Urological Surgery Procedures Quiz

Questions and Answers

Which catheter type is commonly used in surgeries for its specific design features?

Olive tip catheter (correct)

Closed-ended catheter

Double-lumen catheter

Straight tip catheter

What is the purpose of warming irrigation fluids before use in surgeries?

To reduce the risk of hypothermia (correct)

To enhance patient recovery time

To prevent infection during the procedure

To increase fluid absorption in tissues

In which procedure is sterile water primarily used?

Cystoscopy with fulguration

Monopolar cautery procedures (correct)

Transurethral resection of the prostate (TURP)

Bladder irrigation during surgery

What type of irrigation fluid should be used to prevent hemolysis during TURP?

Sorbitol Signup and view all the answers

What type of table is specifically equipped for urological surgeries?

Urological table Signup and view all the answers

What major risk is associated with the use of sterile water in TURP procedures?

Dilutional hyponatremia Signup and view all the answers

What is the primary role of cystoscopes in urological procedures?

To observe and diagnose issues within the urinary tract Signup and view all the answers

What is a significant concern during all types of open prostatectomies?

Intraoperative bleeding Signup and view all the answers

Which property must irrigation fluids possess when used with closed systems?

Absence of contaminants Signup and view all the answers

Which prostatectomy approach provides excellent exposure and easy control of bleeding?

Simple Retropubic Prostatectomy Signup and view all the answers

What additional procedure may be performed during a Suprapubic Prostatectomy?

Fixing bladder conditions Signup and view all the answers

What does a Nerve Sparing Radical Prostatectomy aim to preserve?

Erectile function and urinary continence Signup and view all the answers

Which of the following is a benefit of a Robotic Laparoscopic Radical Prostatectomy?

Shorter recovery time Signup and view all the answers

What approach is preferred for patients with organ-confined carcinoma of the prostate?

Nerve Sparing Radical Retropubic Prostatectomy Signup and view all the answers

Which laparoscopic technique allows for less blood loss and shorter hospital stays?

Laparoscopic Radical Prostatectomy Signup and view all the answers

What is minimally invasive radical prostatectomy primarily designed to improve?

Surgeon’s manual dexterity Signup and view all the answers

What is the recommended maximum hip flexion to prevent nerve injuries during surgery?

90 degrees Signup and view all the answers

What should the perioperative nurse ensure regarding the patient return electrode pad?

It is securely applied to the patient. Signup and view all the answers

Which type of surgeries does not require a count of instruments?

Cystoscopy Signup and view all the answers

What instruments should be included in a basic laparotomy setup for GU surgeries?

Short and long laparoscopic instruments Signup and view all the answers

How should legs be removed from stirrups after surgery?

Slowly to facilitate hemodynamic adjustments. Signup and view all the answers

Which device is commonly used in the lithotomy position?

Stirrups Signup and view all the answers

What type of count is conducted at the beginning of all GU surgical cases?

Major count Signup and view all the answers

What should be used to shield the patient from radiation exposure during surgery?

Lead shields for thyroid and chest areas Signup and view all the answers

What is the primary indication for performing a radical cystectomy with pelvic lymphadenectomy?

When a tumour has invaded the muscular wall of the bladder Signup and view all the answers

What type of surgery involves the removal of bladder lesions through the urethra?

Transurethral resection of Bladder Tumours Signup and view all the answers

In a continent ileostomy, how does the patient eliminate urine?

By performing self-catheterization Signup and view all the answers

What surgical procedure is performed to create an opening into the urinary bladder?

Suprapubic Cystostomy Signup and view all the answers

What is the function of the ileal conduit after a cystectomy?

To divert urine flow into a new bladder created from bowel Signup and view all the answers

Which approach is typically used for diagnostic testing in bladder surgeries?

Transurethral approach Signup and view all the answers

What surgical method utilizes a lithotripsy probe for stone removal?

Minimally invasive surgery (MIS) Signup and view all the answers

Which of the following is not a reason for surgical intervention in ureteral surgery?

Bladder infections Signup and view all the answers

Why is the left kidney usually preferred for removal during a transplant?

The left renal vein is longer than the right renal vein. Signup and view all the answers

Which factor is NOT typically associated with potential kidney donors?

Age over 60 years. Signup and view all the answers

What is a critical requirement for the oxygenation of the donor before organ retrieval?

It must not be interrupted for more than 5 minutes. Signup and view all the answers

During the transplant surgery, which procedure may NOT occur?

