324 LIPOSUCTION - HIPS, THIGHS, BACK and/or ABDOMEN

       with or without TURNOVER

Note if turnover; Patient is intubated on stretcher, foley is placed, then log-rolled on to OR table

May be used in combination with 305 ABDOMINOPLASTY updated July 17, 2016 page 1

 

OPERATIVE TIME: 3-4 hours if alone

ASSISTANT: Yes

USUAL LOCATION: Day and Main OR

ICD9 CODE: V50.1 ELECTIVE COSMETIC, 278.1 LOCALIZED ADIPOSITY

FREQUENCY: 2-3/year

CPT CODE:15877 LIPOSUCTION TRUNK

 

ANESTHESIA NOTES

General, ETT. Patient intubated on stretcher then turned over on to table. Foam face cube for turnover. IV fluid warmer.

PATIENT POSITION | SETUP

● Dr. C will re-enforce markings with Sharpie

● [6-8] blankets for chest and axillary rolls if turnover

● Use foot Plexi-pulses only if lipo knees

● Use sequential teds for all others

● Foley catheter - pull #12 fr separate

● After liposuction roll back to stretcher and slide back to bed

     w/ pillow under knee

● [2] Baer huggers: upper body and lower body, 2" tape

TABLE POSITION

● [6-8] blankets for chest and axillary rolls if turnover

ROOM SETUP

● [2] Baer huggers, upper and lower body,

● pre-warm room thermostat to 72, pre-warm OR table w/ Baer

 

LIPOSUCTION EQUIPMENT

SETUP

LIPO MACHINE:

MD Resource model LS-2 liposuction aspirator● Arrange tubing as sump system

● Check to make sure machine is working

● Liposuction tubing

● [1-2] liposuction canisters


PRESSURE BAGS:

● [2] pressure bags labeled A/A- at head of table

● Insert tumescent solutions into pressure bags

● to be inflated to 300-400mmHg (red).


NOTE: DOWNLOAD/PULL liposuction flow sheet.

PREP

CHG prep set down to blue chux

DRAPING

Large table cover over chest rolls before prep if turnover

Lap chole drape, basic pack, mag pad, [1] 3/4 sheet,

[1] mayo stand cover cut in half,

[8] sticky paper drapes #89731 - 6 are in custom Plastic pack

Extra gowns when turning and changing

CAUTERY

NO CAUTERY; NO GROUNDING PAD

SUCTION

NO WALL SUCTION

 

STERILE SUPPLIES

● marking pen

● [2-4] cysto single tubing sets, one for each pressure bag

● Foley catheter #12 fr

● 3-way stop cock

● Dermabond

● liposuction tubing

SPONGES

lap sponges, towels

NON-STERILE SUPPLIES

[1-2] liposuction canisters, [2-4] pressure bags labeled A and A-

324 LIPOSUCTION continued

page 2

 

TUMESCENT and LOCAL SOLUTIONS


Dr. C will list how many liters of each will be required depending on extent of liposuction.

Will use 1-4 liters total.

TUMESCENT SOLUTION FOR PRESSURE INFILTRATION:

[1-2] liters Solution “A” containing:

1 liter......Lactated ringers

50 cc......Lidocaine 1 % plain

1cc.........Epinephrine 1:1,000

[0-2] liters Solution “A-minus” containing:

1 liter.....Lactated ringers

1cc........Epinephrine 1:1,000

[1-4] pressure bags labeled “A” and “A minus

[2-4] Single sterile cysto tubing

LOCAL INFILTRATION FOR PORTAL SITES:

    ● [1-2] 50cc vial 1% lidocaine w/epi

    ● [1-2] 10cc syringes; [1-2] 25g needles 1½"

NEEDLES | SYRINGES

[1-2] 10cc syringes; [1-2] 25g needles 1½"

fill with 1% lidocaine w/epi

IRRIGATION

Saline irrigation w/ Asepto syringe

MEDICATIONS

[1-2] 50cc vial 1% lidocaine w/epi

 

 

SETS TO OPEN :

Dr C Minor set, lipo cannula and infiltration set, 5mm only to start

INSTRUMENTS USED (ON MAYO STAND)

     FORCEPS

[2] 08 adson

     SCISSORS

str Metz, Reynolds

     NEEDLE HOLDERS

[2] smooth Crile Wood, [2] smooth Webster

     RETRACTORS

none

     KNIFE | BLADES

[1] No. 15

LIPO CANNULAS

Hunsdadt infiltration cannulas

Hunsdadt infiltration handle w/wrench

5mm lipo cannula (blue)

open other cannulas as needed

 

 

No

Type

SN

status

SUTURES 

[ 2-4 ]

5-0 MoncrylP3

Y493

open 2

hold 2

[ 2-4 ]

5-0 fast gut PC-1

1915

open 2

hold 2

[ 1-2 ]

Dermabond

 

open 1

hold 1

 

DRAINS

NO DRAINS

DRESSINGS

Compression garment or binder at end.

Sometimes use 6" ace, 4" ace for legs - ask [hold]

 

POSTOPERATIVE

Roll back on to stretcher, apply compression garment

NOTES

see also liposuction flow sheet, local solutions sheet

see also 306 Abdominoplasty

DATES MODIFIED

Jul 2006, Aug 2007, July 2009, Jan 2010, Dec 2012, May 2014, Oct 2014,

Nov 2015, Jul 2016