Surgical

Procedures
PART 1
BY: A R I E L A N D U A N G B E R M I L L O , R N , M A N

R E F E R E N C E : S U S A N FA I RC H I L D , P E R I O P E R AT I V E N U R S I N G
GASTROINTESTINAL SURGERY
A. LAPAROTOMY

B. APPENDECTOMY

D. SMALL BOWEL RESECTION (ANASTOMOSIS OF SMALL INTESTINE)

E. RIGHT HEMICOLECTOMY ANASTOMOSIS (RESECTION OF THE LARGE INTESTINE)

F. COLOSTOMY

G. HEMORRHOIDECTOMY
A. Laparotomy
oan incision made through the abdominal wall in order to perform surgical
procedures involving abdominal structures.
oWhen a surgeon performs a laparotomy as a diagnostic procedure, without
knowing the exact nature of the patients disease, it is referred as an Exploratory
Laparotomy – may be performed following trauma to the abdomen, or has
undetermined abdominal pain.
oPOSITION: Supine, with arms extended on armboards.

oINCISION SITE: Midline, upper paramedian, lower paramedian (depending on

suspected pathology)
A. Laparotomy procedure
oOPENING SEQUENCE
o Skin is incised with blade 10&20. then the subcutaneous tissue (electrocautery pencil). Blood vessel may
be clamped with a hemostat and tied or cauterized.
o Fascia is incised and underlying muscles are retracted or transected. Paramedian incision will encounter
layer of muscle tissue that can be separated manually or with deep knife.
o Surgeon will grasp the peritoneum and incise it with deep knife and a scissors (Metzembaum/ curve Mayo)
to complete a peritoneal incision.

oEXPOSURE AND EXPLORATION

o Srub person should have several laparotomy sponges and a self-retaining retractor (Balfour), or by manual
retractor (Deaver or Richardson). Lap sponges are moistened with warm saline solution and used to protect
wound edges (Packing the Abdomen).

oEXCISION, REPAIR, REVISION

o Once area of disease has been located, abdominal contents are pack away with moist laps.
A. Laparotomy procedure
oCLOSING SEQUENCE
o Many surgeon irrigate the wound with warm saline solution then suctioned. Following the
irrigation scrub and circulating nurse prepare for the first closing count.
o Peritoneum is closed with absorbable suture in a continuous stitch. Toothed forceps or Kocher
clamps may be used to grasp the peritoneum.
o Next, the fascia is closed with Silk or Vicryl suture in an interrupted stitch. Skin and
subcutaneous tissue is retracted by Army-Navy or Richardson. Upon completion of closure,
the second closing count is performed.
o The SQ layer is closed with interrupted suture (Chromic, Plain) and skin edges are
approximated using Adson forceps.
o At the completion of the skin closure, the area is cleaned and sterile dressing is applied.
Scrub protect the dressing while drapes are removed and circulating nurse applies tape.
o NOTE: infected cases – skin and SQ tissue may be left open and either packed or drained.
A. Laparotomy
oPREOPERATIVE NURSING CONSIDERATIONS
o Irrigation solution should be warm to prevent hypothermia
o Specimen collected must properly labeled and placed in an approved solution.
o All abdominal cases require two closing counts,
B. Appendectomy
oThe excision of the appendix, usually performed to remove an acutely inflamed
organ.
oPOSITION: Supine, with arms extended on armboards.