Removal of the recipient's native kidneys. Signup and view all the answers

What is the purpose of a hydrocelectomy?

To remove an abnormal accumulation of fluid in the tunica vaginalis. Signup and view all the answers

What does the procedure of orchidopexy entail?

Fixation of the testicle in a normal anatomical position. Signup and view all the answers

Which statement is true regarding radical lymphadenectomy?

It involves bilateral resection of retroperitoneal lymph nodes. Signup and view all the answers

Which of the following is not classified as a testicular surgery?

Radical lymphadenectomy Signup and view all the answers

Study Notes

Positioning and Safety in Surgery

Use various positioning devices (e.g., bean bags, bolsters) for lateral positioning based on surgical needs.
Collaborate with the surgical team to ensure safe positioning of patients before, during, and after surgery.
Apply return electrode pad and secure safety straps for patient safety.
In lithotomy position, fasten stirrups to support the legs, ensuring hips are flexed no more than 90 degrees to prevent nerve injuries.
Removing legs from stirrups requires slow coordination to avoid muscle strain and allow hemodynamic adjustments.

Instrumentation for GU Surgery

General urologic surgeries may include open, minimally invasive (MIS), or hybrid methods.
Cystoscopy Setup: Involves a single closed irrigation system (1000ml Saline), with essential light cords and cystoscope types (cystoscopes and resectoscopes), requiring no count.
Open and Laparoscopic Procedures: Nephrectomy, prostatectomy, cystectomy, and pyeloplasty require specific instruments and a major count at the beginning of procedures.

Surgical Equipment and Safety

Use intra-operative fluoroscopy (C-arm) with protective measures against radiation exposure.
Employ lasers (Holmium Yag, Yag KTP Green Light) under strict safety protocols.
Employ different types of ureteral and urethral catheters for surgeries, inserting ureter catheters as stents to minimize accidental cutting.
Utilize specialized urological tables for effective imaging and fluid drainage during surgery.

Irrigation Fluids and Their Uses

Administer sterile distilled irrigation fluid to distend the bladder, facilitating better visualization.
Close system irrigation is critical to prevent cross-contamination; warming fluids reduces hypothermia risk.
Various fluids are used based on the procedure:
- Normal Saline for simple cystoscopy and pyelography.
- Sterile Water for monopolar cautery procedures.
- Iso-osmotic solutions (e.g., Sorbitol, Glycine) for TURP to prevent hemolysis and fluid overload.

Open Prostate Surgery Techniques

Prostatectomy is a common procedure for men aged 50+ involving the removal of the prostate, usually determined by cancer location.
Suprapubic Prostatectomy offers access to the bladder while addressing prostate issues directly.
Simple Retropubic Prostatectomy provides excellent exposure and bleeding control.
Nerve Sparing Radical Retropubic Prostatectomy aims to preserve erectile function while removing the prostate and lymph nodes.

Minimally Invasive Prostatectomy

Robotic and laparoscopic methods enhance precision and reduce recovery time compared to open procedures.
Access through small incisions minimizes blood loss, decreases hospital stay, and limits post-operative pain.

Bladder and Ureteral Surgeries

Bladder surgeries utilize open or transurethral approaches for diagnosis or treatment of tumors.
Procedures like TUR of bladder tumors involve resectoscopy for tumor removal.
Total excision of the bladder with pelvic lymphadenectomy is required for invasive tumors, often involving creation of an intestinal conduit or continent ileostomy for urine diversion.

Ureteral Surgery Indications

Common procedures address urinary tract obstructions caused by stones, infections, or tumors.
Minimal invasive stone removal is performed using a lithotripsy probe under x-ray guidance.
Ureterostomy/Ureterotomy are employed for larger stones or continued drainage.

Kidney Transplantation Procedures

Donor criteria include being free from infection or cancer, with proper monitoring before death.
Renal transplantation involves connecting donor renal vessels to the recipient’s iliac vessels, often without removing native kidneys.

Testicular Surgeries

Hydrocelectomy and orchidopexy address conditions like fluid accumulation and undescended testicles, respectively.
Orchiectomy is the removal of one or both testicles, executed through various approaches based on patient needs, including laparoscopic options.
Radical lymphadenectomy entails comprehensive removal of lymph nodes around renal pedicles for cancer treatment.

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Description

Test your knowledge on critical aspects of urological surgery, including common catheter types, irrigation fluid protocols, and surgical tables. Understand the importance of warming fluids and the risks associated with specific practices in this field. Perfect for students and professionals in the medical domain.