LESSON 3: Procedures in Genitourinary Surgery

Section Ii: general considerations in genitourinary surgery

3-9

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Section II. GENERAL CONSIDERATIONS IN GENITOURINARY SURGERY

3-9. INTRODUCTION

a. Operating room personnel must have a good understanding of the procedure that is planned in order to properly prepare the patient, room, equipment, and supplies. Safety is the prime consideration since the patient is positioned in a lateral, prone, or lithotomy position. These positions are frequently exaggerated to give better access to the organs involved, as for a radical operation on the prostate and bladder. Care must be taken to avoid displacement of the joints in lithotomy as the anesthetized patient is positioned. This is especially true in aged or debilitated patients.

b. In positioning a patient laterally for kidney surgery, the spine is extended to give more access to the retroperitoneal space. This patient should have padding and stabilizing support from rubber-covered pillows, sandbags, and straps. If the electrocautery unit is to be used, care must also be taken to see that no part of the patient touches metal equipment other than the indifferent electrode plate attached to the cautery unit.

c. In some procedures involving stones of the kidneys or ureters, it may be necessary to make X-ray examinations during the procedure. A cassette holder must be placed under the patient who is in the supine, prone, or lithotomy position. The patient positioned laterally will be X-rayed by a cassette held in a sterile wrap.

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