oINCISION SITE: McBurney (muscle splitting) incision

B. Appendectomy Procedure
oIncision in the right lower abdomen, either transversely oblique (McBurney) or vertically
(for primary appendectomy). Wound edges is retracted with Richardson retractor. The
appendix is identified and its vascular supply ligated.
oSurgeon grasp the appendix with a Babcock clamp, the tip of appendix may then be
grasped with a Kelly clamp to hold it up, a moist Lap sponge is placed at the base (stamp)
of the appendix to prevent contamination of bowel contents.
oAppendix is isolated from its attachment to the bowel (mesoappendix), double clamped,
is cut using Metzenbaum scissors and ligated with free ties (absorbable 3-0)
oThe appendix, knife, needle holder, and any clamps or scissors that have come in contact
with the appendix are delivered in a basin to the circulating nurse.
oThe wound is irrigated with warm saline, and is closed in layers. If abscess has occurred
(acute appendicitis) a drain is placed in to the abscess cavity, exiting through the incision.
B. Appendectomy
oPERIOPERATIVE NURSING
o Instruments used for amputation of the appendix are to be isolated in a basin
o If ruptured, surgeon may use antibiotic irrigation prior to closure of abdomen with an
insertion of a drain
o There may be no skin closure if the appendix has ruptured.
C. Colostomy
oFormation of an opening into the colon, brought out onto the abdominal wall as a stoma.
The opening can be either permanent or temporary,
oThis position is usually performed for lesions in the large intestine caused by cancer,
diverticulitis, or obstruction of the large intestine in an area close to the cecum.
oTEMPORARY (Loop) COLOSTOMY – performed to divert the fecal stream from the distal
colon, which may be obstructed by tumor inflammation. May be created in the transverse
colon or sigmoid colon.
oPERMANENT COLOSTOMY – performed to treat malignancies of the colon, bowel
incontinence or irritable bowel disease. Created same with temporary colostomy but most
often is an end colostomy.
oPOSITION – supine, with arms extended on arm boards.

oINCISION SITE – dependent on the segment of colon to be used.

C. Colostomy Procedure
oAbdomen is opened and the segment of colon is mobilized. The colon can be
brought out of incision site.
oThe appropriate segment is excised between two atraumatic (intestinal) clamps
to prepare and create the stoma.
oAbdomen is irrigated with warm saline, and closed in layers in a routine fashion.

oA colostomy pouch is applied over the stoma.

C. Colostomy

oNURSING CONSIDERATIONS
o Colostomy pouch may or may not be applied in surgery. A Vaseline gauze may encircle
the stoma with a “fluff” type dressing applied.
o Colostomy pouch may be delayed until the clinical specialist (ostomy nurse) work with
the patient and family.
D. Hemorrhoidectomy
oExcision of painful, distended veins of the anus and rectum.

oHemorrhoids are classified as internal or external, depending on their location.

oAnesthesia may be regional, local, or general.

oPOSITION: Lithotomy, modified lateral (Sims)

oSKIN PREPARTION: the buttocks is taped apart with wide adhesive tape on each
side of the anus, attaching the other end to the table frame.
D. Hemorrhoidectomy Procedure
oBefore beginning of surgery, a sigmoidoscopy may be performed, followed by a
gentle dilation of the rectum.
oThe hemorrhoid is grasped with a Allis or Kocher clamp. The proximal portion is
excised by scalpel or cautery. Bleeders are controlled with ligature ties (Chromic
3-0) or by cautery.
oCare is taken not to excise too much skin, or mucous membrane to avoid injury to
the sphincter mechanism.

oNURSING CONSIDERATION
o Be prepared to perform sigmoidoscopy prior to procedure.
o Protect the skin under the adhesive tape with tincture of benzoin.
BILLIARY SURGERY
A. HEPATIC RESECTION

B. LAPAROSCOPIC CHOLECYSTECTOMY
https://youtu.be/dv3X40858oA?si=T2f-lo9VDOZVawka

C. WHIPPLE PROCEDURE (PANCREATODUODENECTOMY)

D. SPLENECTOMY https://youtu.be/41QtKsqqAPw?si=8NAYokRSI1F3Lhtp
A. Hepatic Resection
oA small wedge biopsy, local excision of tumor, or a major lobectomy.

oIndication: trauma, cysts, or tumor (benign, primary, or secondary).

oPOSITION:
o Partial left lobe excision- supine, with arms extended on arm boards
o Major lobe resection- modified lateral position with elevation of hepatic area (Bean-Bag).

