107 MASTOPEXY with SALINE or GEL IMPLANTS

see also 102 Saline Implant Setup, 106 Mastopexy, 108 Breast Augmentation

updated August 31, 2013

page 1

 

OPERATIVE TIME 3 ½ hours

ASSISTANT: yes

CPT CODE(S):

19316 MASTOPEXY, 19325 BREAST AUGMENTATION WITH IMPLANT

ICD9:

V50.1ELECTIVE COSMETIC, 757.6 BREAST

 

ANESTHESIA NOTES

GA, ETT or LMA, Kefzol 1gm IV

PATIENT POSITION | SETUP

supine, 6 chux, arms out on boards, covered with green towels and taped, 2" silk. Plexipulses,

Tattoo kit: Methylene blue, 22g needle, 18g needle, 3cc syringe, Kelly clamp, 4x4's, gloves

TABLE POSITION

Pillow under knees, Dr. C will position table. Sometimes sits patient upright during surgery.

ROOM SETUP

Pre-warm table with Baer hugger

 

EQUIPMENT

Baer hugger, bag decanter. Headlight and light source, wrapping boards, pump up stool

IMPLANTS

Implant sizers - NOTE: as of 2013, sterile, non-reusable implant sizers will be provided by the OR.

Implants - open only when requested, verify with Dr. before opening.

DO NOT REMOVE ANY STICKERS. KEEP ALL LABELS AND PACKING IN BOX. MARK BOX WITH R or L SIDE AND RECORD VOLUME. INCLUDE 6 PT ID STICKERS FOR DR. TO USE.

SPECIALS

none

PREP

CHG prep set, down to blue chux

DRAPING

Plastic drape pack. Lap chole drape, mag pad, [3] quarter sheets, [2] mayo stand covers, [6] sticky paper drapes, basic pack

CAUTERY

Machine at head of bead. Bovie 30/30 pure, Saf-T-Vac

[2] bovie tips: Valleylab coated silver tip and flat tip bovie extender

SUCTION

At head of table.

[2] suctions: regular plastic Yankauer and Saf-T-Vac

[2] sterile suction tubing

 

SOLUTIONS | IRRIGATION

● Normal saline irrigation [3] liters

● [2] Asepto syringes

● Kefzol irrigation for implants w/ blue bulb

OPEN ONLY IF USING SALINE:

    ● Hang 2L sterile IV saline to fill implants

    ● Cysto tubing, single

NEEDLES | SYRINGES

● [6-8] 60cc syringes for filling implants,

● [2] 20cc syringes for solution “C”

● [2] long Quincke 22g spinal needles

LOCAL ANESTHETIC

Solution “C” 200cc - Mix 2% lidocaine w/epi 50cc +

          0.5%Marcaine w/epi 50cc + NS 100cc

MEDICATIONS

● methylene blue

● Kefzol 1 gm for irrigation

● Bacitracin ointment 2oz

 

107 MASTOPEXY with SALINE IMPLANTS

PAGE 2

 

SETS TO OPEN

Dr. C Plastic set, retractor set

INSTRUMENTS USED (ON MAYO STAND)

     FORCEPS

Martin 7x8 tissue, 01 Adson, 03 Adson, regular adson

     SCISSORS

curved Mayo serrated, str Mayo, str Metz

     NEEDLE HOLDERS

[4] Crile wood, [2] Mayo Hagar, [2] Olson Hagar

     RETRACTORS

[2] large facelift, breast retractor, Richardson, Army Navy,

Double ended gold retractor

     KNIFE | BLADES

[2] knife handles, [4] No. 10 blades

 *** Do not use blades from packs***

     OTHER

[2] Hemostats for drains

 

STERILE SUPPLIES

[4] marking pens, [2] Asepto syringes

SYRINGES and CONNECTORS

● [2] Asepto syringes

● [1] Blue bulb syringe for antibiotic irrigation

OPEN ONLY IF USING SALINE:

    ● [8-10] 60cc syringes for filling sizers and implants

    ● [1] Twist-n-Ject stop cock

    ● [2] blue one-way valve connectors

    ● [1-2] Cysto tubing, single

SPONGES

[4] Lap sponges

NON-STERILE SUPPLIES

Wrapping board, large or medium, baby powder

 

 

No

Type

SN

status

SUTURES

[ 4 ]

2-0 Vicryl CT-1

J945

open

 

[ 6 ]

3-0 Monocryl SH

Y416

open

 

[ 4 ]

4-0 Monocryl PS-2

Y426

open

 

[ 2 ]

5-0 Monocryl P3

Y493

 

hold

[ 2 ]

5-0 Plain gut P3

1915

 

hold

[ 2 ]

3-0 Ethilon PS-1

1663

 

hold

 

DRAINS

[2] 15 Fr. Round Blake drains with connectors and reservoir bulbs - 2188. - hold do not open

DRESSINGS

● [2] tongue blades

● [2] 3x18 Vaseline gauze

● [2] 4x4 dressing sponges

● [2] cut drain sponges

● [2] ABD

● [2] 6" Ace

● [3] kerlix

● [2] safety pins

 

POSTOPERATIVE

Lift with wrapping board, 3 people

Safety pin reservoirs to ace, mark with Sharpie

NOTES

 

 

COMMENTS

 

SEE ALSO, SAME AS

see also 102 Saline Implant Setup, 106 Mastopexy, 108 Breast Augmentation

DATES MODIFIED

October 2006, March 2008, Sept 2009, Mar 2013, Aug 2013