scopic proce-
dures much
easier, says
Ms. Miller. "If
you've got a
straight scope,
you've got a
limited view.
The articulat-
ing scope can
move around
and survey the
field a little
better," she says. "It's a tight space you're working in, so this helps you
visualize the other instruments." Ms. Hrnicek adds that articulating
scopes work particularly well for single-incision procedures, since they
make manipulation of instruments much easier.
Finally, don't overlook the power of positioning. Ms. Miller's sur-
geons often place patients in Trendelenburg positions to let gravity
shift the organs away from the surgical site. To help make this safer for
patients and to keep them from slipping, her facility uses a special
positioning pad.
"It feels like a memory foam pad that we put on the OR bed. It's
strapped to the bed itself, and it causes less slippage in reverse
Trendelenburg or steep Trendelenburg, which we use to help to move
the organs out of the way for prostate or GYN procedures," she says.
"In the old days we would use these hard shoulder braces that caused
skin breakdown. But if you're doing a robot hysterectomy or prostate-
ctomy, this positioning pad seems to give much better results."
5 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A U G U S T 2 0 1 6
• USE GRAVITY Positioning a patient in Trendelenburg shifts organs away from the surgical site,
giving the physician more room to operate.
Pamela
Bevelhymer,
RN,
BSN