o INCISION SITE: thoracoabdominal (right lobe); subcoastal; midline abdominal

(left lobe)
A. Hepatic Resection Procedure
oWEDGE RESECTION
o Abdomen is entered. A wedge is cut from the edge of the liver. Incised edges are closed
o Wound is irrigated and closed

oHEPATIC LOBECTOMY
o The incision and feasibility of the resection is determined.
o If a thoracoabdominal incision is used, abdominal portion is incised first. Incising through
the seventh and eight interspace, incising the diaphragm.
o The hepatic artery, portal vein, and major biliary ducts are controlled by vascular forceps.
The liver parenchyma is divided, pausing to ligate the major vessels and biliary channels.
o The exposed parenchyma may be covered by the greater omentum or absorbable
hemostatic agents
o Wound is irrigated with warm saline, the drains are inserted, and the wounds is closed in
layers.
A. Hepatic Resection
oNURSING CONSIDERATIONS
o Confirm with blood bank the number of available units
o For thoracoabdominal approach, obtain and prepare the chest drainage system
o Confirm ICU bed if requested (Lobectomy)
B. Cholecystectomy
oLaparoscopic Cholecystectomy – cannulation of the gallbladder under direct
laparoscopic visualization, and removal of the gallbladder.
oHas many advantages than open cholecystectomy, including reduction of
hospital stay and postoperative recovery time.
oIn acute cholecystitis, the normal bluish-green gallbladder becomes distended
and inflamed due to obstruction by one or more gallstones.
oIn removing the gallbladder, the common duct is left unimpaired so that it
becomes a functional passageway for the elimination of bile via the duodenum.
B. Cholecystectomy
oEvaluation of candidates for the procedure:
o Abdominal UTZ result confirming presence of gallstones
o If suspected gallstones in duct, ERCP (endoscopic retrograde cholangiopancreatography) is
advised
o Patient should be a candidate for open cholecystectomy with appropriate pre-op workups

oContraindication:
o Pregnancy, acute cholangitis, septic peritonitis, and severe bleeding disorders, and patients
who are not candidate for an open laparotomy because of coexisting medical illness.

oPOSITION: supine, with arms extended on arm boards. A small pad may be placed
under the right upper quadrant to facilitate exposure of the gallbladder.
oINCISION SITE: Umbilicus (Laparoscope), anterior axillary, upper midline,
midclavicular (operative trocar sites)
B. Cholecystectomy Procedure
oFollowing positioning, the insufflation needle is placed through a small incision just
above the umbilicus, into the peritoneal cavity. A polyethylene tube is connected to
the insufflation device and the needle. A pneumoperitoneum (for visualization) is
established with approx. 2-4 liters of CO2, until the meter registers 12-14 mmHg of
intraabdominal pressure.
oInsufflation needle is withdrawn and the incision is enlarged. The trocar and sleeve
(10 or11 mm) is inserted into the abdomen.
oThe trocar is withdrawn from the sleeves, and the proper location of the sleeve is
confirmed.
oAn operating laparoscope (10 or 11 mm) with attached camera is inserted through
the sleeves to confirm intraperitoneal placement. The CO2 tubing is attached to the
sleeve to maintain the inflation of the abdomen.
B. Cholecystectomy Procedure
oACCESSORY TROCAR PLACEMENT

oTwo additional puncture wounds are created, and accessory trocars are placed under
direct laparoscopic visualization for manipulation and dissection of the gallbladder.
o 10 mm trocar with cannula is placed between the xiphoid and the umbilicus , to the right of the
midline.
o 5 mm trocars are placed just below the right costal margin; one anterior axillary line and one at
the midclavicular line.

oThe gallbladder is removed from the liver bed using electrocautery.

oThe operative site is irrigated with copious amount of sterile saline, and the field is
observed for possible bleeding sites or bile leakage.
oThe sheeths are removed after hemostasis has been obtained, and the puncture
wounds closed (2-0,3-0, and 4-0 absorbable suture)
B. Cholecystectomy
oNURSING CONSIDERATIONS:
o Check all equipment to promote safety
o Heparinized saline solution may be used to irrigate the abdominal cavity and retard clot
formation.
o Foley catheter and NG tube should be inserted prior to beginning the procedure
o Allow adequate time for room set-up and preparation, owing to amount of extra
equipment
o Patient needs to be prepared (physically and mentally) for the possibility of an open
procedure.
C. Pancreatoduodenectomy
oAka. Whipple Procedure

oRemoval of the head of the pancreas, the very proximal portion of the jejunum,
the distal third of the stomach, and the distal half of the common bile duct, with
reestablishment of continuity of the biliary, pancreatic, and gastrointestinal tracts.
oThis procedure is usually performed for regional malignancy and benign,
obstructive, or chronic pancreatitis.
oPOSITION: Supine, with arms extended on arm boards

oINCISION SITE: transverse, midline, or paramedian incision.

