GS2 appe, GB

[by me]

멸균장)
lapa set, mayo, bowl(s), 사중, LH, lapa inst(+ scope), trocar(5mm*2, 11mm*1), cottonoid, endobovie(일자/hook), pumpline, ligasure(1937), beri tip, hemolock 5mm(+ tip)

package장)
lapa pack, suction line, bovie, MP(1*1, 3*2), blade#15, steri-strip, surgifit 3-0 cutting, drain set(JP200, nylon 3-0, tubeguard)

수술방)
glove(7.5), polysorb 2-0*1, 10cc syr, lapbag(m)
prep)
5mm tip, aspiration needle, 50cc syr, collaform, v-seal, artisential(5ACF_clinch fcp_croc) 5AUF(x)

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(1) painting & drape
⦁ assist에게 painting할 betadine ball과 sponge fcp 주기
⦁ utility4 -> 대공 -> 사각포 (pubic-axillary-subxiphoid)
(2) skin incision & trocar insert
⦁ ATF로 umbilical 잡고 mess로 incision
⦁ hook2로 ret 후 kelly1로 dissection, 11mm trocar insert (scope과 co2 연결)
⦁ (mess-5mm trocar)*2, position change
(3) dissection
⦁ babcock으로 small bowel 들춰 cystic duct, artery 찾기
⦁ dissector로 duct, artery 구분 & dissection
(4) GB resection
⦁ duct는 5mm hemolock 3번 찝고 -> metzen
⦁ artery 동일
⦁ artisential로 GB와 liver 분리 -> “drain, beri 등 질문“
(5) lapbag insert
⦁ scope -> lapbag-babcock -> cut sci -> trocar out -> kelly-senn-puspen -> trocar in -> irri? -> drain-babcock -> suture(senn 먼저. mosquito&cut)
() dressing
alchol -> strei-strip -> betadin -> v-seal -> peanut + 2x2 + tubeguard -> MP

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- trocar 뚫는 위치
- assi와 surgen 어디에 위치하는지
- hemolock 찝을 때 어디에 가깝게?
- 아직 appe 정리 안 됨
- kelly. proximal fascia protect 되면서 공간되어지니까 bovie로 incision. 아님 distal 쪽으로 bovie