44 r

Anesthesio

enough to hear; therefore, disreqssion oT-the diagnosis, other medical information, and idle conversation should be limited accordingly. Observe measures to maintain the patient's privacy.

The patient, although bften sedaqed, may be alert

Port lll

SURGICAL
PROCEDURES

INCLUDING MINIMAL ACCESS

PROCEDURES

surgery progresses, visualization of the structures is facilitated by the use of traction and countertraction. A protocol has been developed in the performance of .=kin (and certain mucosal) iniisions. A hrst scalpel (or -skin" knife) is used and then discard.ed for a iecond f"Jp"l (or "deep" knife). Underlying tissues are serially incised and distracted by the use oftoothed forceps, re_

An appropriately placed, carefully performed inci_ _ <irtn provides the exposure n"ce."a.y for the executibn ofa safe and rapid definitive surgicai procedure. As the

d".iog as little harm to the patieni as possible. With few exceptions, the paramount need is to expose in order.to visualize.the operative field while preserving the pa.tient's capacity to heal.

Opetative procedures, as all medical treatments, are performed to provide correction of a problem, whileren_