C. Whipple Procedure
oThe abdomen is opened and explored

oThe distal portion of the stomach, extrahepatic biliary tract, head of the pancreas,
and entire duodenum are immobilized.
oIf the tumor has invaded the base of mesocolon, portal vein, aorta, vena cava, or
superior mesenteric vessels, this procedure is usually abandoned, and a lesser
procedure (biliary tree bypass/ stomach bypass) will be performed
oThe proximal end of the jejunum is anastomosed to the distal pancreas. The common
bile duct is anastomosed to the jejunum with an end-to-side technique. The distal
stomach is anastomosed to the jejunum (also end-to-side). Additionally, various
plastic stents may be placed in the biliary or pancreatic anastomosis.
oThe wound is irrigated, drains inserted and secured, and abdomen is closed in layers.
C. Pancreatoduodenectomy
oNURSING CONSIDERATIONS:
o Verify with blood bank the number of available units
o Accurate intake and output recording is essential for adequate replacement therapy
o Instrument that have touched “dirty” areas must be isolated (no-touch technique)
o Scrub person should receive specimens in a basin
o Have appropriate stents available, unopened.
D. Splenectomy
oRemoval of the spleen

oIndication: accidental traumatic injury, hematologic disorders, congenital anemia,

splenomegaly (portal hypertension), tumors, or cysts.
oPOSITION: Supine with arms extended on armboards

oINCISION SITE: midline, left subcostal

D. Splenectomy Procedure
oIn situation where spleen is extremely large, a combined thoracoabdominal
incision may be used to allow for greater visualization and manipulation.
oA reservoir should be set up for immediate suction during trauma, since the
abdomen is often filled with blood. Manual removal of clots may be required
therefore a basin is brought to the incision following entry and exposure.
oThe spleen is identified and splenic hilum is isolated, taking care not to injure the
tail of pancreas. Using Metzenbaum scissor the spleen is dissected free from its
abdominal attachments.
oOnce the spleen is mobilized, the splenic artery and veins are identified. Vascular
clamp are placed across the structures, and are ligated (2-0 silk ties) separately
or together. Vessels are cut, completely freeing the spleen.
D. Splenectomy Procedure
oThe wound is irrigated with warm saline and the area further explored for bleeders.
When complete hemostasis has been achieved, the abdomen is closed in layers.
oIf optimal hemostasis cannot be achieved, a closed wound drainage system may be
required.

oNURSING CONSIDERATIONS:
o Reservoir should be set up to accommodate large amount of blood loss (trauma surgery)
o Accurate intake and output recording
o Large number of lap sponges may be needed
o Patient may require an ICU bed following surgery, and may leave procedure room intubated.
HERNIA REPAIRS
A. HERNIORRHAPY
A. Herniorrhaphy
oRepair of a herniation (protrusion) of the abdominal contents, caused by a
musculofascial defect in the abdominal wall or groin area.
oIn the inguinal/femoral regions, two types of herniation commonly occur:
o Direct Hernia – usually resulting from stress, causing the peritoneum to bulge through
the fascia in the groin area. The peritoneal bulge (sac) may contain abdominal viscera.
o Indirect Hernia – caused by a congenital defect in the internal abdominal ring, causing
the peritoneum to bulge along the spermatic cord. It may or may not contain abdominal
viscera.

oPOSITION: supine, with arms extended on arm boards

oINCISION SITE: groin area, right or left oblique

A. Herniorrhaphy Procedure
oBegins by incision of the groin. Incision is deepened using Metzenbaum scissors
and cautery is used to control small bleeders. Both blunt and sharp dissection are
used to gain access to the hernia.
oAfter incising the fascia that lies over the spermatic cord (male), several small
hemostats are placed on the edge of the incised fascia (used as retraction).
oIf direct, the surgeon will begin to suture the defect using interrupted suture (2-0)
of varying materials.
oIf indirect, the surgeon will dissect the sac away from the cord using Metzenbaum
scissors; the sac is opened and the edges grasped with hemostats. The content of
the sac are pushed towards the abdomen (index finger), and if small, the sac may
be ligated in place.
A. Herniorrhaphy Procedure
oFor large sac, a purse-string suture may be used to close the sac. The sac is
closed near the abdominal wall, and the edges removed. (this becomes the
specimen)
oThe wound is closed in individual layers:
o Fascia – 2-0 nonabsorbable suture, with or without a strip of synthetic mesh for extra
strength (for recurrent hernias) sewn directly to the fascia edges.
o Subcutaneous layer – 2-0 nonabsorbable suture, with application of Steri-Strips, as a
subcuticular closure, or subcutaneous and skin closure performed in a routine manner.

