tailieunhanh - Positioning Techniques in Surgical Applications - part 10

Dị tật bẩm sinh để thực quản (ví dụ như thực quản hẹp, nhân đôi thực quản), mở và các thủ tục xâm lấn tối thiểu đến phổi (ví dụ như sequestra, giãn phế quản, khối u). Bên vị trí ở phía bên lành mạnh, vị trí ở phía bên tay trái cho hẹp thực quản | 284 Chapter 21 Paediatric surgery Lateral position D Figs. . Indications Congenital deformities to the oesophagus . oesophagus atresia oesophagus duplications open and minimally invasive procedures to the lungs . sequestra bronchiectasis tumours . Lateral position on the healthy side position on the left-hand side for oesophagus atresia Preparations 4 Gel cushions sandbags possibly wedge cushion 4 Gel cushions for the legs 4 Leg holders only for larger children 4 Padding for the legs and feet 4 Warming mat warming lamp Positioning 4 Children s operating table in the neutral position 4 Connect the warming mat and lamp affix the temperature sensor 4 Prepare and induce the anaesthetic in the supine position 4 Transfer to the lateral position in the operating theatre 4 The upper arm is positioned in the cranial direction padded and fixed in a cloth sling to the anaesthetic screen for infants the arm is fixed in a lying position at the head with plaster strips 4 In larger children pull the lower arm so that the body weight does not lie directly on the shoulder and extend in this position 4 Stabilise the body with sandbags or gel cushions possibly wedge cushions 4 Fix the lower leg with body belts for older children and plaster strips for younger children 4 Pad the parts of the body at risk from pressure 4 Apply the neutral electrode connect to the HF surgery device 4 Use compresses to protect the electrode during disinfection 4 Position the operating lamps Risks 4 Positioning injuries from lacking or inadequate padding particularly for the face and genitals 4 Burns from lacking moisture protection for the neutral electrode 285 21 Various positions Fig. . Modified lateral position for thoracoscopy Fig. . Arm spread out fixed to the anaesthesia screen Fig. . Padding under the back Fig. . Padding under the legs Fig. . Arm positioning Fig. . Lateral position for lower lobe resection 286 Chapter 21 Paediatric surgery