Supplies for a Bowel Resection

In practice

The preference card for the bowel resection lists a linear cutter with reloads, a circular stapler, a clip applier, laparotomy pads, vessel loops, a drain, and suture. Toni, the scrub person, opens the laparotomy pads and counts them with the circulating nurse; the staplers and their reloads are pulled into the room but left closed. During the case, the surgeon uses vessel loops to lift and protect structures, and Toni adds each loop to the count as it is opened. Clips close several small vessels. When the surgeon is ready to divide the bowel, Toni confirms the stapler and reload size aloud, and the circulating nurse opens them. The linear cutter divides and seals the bowel in one firing; Toni sets each spent reload aside in a fixed place. To rejoin the bowel, the surgeon asks for the circular stapler, and Toni passes it ready to use. Near closing, the surgeon places a drain, and Toni has the securing suture loaded. At the closing count, sponges, sharps, small items such as the vessel loops, and instruments are all reconciled, and the devices are accounted for under the facility's tracking process. The circulating nurse records the drain's location and the staplers used.