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A Technique to Facilitate Ureteroscopic Surgery By Placing the Instrument Table in an Efficient Position

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A TECHNIQUE TO FACILITATE URETEROSCOPIC SURGERY BY PLACING THE INSTRUMENT TABLE IN AN EFFICIENT POSITION

Cu N Phan, M.D., Dominic Tran-Nguyen, B.S., Jeffrey W. Wong, B.A., Jin S. Lee, B.A., Jonathan M. Nguyen, B.S.


Purpose: Traditionally, for ureteroscopic procedures, the instrument table is placed away from and behind the surgeon. When the surgeon needs an instrument, the surgeon must rely on an assistant to provide the instruments from the table. The surgeon also relies on an assistant to hold surgical tools including guide wires and baskets to prevent them from falling on the floor. In an academic setting, this is usually not a problem because the resident has the support of their surgical technicians, fellows, and attending physicians. However, in private practice, a urologist is lucky to have an assistant who is familiar with the surgical instruments. By positioning the instrument table adjacent to and on the side of the surgeon’s dominant hand, the surgeon can perform the procedure more efficiently. 

 

Materials and Methods: Position the instrument table adjacent to the surgeon’s dominant hand and beneath the patient’s legs. This positioning allows the instruments to be readily accessible to the urologist. An additional benefit of this positioning is that it allows surgeons to rest the elbow of their dominant hands on the table during lengthy procedures, minimizing fatigue. 

 

Conclusion: This positioning reduces fatigue, keeps the physicians in close proximity to their instruments, and is ergonomic. Please give this positioning a try.