oNURSING CONSIDERATIONS:
o Synthetic mesh is often used to repair recurrent hernias or large ventral hernias. Follow
sterilization instructions.
o A specimen will be collected only during an indirect herniorrhaphy.
Surgical
Procedures
ARIEL ANDUANG BERMILLO, RN,
MAN
PROCEDURES INVOLVING THE
BREAST
A. EXCISION OF BREAST MASS (BIOPSY)

B. MASTECTOMY https://youtu.be/AXD_2T0r_Jk?si=FpiH6IKK0WbCF2aM
PROCEDURES OF THE NECK
A. THYROIDECTOMY
A. Thyroidectomy
oRemoval of all or a portion of the thyroid gland

oUsually performed to treat various disease of thyroid gland (hyperthyroidism or

cancer) that cannot be treated effectively by chemotherapy or medication. A total
thyroidectomy is indicated for certain carcinomas and to relieve tracheal or
esophageal compression.
oPOSITION: supine, with rolled towel or sandbag between the scapulae,
hyperextending the neck. If table is placed in reverse Trendelenberg position, a
padded foot board should be used to prevent the patient from slipping down
toward the end of the table.
A. Thyroidectomy Procedure
oThe incision is made above the sternal notch. The platysma muscles are separated
or divided, and blunt and sharp dissection are employed until the thyroid is exposed.
The gland is then mobilized, and all or part is removed depending on the involved
pathology.
oHemostasis is obtained, and the wound is irrigated with warm saline. A drain may be
inserted, and the incision is closed in layers by an interrupted method.

oNURSING CONSIDERATIONS:
o Surgeon may request a fine silk suture to use to mark the incision line.
o The dressing is usually secured by a thyroid collar using a towel folded in thirds lengthwise.
Placed around the neck, crisscross in front then fastened with tape
GYNECOLOGIC AND OBSTETRIC
SURGERY
I. ABDOMINAL PROCEDURES
◦ A. ABDOMINAL HYSTERECTOMY
◦ B. TUBAL LIGATION
◦ C. SALPINGO-OOPHORECTOMY

II. VAGINAL PROCEDURE

◦ A. DILATATION AND CURETTAGE (D&C)
◦ B. CONIZATION OF THE CERVIX

III. OBSTETRIC SURGERY

◦ A. CESAREAN SECTION
◦ B.
A. Hysterectomy
oSurgical removal of the entire uterus through an abdominal incision.

oIndication: endometriosis, adnexal disease, postmenopausal bleeding,

dysfunctional uterine bleeding, and benign fibromas or malignant tumors.
oFor women in their childbearing years, this surgery may affect them
psychologically. Post operative depression is common and should be approached
from a multidisciplinary point of view.
oPOSITION: Supine, with arms extended on armboards

