Building a Laparotomy Set

In practice

The circulating nurse opens the major laparotomy set, and the scrub person, Drew, checks it against its tray list before setting the Mayo stand. Cutting first: two knife handles with blades, a heavy pair of curved Mayo scissors for fascia, a straight Mayo for suture, and Metzenbaum scissors for delicate tissue. Grasping next: DeBakey forceps for gentle handling, toothed forceps for skin and fascia, and long forceps for deep work. Clamps: several curved hemostats in small and larger sizes, right angle clamps for passing ties, Kocher clamps for tough fascia, and Babcock clamps for holding bowel. Retractors: a pair of Army-Navy retractors for the skin, Richardson retractors for the abdominal wall, a Deaver for deep organs, malleable retractors to protect the bowel, and a Balfour self-retaining retractor with its blades. Suction: a Yankauer for general use and a Poole for large volumes. Suturing: needle holders in two lengths, the longer one for deep closure. Towel clamps and sponge forceps complete the set. Drew notes that the Balfour has two separate side blades and a center blade, each counted individually. One malleable retractor listed on the tray card is missing, and Drew tells the circulating nurse before the count, so the record starts accurate and a replacement is opened.