Abstract
Proper room setup is a key component to the successful outcome of any surgical procedure. This is especially true of ureteroscopic procedures as these procedures are technology intensive and space is at a premium. A poorly positioned back table or piece of equipment can not only extend operative times but can also potentially endanger the patient, result in damage to expensive equipment, and can cause significant discomfort and inconvenience for the surgeon. Equally important, if not more so, is correct patient positioning. The ability for the surgeon to access structures of interest is solely dependent on patient positioning. Concomitantly, it is the surgeon’s responsibility to reduce or eliminate the risk of position-related injuries. In this chapter we discuss surgical suite ergonomics, room setup, X-ray positioning and safety, and choice of irrigant. We also discuss appropriate patient positioning in the dorsolithotomy and prone positions as well as associated complications.
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References
van Deet MJ, Meijerink WJHJ, Hoff C, et al. Optimal ergonomics for laparoscopic surgery suites: a review and guidelines. Surg Endosc. 2009;23:1279–85.
Kaya OI, Moran M, Ozkardes AB, et al. Ergonomic problems encountered by the surgical team during video endoscopic surgery. Surg Laparosc Endosc Percutan Tech. 2008;18:40–4.
Hemal AK, Srinivas M, Charles AR. Ergonomic problems associated with laparoscopy. J Endourol. 2001;15:499–503.
Berguer R, Chen J, Smith WD. A comparison of the physical effort required for laparoscopic and open surgical techniques. Arch Surg. 2003;138:967–70.
Johnston 3rd WK, Hollenbeck BK, Wolf Jr JS. Comparison of neuromuscular injuries to the surgeon during hand assisted and standard laparoscopic urologic surgey. J Endourol. 2005;19:377–81.
Beurger R. Surgery and ergonomics. Arch Surg. 1999;134:1011–6.
Wong SW, Smith R, Crow P. Optimizing the operating theatre environment. ANZ J Surg. 2010;80:917–24.
McKenna JV. The case for motion and time study in surgery. Am J Surg. 1957;94:730–4.
Haramis G, Rosales JC, Palacios JM, et al. Prospective randomized trial of foot gel pads for operating room staff comfort during laparoscopic renal surgery. J Urol. 2010; doi:10.1016/j.urology.2010.01.018
Graversen JA, Korets R, Mues AC, et al. Prospective randomized evaluation of gel mat foot pads in the endoscopic suite. J Endourol. 2011;25:1793–6.
Elkoushy MA, Shahrour W, Andonian S. Pulsed fluoroscopy in ureteroscopy and percutaneous nephrolithotomy. Urology. 2012;79(6):1230–5.
Shultz RE, Hanno PM, Wein AJ, et al. Percutaneous ultrasonic lithotripsy: Choice of irrigant. J Urol. 1983;130:858–60.
Hull RD, Raskob GE, Gent M, et al. Effectiveness of intermittent pneumatic leg compression devices for preventing deep vein thrombosis after total hip replacement. JAMA. 1990;263:2313–7.
Bailey JP, Kruger MP, Solano FX, et al. Prospective randomized trial of sequential compression devices vs low-dose warfarin for deep venous thrombosis prohylaxis in total hip arthroplasty. J Arthroplasty. 1991;6(Suppl):S29–35.
Hansberry KL, Thompson Jr IM, Bauman J, et al. A prospective comparison of thromboembolic stockings, external sequential pneumatic compression stockings and heparin sodium/dihydroergotamine mesylate for the prevention of thromboembolic complications in urological surgery. J Urol. 1991;145:1205–8.
Korkes F, Lopes-Neto AC, Mattos MH, et al. Patient position and semi-rigid ureteroscopy outcomes. Int Braz J Urol. 2009;35:542–7.
Hunter PT, Hawkins IF, Finlayson B, et al. Hawkins-Hunter retrograde transcutaneous nephrostomy: a new technique. Urology. 1983;22:583–7.
Lawson RK, Murphy JB, Taylor AJ, et al. Retrograde method for percutaneous access to kidney. Urology. 1983;22:580–2.
Grasso M, Lang G, Taylor FC. Flexible ureteroscopically assisted percutaneous renal access. Tech Urol. 1995;1:39–43.
Sountoulides PG, Kauffman OG, Louie MK, et al. Endoscopy-guided percutaneous nephrostolithotomy: benefits of ureteroscopic access and therapy. J Endourol. 2009;23(10):1649–54.
Landman J, Venkatesh R, Ragab M, et al. Comparison of intrarenal pressure and irrigant flow during percutaneous nephroscopy with an indwelling ureteral catheter, ureteral occlusion balloon, and ureteral access sheath. Urology. 2002;60:584–7.
Landman J, Venkatesh R, Lee DI, et al. Combined percutaneous and retrograde approach to staghorn calculi with application of the ureteral access sheath to facilitate percutaneous nephrolithotomy. J Urol. 2003;169:64–7.
Khan F, Borin JF, Pearle MS, et al. Endoscopically guided percutaneous renal access: “Seeing is believing”. J Endourol. 2006;20:451–5.
Akhavan A, Gainsburg DM, Stock JA. Complications associated with patient positioning in urologic surgery. Urology. 2010;76:1309–18.
Winfree CJ, Kline DG. Intraoperative positioning nerve injuries. Surg Neurol. 2005;63:5–18.
Warner MA, Martin JT, Schroeder DR, et al. Lower-extremity motor neuropathy associated with surgery performed in patients in a lithotomy position. Anesthesiology. 1994;81:6–12.
Ubee SS, Manikandan R, Athmanathan N, et al. Compartment syndrome in urological practice. BJU Int. 2009;104:577–8.
Simms MS, Terry TR. Well leg compartment syndrome after pelvic and perineal surgery in the lithotomy position. Postgrad Med J. 2005;81:534–6.
Edgecombe H, Carter K, Yarrow S. Anesthesia in the prone position. Br J Anaesth. 2008;100:165–83.
Matsen 3rd FA, Winquist RA, Krugmire Jr RB. Diagnosis and management of compartmental syndromes. J Bone Joint Surg Am. 1980;62:286–91.
Pearse MF, Harry L, Nanchahal J. Acute compartment syndrome of the leg. BMJ. 2002;325:557–8.
Hutton M, Rhodes RS, Chapman G. The lowering of postischmic compartment pressures with mannitol. J Surg Res. 1982;32:239–42.
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Graversen, J.A. et al. (2013). Ureteroscopy: Patient Positioning and Room Setup. In: Monga, M. (eds) Ureteroscopy. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-206-3_19
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DOI: https://doi.org/10.1007/978-1-62703-206-3_19
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