LAMINECTOMY
PATRICIA CALADO
BEA BARREDO
CONTENT
1
Pre-Operative
2
Surgical Safety
3
Roles of the
4
Positioning
Checklist Checklist Scrub Nurse Device and
and Pressure
Circulating Points of
Nurse Laminectomy
Procedure
LAMINECTOMY
A type of surgery (Major) in which a surgeon removes
part or all of the vertebral bone (lamina). This helps ease
pressure on the spinal cord or the nerve roots that may
be caused by injury, herniated disk, narrowing of the
canal (spinal stenosis), or tumors.
LAMINECTOMY INSTRUMENT SET
SPONGE HOLDER
BLADE HOLDER #3, 4, 7
LAMINECTOMY INSTRUMENT SET
ARTERY CURVED AND STRAIGHT
FORCEPS
ALLIS
LAMINECTOMY INSTRUMENT SET
NEEDLE HOLDER
METZ AND MAYO SCISSORS
LAMINECTOMY INSTRUMENT SET
ARMY NAVY RETRACTOR
LANGERBECK RETRACTOR
LAMINECTOMY INSTRUMENT SET
BAYONET FORCEP
DISSECTOR
LAMINECTOMY INSTRUMENT SET
NERVE ROOT RETRATCOR
ONE END RETRACTOR
LAMINECTOMY INSTRUMENT SET
COBS RETRACTOR
PERIOSTEUM ELEVATOR
LAMINECTOMY INSTRUMENT SET
SUCTION
MASTOID RETRACTOR
LAMINECTOMY INSTRUMENT SET
HEMILAMINECTOMY RETRACTOR
CURETTE
SCENARIO
Mr. James Sanchez a 35 year old man is
scheduled for a lumbar laminectomy for a
herniated disc at 1.2-3. Past history and review of
systems reveal a previous diagnosed of sickle cell
trait. The rest of the history is noncontributory.
Physical examination show no abnormality
except neurologic findings compatible with the
herniated lumbar disc.
PRE-OPERATIVE CHECKLIST
Identification of the Patient James Sanchez
Consent form Obtained
Age 35 years old
Nature of Surgery Lumbar laminectomy
Last Menstruation Not applicable
Dentures None
Contact lenses, Hearing aides None
Previous Surgery None
PRE-OPERATIVE CHECKLIST
Medications None
BP: 120/70 T: 35C PR: 78bpm RR: 19bpm
Vital Signs
O2sat: 96%
Allergy status None
Nail Polish None
Accessories None
NPO Last meal: 8hrs ago
SURGICAL SAFETY
CHECKLIST
BEFORE INDUCTION OF ANESTHESIA
(SIGN IN)
Has the patient confirmed his/her identity, site,
procedure, and consent?
Is the site marked?
Is the anesthesia machine and medication
check complete?
Is the pulse oximeter on the patient and
functioning?
Does the patient have a:
-- Known allergy?
-- Difficult airway or aspiration risk?
-- Risk of > 500ml blood loss (7 ml/kg in children)?
SURGICAL SAFETY
CHECKLIST
BEFORE SKIN INCISION (TIME OUT)
Confirm all team members have introduced
themselves by name and role
Confirm the patient’s name, procedure, and
where the incision will be made
Has antibiotic prophylaxis been given within To Anesthetist:
the last 60 minutes? Are there any patient-specific concerns?
Anticipated Critical Events
To Surgeon: To Nursing Team:
What are the critical or non-routine steps? Has sterility (including indicator results) been
How long will the case take? confirmed?
What is the anticipated blood loss? Are there equipment issues or any concerns?
Is essential imaging displayed?
SURGICAL SAFETY
CHECKLIST
BEFORE PATIENT LEAVES OPERATING ROOM
(SIGN OUT)
Nurse verbally confirms:
The name of the procedure
Completion of instruments, sponge, and
needle counts
Specimen labeling (read specimen labels
aloud; including patient name)
Whether there are any equipment problems
to be addressed
To surgeon, anesthetist, and nurse:
What are the key concerns for recovery and
management of this patient?
ROLE OF CIRCULATING NURSE
Coordinating patient care before, during, and after surgery.
Providing emotional support to the patient, family members, and operative team.
Ensuring patient safety, monitoring, positioning, and compliance to the rules and
guideline of the operating room.
Maintaining sterile technique when providing whatever is necessary throughout
the procedure.
Complete documentation in the intra operative record.
Ensures specimens are labeled correctly and sent to the designated department -
Ensuring proper surveillance to determine any environmental hazards.
Ensure proper counting of all items used in surgery and proper documentation in a
count sheet.
Communicating any relevant informations to family members and other involved
healthcare team members
ROLE OF SCRUB NURSE
Ensure the operating room are clean and ready for set up
Prepare the instrument equipment supplies needed for the surgery
Count of all instruments and sponges and other items to be use for surgery
Preserves the sterile environment by scrubbing in which requires surgical hand
brushing and putting on sterile gowns and gloves
Assist the surgeon in gowning and gloving
Helping the surgeon in putting the sterile grip to the patient
Assist in passing the instruments and other things during the surgery
Monitors the surgery to ensure everything remains sterile
Before the surgery finish ensures completeness of sponges, instruments and other
items used in surgery
Helps the surgeon in application of dressing
Place all the instrument in the instrument tray and sent to CSSD for sterilization
Ensures documentation is doneand specimen is taken off properly
POSITIONING
DEVICE &
PRESSURE POINTS
OF LAMINECTOMY
PROCEDURE
POSITIONING DEVICE
The patient should be in a
positioning device called
montreal laminectomy
support used in spinal
procedure requiring the prone
position.
PRESSURE POINTS
It is important to pay special attention to head, neck and upper
limbs position, as well as to pressure points at the elbow, knees and
ankles.
Where the body is in contact with the surgical table, some pressure
points are created and that can cause peripheral nerve
neuropathies and skin breakdown.
