Podcast
Questions and Answers
Which catheter type is commonly used in surgeries for its specific design features?
Which catheter type is commonly used in surgeries for its specific design features?
What is the purpose of warming irrigation fluids before use in surgeries?
What is the purpose of warming irrigation fluids before use in surgeries?
In which procedure is sterile water primarily used?
In which procedure is sterile water primarily used?
What type of irrigation fluid should be used to prevent hemolysis during TURP?
What type of irrigation fluid should be used to prevent hemolysis during TURP?
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What type of table is specifically equipped for urological surgeries?
What type of table is specifically equipped for urological surgeries?
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What major risk is associated with the use of sterile water in TURP procedures?
What major risk is associated with the use of sterile water in TURP procedures?
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What is the primary role of cystoscopes in urological procedures?
What is the primary role of cystoscopes in urological procedures?
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What is a significant concern during all types of open prostatectomies?
What is a significant concern during all types of open prostatectomies?
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Which property must irrigation fluids possess when used with closed systems?
Which property must irrigation fluids possess when used with closed systems?
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Which prostatectomy approach provides excellent exposure and easy control of bleeding?
Which prostatectomy approach provides excellent exposure and easy control of bleeding?
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What additional procedure may be performed during a Suprapubic Prostatectomy?
What additional procedure may be performed during a Suprapubic Prostatectomy?
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What does a Nerve Sparing Radical Prostatectomy aim to preserve?
What does a Nerve Sparing Radical Prostatectomy aim to preserve?
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Which of the following is a benefit of a Robotic Laparoscopic Radical Prostatectomy?
Which of the following is a benefit of a Robotic Laparoscopic Radical Prostatectomy?
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What approach is preferred for patients with organ-confined carcinoma of the prostate?
What approach is preferred for patients with organ-confined carcinoma of the prostate?
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Which laparoscopic technique allows for less blood loss and shorter hospital stays?
Which laparoscopic technique allows for less blood loss and shorter hospital stays?
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What is minimally invasive radical prostatectomy primarily designed to improve?
What is minimally invasive radical prostatectomy primarily designed to improve?
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What is the recommended maximum hip flexion to prevent nerve injuries during surgery?
What is the recommended maximum hip flexion to prevent nerve injuries during surgery?
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What should the perioperative nurse ensure regarding the patient return electrode pad?
What should the perioperative nurse ensure regarding the patient return electrode pad?
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Which type of surgeries does not require a count of instruments?
Which type of surgeries does not require a count of instruments?
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What instruments should be included in a basic laparotomy setup for GU surgeries?
What instruments should be included in a basic laparotomy setup for GU surgeries?
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How should legs be removed from stirrups after surgery?
How should legs be removed from stirrups after surgery?
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Which device is commonly used in the lithotomy position?
Which device is commonly used in the lithotomy position?
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What type of count is conducted at the beginning of all GU surgical cases?
What type of count is conducted at the beginning of all GU surgical cases?
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What should be used to shield the patient from radiation exposure during surgery?
What should be used to shield the patient from radiation exposure during surgery?
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What is the primary indication for performing a radical cystectomy with pelvic lymphadenectomy?
What is the primary indication for performing a radical cystectomy with pelvic lymphadenectomy?
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What type of surgery involves the removal of bladder lesions through the urethra?
What type of surgery involves the removal of bladder lesions through the urethra?
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In a continent ileostomy, how does the patient eliminate urine?
In a continent ileostomy, how does the patient eliminate urine?
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What surgical procedure is performed to create an opening into the urinary bladder?
What surgical procedure is performed to create an opening into the urinary bladder?
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What is the function of the ileal conduit after a cystectomy?
What is the function of the ileal conduit after a cystectomy?
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Which approach is typically used for diagnostic testing in bladder surgeries?
Which approach is typically used for diagnostic testing in bladder surgeries?
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What surgical method utilizes a lithotripsy probe for stone removal?
What surgical method utilizes a lithotripsy probe for stone removal?
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Which of the following is not a reason for surgical intervention in ureteral surgery?
Which of the following is not a reason for surgical intervention in ureteral surgery?
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Why is the left kidney usually preferred for removal during a transplant?
Why is the left kidney usually preferred for removal during a transplant?
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Which factor is NOT typically associated with potential kidney donors?
Which factor is NOT typically associated with potential kidney donors?
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What is a critical requirement for the oxygenation of the donor before organ retrieval?
What is a critical requirement for the oxygenation of the donor before organ retrieval?
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During the transplant surgery, which procedure may NOT occur?
During the transplant surgery, which procedure may NOT occur?
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What is the purpose of a hydrocelectomy?
What is the purpose of a hydrocelectomy?
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What does the procedure of orchidopexy entail?
What does the procedure of orchidopexy entail?
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Which statement is true regarding radical lymphadenectomy?
Which statement is true regarding radical lymphadenectomy?
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Which of the following is not classified as a testicular surgery?
Which of the following is not classified as a testicular surgery?
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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.