58 .

Surgicot Procedures lncludlng Minimol Access Procedutes

Breosf Procedures

59

Equipment Electrosurgical unit

Suction

1mcil tip clean as necessary. The use of two electron-ngical pencils may be indicated so that a cleari tip will irlwafs be available. Avoid a burn injury to the patient !5r protecting the electrosurgical pencil not in use by heeping it in a holder.
Several knife blade changes may be required because fibrous nature of the tissues incised; notify the ffigeon when a blade is new. If a skin graft is necessary, one thigh must be prepared and draped along with the main operative site. Inigation is usually with water, not saline, to lessen

lnstrumenfotion Major procedures tray edditional curved Crile clamps and large towel clips Hemoclip appliers (small, medium, large) Rake retractors (4 or 6 prong)
Supplies Basin set Blades, several No. 10

dthe

the survival of tumor cells.

Estrogen and progesterone assays may be requested

Electrosurgical

pencil

Suction tubing Needle magnet or counter Tube (or impervious) stockinette Hemoclips (small, medium, large) Electrosurgical pencil holder (optional) Dermatorne (foiskin graft) (e.g', Brown, and necessary supplies including: mineial oil' saline, tongue blades, and petrolatum-impregnated gauze)

ou the specimen.

With breast reconstruction, intravenous fluorescin

d5re

may be epployed to determine viability of the flap,

Drainage unit (e.g., Hemcivae)

Pressure dressing Marlex mesh, optional Infl atable breast prothesis (optional)

SpeciolNotes' The circulator must confirm with the patient the side
of the lesion. If mastectomy is to follow a breast biopsy, the patient is reprepared, and redraped, the team is -regowned and. gl,oved, and the instruments are changed. ' Prepare gently to avoid the potential of dislodging

tumor cells. The circulator will hold out the prepped arm to receive the double (or impervious) stockinette; the arm is then held by scrubbed Personnel. Check coagulation and cutting settings on the electrosurgical .t-ttit. Oft"tt a great deal oJ the dissection is perforired with the cautery. Keep the electrosurgical