oINCISION SITE: lower transverse (Pfannenstiel), vertical, midline or paramedian

(lower)
A. Hysterectomy Procedure
oAfter incision of skin, deep knife or cautery is used to deepen incision to SQ tissues.
Fascia is nicked with deep knife and incised using curved Mayo scissors. Fascia is
separated from underlying muscle using two or more Kocher clamps.
oThe muscle layer is divided manually. Peritoneum is lengthened with Metzenbaum
scissors. A self retaining (O’Sullivan-O’Connor or Balfour) retractor is placed with moist
lap sponges protecting wound edges.
oSurgeon will “pack the bowel” away from the uterus and operating table is placed in
slight Trendelenberg position.
oUterus is isolated from the uterine ligament and adnexa (ovaries and fallopian tubes).
Ochsner or Kocher clamp is used to clamp the ligament and ligated using absorbable
suture. Curved Mayo scissors is used to free uterus from the adnexa.
A. Hysterectomy Procedure
oUsing a Metzenbaum scissors, the surgeon separates the uterus from the bladder
by dissecting the peritoneal covering from the bladder, since both organs are
attached by the peritoneal covering.
oAt the level of the cervix, long Allis or Kocher clamps are placed around the edge of
cervix, and it is divided from the vagina using a long (pelvic) scissors.
oIf ovaries are to be preserved, the ovarian ligament is ligated and divided adjacent
to the uterus.
oThe uterus, now completely free is passed off as specimen together with
instruments that have contacted with the cervix or vagina.
oClosing the wound, irrigate with warm saline and achieve hemostasis.
A. Hysterectomy
oNURSING CONSIDERATIONS:
o Foley catheterization is done after internal vaginal prep
o Instrument that have come in contact with cervix and vagina are considered
contaminated
o Sponges may be place in the vagina prior to closing, it is included in the counting and
must removed before patient leaves the room.
B. Dilatation and Curettage
oThe gradual enlargement of the cervical os and the curetting (scraping) of
endometrial or endocervical tissue for histologic study.
oPerformed to: diagnose cervical or uterine malignancy; control dysfunctional
uterine bleeding; complete an incomplete abortion; aid in evaluating infertility;
and/or relieve dysmenorrhea.
oPOSITION: lithotomy, arms may be extended on arm boards
B. Dilatation and Curettage
oProcedure:

oa speculum is placed in the vagina. Using a Hegar dilators, the surgeon begins to
dilate the cervical opening.
oA Telfa sponge is placed over the bill of the speculum. The uterus is gently
curetted, allowing tissue specimen to collect on the Telfa sponge.
oSmall serrated curette is used to remove retained placental tissue, while large
blunt curette and forceps are used to remove tissue.
oThe speculum is removed and the perineum is dressed with a perineal pad.
B. Dilatation and Curettage
oNURSING CONSIDERATIONS:
o Stirrups are padded and coccygeal support is placed to protect lower sacral area.
o Raise and lower leg together to prevent injury to the rotator hip joint.
o If multiple specimen is obtained, they should be placed in separate containers and
labeled accordingly.
C. Cesarean Section
oThe delivery of a viable fetus through abdominal and uterine incisions.

oIndications: dystocia (failure to progress); cephalopelvic disproportion;

malrotation; and placenta previa. Emergency C-section are performed because of
life threatening conditions (fetal distress, umbilical cord prolapse, or abruptio
placenta).
oPOSITION: Supine, with a small roll under the right hip (to reduce vena cava
compression). Arms are extended on arm boards.
oINCISION SITE: Vertical (low midline); Pfannenstiel (low transverse)
C. Cesarean Section Procedure
oThe abdomen is opened, the rectus muscles are separated, and the peritoneum
incised exposing the distended uterus.
oThe scrub person must be ready with the suction, dry Laps, and a bulb syringe.
The bladder is retracted downward using Balfour retractor. A small incision is made
and a extended by a bandage scissors (blunt tip to prevent injury to baby’s head).
oThe amniotic sac is aspirated and the surgeon delivers the infants head in an
upward position. The baby’s airway is suctioned with bulb syringe and the baby is
completely delivered and placed upon the mothers abdomen.
oUmbilical cord is double clamp and cut. And the placenta is delivered and placed
in a basin.
C. Cesarean Section Procedure
oThe uterine cavity is irrigated with warm saline and inspected for any remaining
tissue or clots, then wiped dry with a Lap sponge in preparation of uterine closure.
oThe closure is performed in two layers with a heavy absorbable suture (0-chromic
or 0-Vicryl), using a continuous stitch; the second overlapping the first.
oThe uterus is pushed back to pelvic cavity then irrigated with warm saline and
closed in layers.
oSkin is closed with the surgeons preference.
C. Cesarean Section
oNURSING CONSIDERATIONS:
o In preparation, the neonatal warming units should be checked for proper functioning
o Oxytocin should be available to administer IV
o Once uterus is opened, immediate suction is needed.
o Before infants leave the OR, circulating nurse completes the babys record
o Pediatrician are notified to complete their required infant set-up
o After suctioning the babys airway using bulb syringe, it is placed together with the baby
for airway clearance measure
GENITOURINARY SURGERY
A. TRANSURETHRAL RESECTION OF THE PROSTATE GLAND (TURP)

