HOW TO PREPARE OPERATION THEATER FOER HERNIA SURGERY

2. DEFINATION
 A hernia happens when an internal organ pushes through a weak spot in your
muscle or tissue. There are several types of hernia that are, inguinal hernias,
femoral hernias, umbilical hernias and hiatal hernias.
 Most hernias occur within the abdominal cavity, between the chest and the hips.
ANAESTHESIA POINT OF VIEW
Open hernia repair can be performed with the following types of anesthesia:
 General
 Regional (spinal epidural)
 Local
 The choice of anesthesia technique may be influenced by patient preferences and
the medical history.

3. MACHINE USED
 Cautery machine
 Hand piece cautery for cut and coagulation.
 Foot paddle [if required]
 Cautery pad
 Warmer machine

4.  Continuous-flow anesthetic machine used to provide a measured and continuous
supply of gases (oxygen, nitrous oxide, etc.), mixed with a required concentration
of anesthetic vapor to the patient at a required pressure and rate.
 Anesthetic vaporizers( sevoflurane , Desflurane , Isoflurane) .
 Oxygen mask to deliver oxygen and/or to administer aerosolized medications
 Nasal oxygen set
 Yankauer suction tip
 Peripheral venous catheter
 Artificial resuscitator (Bag valve mask)manual ventilation.
 Laryngoscope used to view larynx including the vocal cords, the glottis, etc.

5.  Spinal needle [if required]
 Epidural catheter
 Syringe pump
 Iv set
 Bivalve with extn [10 cm or 200 cm]
 Fit fix suction

6.  Kidney tray with oxygen mask.
 Magill’s forceps
 Laryngoscope set (laryngoscope blade and handle)
 Themlcaine 2% jelly
 Syringes 10cc or 20cc
 Endotracheal tube
 Ryle’s tube
 Male or female airways.
 LMA
 Mac coil and buji.
 Gauze swab
 Nasal drop
 Lox10% spray
 Durapore / Micropore/ Dinaplast sticking .

7.  In spinal anaesthesia sitting position is given.
 Betadine 10%
 ASD [Bactorub]
 Syringe’s [10cc and 5cc]
 Needles .
 Anawin heavy
 Loxicard 2%
 Fentanyl
 LP needle 25 G [orange]

8.  The correct surgical side (left or right) should be confirmed and marked
preoperatively in the holding area.
 In open hernia repair the patient should be placed in the supine position, with the
upper extremities comfortably secured. He or she should be at ease, and the
position should be comfortable for the surgical team.
 The surgical site is prepared and draped , so that the patient’s upper abdomen
and lower limbs are covered and only the intended operative groin site is exposed.

9.  Glycopyrolate and midazolam [1ml each]
 Fentanyl [10 ml or 2 ml diluted in NS]
 Propofol [20ml]
 Atracurium
 Supacef [1.5g diluted in 20ml NS]
 Paracetamol
 Emset.
 Hydrocortisone

10. Major basic set - A standard open surgical tray should be available. Instruments and materials on
hand may include the following:
 Syringe
 25-Gauge needle
 Surgical knife with blade
 Mosquito forceps
 Dissecting scissors
 Polypropylene (Prolene) or polyester mesh
 Langenbeck retractors
 Adson thumb forceps
 Needle holder
 Sutures (absorbable or non absorbable)
 Penrose drain or umbilical tape
 Noncrushing intestinal clamps (in case bowel resection is required, in a strangulated hernia) etc.

11.  2.0 Vircyl
 1 loop ethilon
 3/0 ethilon
 2.0 prolene
 3/0 rapid vicryl
 Prolene mesh [7.5cm×15cm]

12. THANK YOU