30/11/2019
Procedural Considerations
Intraoperative Nursing Care
Procedure commenced. Four incisions each likened to small stab were made to the abdomen. • Umbilical incision, blunt laparoscopic port inserted for the camera • Right upper quadrant incision for a 5mm port and a grasping forceps
• The theatre nurse is the patient's advocate • Monitor fluid loss • Vital signs monitor for anaesthesia induced hypotension • Thermoregulation: warm irrigation fluid • Specimen care: correct label and handling • Give local anaesthetic if agreed by the anaesthetist
• Right lower quadrant incision for second 5mm port • Left upper quadrant incision for a third 5mm port
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Procedural Considerations Laparoscopic instruments • Endoscopic suction and irrigation device • Light handle • Needle counter box • Anti fog for camera cleaning • Raytec swabs (10X10) 10 pieces, (30X30) 10 pieces • Blade 15 • Sutures as preferred • Wound dressing
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Post operative care/recovery
Surgical Set Up/Drapping
In recovery room • Oxygen supplement • IV hydration till oral diet • Monitor vitals • Pain management • Monitor level of consciousness • Incentive spirometry • Repeat routine bloods-FBC • Blood gas- monitor for acidosis
On the ward • Early ambulation as tolerated to avoid venous stasis • Monitor for pulmonary complications acute chest • Continue pain management in this patient • Psychological and emotional care • Family care Outcome • Surgery was successful • Pain aptly managed • Sickle cell related complications well controlled • Discharged on day 2 post surgery.
• Maintain temperature • Assess surgical sites • Monitor abdomen for bleeding • Monitor for complications from CO2 use
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