B. NEPHRECTOMY

C. KIDNEY TRANSPLANTATION

D. OPEN PROSTECTOMY

E. UPPER TRACT UROLITHOTOMY

F. VASECTOMY

G. CIRCUMCISION
A. Transurethral resection of the
prostate gland (TURP)
oNURSING CONSIDERATIONS:
o In preparation, the neonatal warming units should be checked for proper functioning
o Oxytocin should be available to administer IV
o Once uterus is opened, immediate suction is needed.
o Before infants leave the OR, circulating nurse completes the babys record
o Pediatrician are notified to complete their required infant set-up
o After suctioning the babys airway using bulb syringe, it is placed together with the baby
for airway clearance measure
ORTHOPEDIC SURGERY
A. OPEN REDUCTION OF THE HUMERUS

B. OPEN REDUCTION OF THE RADIUS/ ULNA

C. ORIF – FRACTURE OF THE FEMORAL SHAFT

D. AMPUTATION OF LOWER EXTREMITY

E. TOTAL HIP REPLACEMENT (ARTHROPLASTY)

F. BUNIONECTOMY

G. CORRECTION OF SCOLIOSIS
NEUROSURGERY
A. CRANIOTOMY

B. VENTRICULOPERITONEAL SHUNT (VP SHUNT)

SPINAL SURGERY
A. LAMINECTOMY

B. ANTERIOR CERVICAL FUSION (CLOWARD TECHNIQUE)

THORACIC AND
CARDIOVASCULAR SURGERY
A. THORACOTOMY https://youtu.be/4XO9-HGtYk0?si=WUC72IHX-0V0auBw

B. SEGMENTAL RESECTION OF THE LUNG

C. LOBECTOMY

D. ABDOMINAL AORTIC ANEURYSMECTOMY

E. ARTERIOVENOUS SHUNT/ FISTULA

F. MEDIAN STERNOTOMY APPROACH

G. VALVULAR SURGERY

H. CORONARY ARTERY BYPASS SURGERY

I. INSERTION OF A PERMANENT PACEMAKER – TRANSVERNOUS APPRAOCH

CONGENITAL ANOMALIES: HEART
ANF GREAT VESSELS
A. PATENT DUCTUS ARTERIOSUS LIGATION

B. CORRECTION OF COARCTATION OF THE THORACIC AORTA

C. CLOSURE OF ATRIAL/VENTRICULAR SEPTAL DEFECT

D. CORRECTION OF TETRALOGY OF FALLOT

E. CORRECTION OF TRANSPOSITION OF THE GREAT VESSELS

F. REPAIR OF TRICUSPID ATRESIA

G. REPAIR OF TRUNCUS ASTERIOSUS

CONGENITAL ANOMALIES: HEART
ANF GREAT VESSELS
A. PATENT DUCTUS ARTERIOSUS LIGATION

B. CORRECTION OF COARCTATION OF THE THORACIC AORTA

C. CLOSURE OF ATRIAL/VENTRICULAR SEPTAL DEFECT

D. CORRECTION OF TETRALOGY OF FALLOT

E. CORRECTION OF TRANSPOSITION OF THE GREAT VESSELS

F. REPAIR OF TRICUSPID ATRESIA

G. REPAIR OF TRUNCUS ASTERIOSUS

EENT PROCEDURE
A. CATARACT EXTRACTION

B. MYRINGOTOMY

C. TONSILLECTOMY AND ADENOIDECTOMY (A&D)

D. LARYNGOSCOPY

E. TRACHEOSTOMY

F. RADICAL NECK DISSECTION

G. CLEFT LIP REPAIR

H. CLEFT PALATE REPAIR

PEDIATRIC PATIENT IN SURGERY
A. INGUINAL HERNIA REPAIR

B. REPAIR OF OMPHALOCELE

C. PYLOROMYOTOMY FOR PYLORIC STENOSIS

D. REPAIR OF TRACHEOESOPHAGEAL FISTULA

C. REPAIR OF INTUSSUSCEPTION

E. RESECTION AND PULL-THROUGH FOR HIRSCHSPRUNG’S DISEASE

(AGANGLIONIC MEGACOLON)

F. REPAIR OF IMPERFORATE ANUS