Help with equipment

[Interstellar95]

Hello!

I just started in an OR that does a lot of breast cases (e.g sentinel lymph node biopsies, partial mastectomies, lumpectomies, etc.). Thus I was exposed to unfamiliar equipment, and I want to know in what instances/surgeries would we use the following: neoprobe, Faxitron, ultrasound machine?

also, on a side note: is there a trick to changing the co2 tanks in a laparoscopic tower easily? I’m having a tough time

[Rose_Queen, BSN, MSN, RN]

Please seek this information from your preceptor, a colleague, or your supervisor as there are many different set ups between different facilities. They would be best to guide you on the equipment specifically used by your facility as well as surgeon preferences.

[11blade, RN]

The equipment used in those cases will be surgeon dependant. You should be looking at the case posting, surgeon and equipment list. If the preference cards are crap, which most are, make your own notes as you do cases with each surgeon. Note the posted name of the case and list the equipment needed. Best OR practice is if not sure, have it ALL in the room and THEN ask the doc which one they want. Yeah, it's labor intensive, at first. But the doc appreciates you don't have to leave to get something, and, you can adjust for the next time you do that specific type of case.

Rule of thumb-Always have an ultrasound in the room on breast case, if the surgeon is a fan of that machine. Time elapses from Dr. ofc visit, to mammogram to actual day of surgery. Those lumps wax and wane sometimes-that's what the ultrasound helps with...finding the lumps at day of surgery so the surgeon has a mental image of how big/small they will go with extraction. PRO TIP-Watch screen when surgeon is using US probe. Note how many sutures you have on table vs how much breast tissue to go thru to get to lump. You might need more.

The others-Faxitron, Neoprobe. Those depend on things happening with the patient in other departments. Usually the pt. goes to radiology to have radioactive dye injected and/or have a wire inserted under fluoroscopy to localize the lump. Neoprobe is reading the uptake of the iosotopes to lymph nodes for 'sentinel lymph node' biopsies. I'm guessing Faxitron is a brand name for a machine that is a box on wheels that you can do a small x-ray of tissue in the operating room so surgeon can see if she got all the target tissue. If so, Faxitron would be indicated with anything that is 'needle-localized', the procedure done in radiology BEFORE the patient comes to OR.

If you are working with a surgeon that specializes in breasts, all day, every day...just have all the 'toys' in the sandbox and every one should play happy.