Outpatient Surgery Magazine

Back To Work - June 2020 - Subscribe to 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://outpatientsurgery.uberflip.com/i/1259627

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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.

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