VATS Pleurodesis Set-Up

Bed Position

  • Table with bean bag – draw sheet under, regular sheet over
  • Bed Position – slide to head
  • Arm board, and right angle arm holder – arm board and bracket on lower rail
  • Suction tubing for the bean bag
  • Gloves – 8 1/2 blue, 8 micro/pink

Anesthesia

  • Double lumen tube, or bronchial blocker
  • Bronchoscope – GlideScope (purple)
  • +/- Arterial Line/Foley

Equipment

  • Scope – 10mm 30 degree ( have 5mm 30 degree in room)
  • Ports – 12mm X 2, 5mm X 1  (thing with the thing)
  • CO2 tubing – cut off 2 feet of purple tubing
  • Standard suction tubing and yankauer
  • Suction irrigator with irrigation set up
  • Ring clamp (sponge stick no sponge)
  • Maryland grasper
  • Wavy grasper – see picture

  • Red rubber catheter (12fr)
  • Asepto/blub irrigator
  • 2 bottles of talc
  • Pleurevac canister – dual
  • Two 24 Blake drains
  • Two Christmas tree connectors
  • Pleurx in the room, not opened

Drape, Set up, Start

  • Standard drape with pockets
  • Pass off first: Camera -> Light Cord -> CO2 Tubing -> then blunt towel clip
  • Pass off second: Cautery -> Suction tubing -> Suction Irrigator without the tip ->  then blunt towel clip
  • Pass last: cautery holster-hemostat, light handles, magnet, marker
  • Time-out
  • Getting in: Local, 15 blade scalpel, ring clamp, cautery, 12mm sleeve loaded on the 10mm/30 camera, connect and turn on CO2

Sutures

  • 0 Vicryl UR 6
  • 0 Silk chest tube stitches X 2
  • 4-0 Monocryl X 2
  • Dermabond

Chest Tube Dressings

  • 4X4 gauze
  • Medipore Tape