe (不論remark有寫與否, partial nephrectomy case 一定要有USG)

-ICG camera (in URO 3D TV) 

Instrument Set:

-S001A Abdominal Basic, Major

-S001B Abdominal Basic, Retractor

-S104H Laparoscopic Urology Instrument

-S104I  Uro Lap Vascular Clamp Set

Supplement item:

Must use:

-SURG0914 Exploration Probe, 5mm

-SURG0920 Endo-Clip Applying Forcep ML+Black Stopper (R Cap)

-SURG0919 Hemo-O-Lok Clip Applicator, ‘L’ with Black Cap

-SURG0916 Clip applicator, PDS (Ethicon) (L) with Rubber cap x 2

-SURG1097 FOB (red+green) 

-SURG0133 Thermo Flask with cover (SO4) 

Standby:

-SURG0924 EndoBabcock forceps (Storz), 5mm (4 IN 1)

-SURG0917 Hemo-O-Lok Clip Applicator, 5mm, ‘ML’ with Black Cap

-SURG0918 Hemo-O-Lok Clip Applicator, ‘XL’ with Black Cap

-SURG1011 Reducing Sleeve with white Cap

-Endoeye 3D

-10mm 30o IR lens (URO)

Flexible Cystoscopy stage

-Foley consumables
-#15, 10 blade

-Vascular sling (Red + Blue + Yellow)

-O silk tie

Transperitoneal approach

-12mm blunt tip balloon trocar

-12mm Trocar port x 2

Retroperitoneal approach

-Spacemaker x 1

-12mm Trocar port x 1

-Kii Fios First Entry(CFF73) 12 x 100mm port x 1

-Paraffin oil

-Lap scissors

-Lap instrument pouch x 2

-Powerseal 37mm

-Fr. 15 Blake drain & bedside bag

-2/O silk suture

-J needle x 2

-PDS 1 needle x 2

-Skin Stapler

Standby: 

-Mini Raytec gauze

-Endobag for specimen

-Flosseal and Tisseal applicator 

-Metal clip

-Absolok clip

-Hemo-O-Lok ML / L / XL

-Stratafix 3/O (SXPP1B420)

-Stratafix 2/O (SXPP1B456)

-Port Prep. Dr. Francis Wong: Cvd Artery Forceps; Others: St Artery Forceps

-All lap instruments, trocars, and lap USG probe must be lubricated with paraffin oil

-Sling cut to 10cm

-Vascular clamp tied with silk

-Stratafix 3/O  x 2 clip with absolok

-Stratafix 2/O  x 1 clip with absolok

-Universal Pack

Draping Steps

1. Betadine skin prep

2. Towel for soaking 

3. Lower body drape

4. Upper body drape

5. Side drape x 2

1. After draping, connect 

-Hand control diathermy

-Suction tubing

-Endoeye

-Insufflating tubing

-Lap monopolar cable

-Lap bipolar cable

-Ligasure

2. Opening of the 1st port 

-# 15 blade

-Short raytec gauze

-Ramsey tooth forceps

-Straight artery forceps x 4

-S-shape retractors x 2

3. Opening of other ports

-#15 blade

-12mm disposable trocar / 5.5mm Threaded Port

4. Identification of artery by vascular sling

-10 cm sling

-Hemo-O-Lok clip (L/XL)

5. Clamping artery

-Lap applicator

-Vascular clamp (usually straight clamp) 

-Start timer

6. Cutting and suturing of kidney

-Endoscissors

-Endoneedle holder x 2, mounted V-Loc 3/O

-Absolok clips (if clips <= 2, please alert circulating nurse)

-After suturing of several V-Loc 3/O, Stratafix 2/O will be used

7. Unclamp artery

-Clip remover

-Stop timer, record the clamping time on a draft paper for surgeon

8. Specimen 

-Endobag

-Hemo-O-clip (L/XL)

9. Closing

-Drain & silk anchor

-J needle

-PDS 1

-Skin stapler

-Cosmopor

Put Ice NS bag x 3 from freezer to fringe the night before. 

Instruments:

Osteotome 

Hammer

small towels

Basin x 2