Outpatient Surgery Magazine - Subscribers

Back To Work - June 2020 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://magazine.outpatientsurgery.net/i/1260233

Contents of this Issue

Navigation

Page 102 of 116

spine can be most problematic because surgeons are not able to see the sacrum or the C2 vertebrae at the same time. Most oper- ating rooms are limit- ed because C-arms don't provide full-body fluoroscopic images, so surgeons must place an artificial marker to identify a place to start their count to the correct vertebrae. Most spine surgeons make three localized counts to confirm the intended surgical site. One takes place pre-incision. After the patient is intubated, anesthetized and positioned for surgery, the first intraop- erative image is taken with a C-arm. My general practice is to place a needle through the skin for the pre-incision imaging. The needle over- lays the area of the spine I want to operate on. It shows up on the X- ray so I can confirm that it's at the vertebrae that needs repair. The second X-ray is taken after the incision is made. The bone is exposed, but before the actual procedure has begun. I place a surgical tool on the bone and capture another image to make sure the bone I'm about to remove is the correct one. The count I make ends when I get to the disc that has the tool atop it. A third and final X-ray is taken after the procedure has been completed to confirm the location was correct. 2. Perform separate time outs The main culprit for wrong-site surgeries is a simple counting error J U N E 2 0 2 0 • O U T P A T I E N T S U R G E R Y . N E T • 1 0 3 BACK TO BASICS Everyone involved in a case should actively participate in processes put in plance to ensure the surgeon operates at the correct spine level.

Articles in this issue

Archives of this issue

view archives of Outpatient Surgery Magazine - Subscribers - Back To Work - June 2020 - Outpatient Surgery Magazine