VH - sit or stand

From: Joanne Bulley, MD (islesannie@yahoo.com)
Sat Apr 9 19:58:20 2005


I have always stood for VH ... whenever I sat (in residency) I found I stood for various parts, so I just stood. Used to drive one attending crazy - he was obsessed that you should sit so you didn't get fatigued. He ahd some of the LONGEST ever operating times no matter what surgery he did! In addition, I am short enough that it was really hard for the asst's if I sat.

Rather than the narrow mayo -- I take the extender from the table and put it on (at right angles) the part of the table that folds down from under the thighs (after they are in the Allen or candy canes). It stays in place - is narrow enough that even if you are short (and thus have short arms as well) you can reach over it into the pelvis. I usually have it angled a bit so that if an instrument slips -it slips toward the patient instead of onto the floor.

Joanne

At Sat, 9 Apr 2005, Henry Gregor wrote: >
>Agree, agree. BTW, not only is standing much easier for, and considerate of, the assisting staff, I found standing - after years of sitting - seems better for me as an operator, allowing for more variations of twisting, bending, raising, lowering of torso with better accommodation to variations of the operative field and presenting anatomy. With a narrow Mayo stand between oneself and the patient, the benefits of a seated lap tray need not be sacrificed. BTW, pardoning my ignorance or TDA (temporary dumb attack), what's PK? Also, has anyone been using staples for VH? (I've tried it and finished a couple of satisfactory 30-50 minute cases which would otherwise been 10-15 mins shorter, lol.)
>
>"R. Daniel Braun" <rd.braun@gmail.com> wrote:The studies show less adjacent organ damage with VH. It is only harder
>on the neck and back of the Assistant, not the Surgeon. And it is less
>hard on the Assistants if the surgeon stands.
>I continue to be amazed at no matter how dificult the VH, the minimal
>amount of postop morbidity that exists. IMHO, the only indication for
>an LAVH or TAH is a pubic arch of 85 degrees or less.
>Anybody on this list using either Ligasure or PK for Vag. Hyst? What
>comments do we have about that technology?
>
>Dan
>
>R. Daniel Braun
>Kinky for Governor

--
Joanne Bulley, MD
Keene, NH, USA




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