10 OR set-up tips for endoscopic sinus surgery

1. Raise the operating table at an angle so that the patient’s body can be positioned at approximately 20-degree angle. The table arrangement should allow flexing the patient’s head at the neck.
2. Enough space shall be provided under the table so that the surgeon can place his/her legs under the table and sit closer to the patient.
3. An easily adjustable seat is required to maximize the comfort level for the surgeon and minimize the neck problems and weariness.
4. Sitting arrangement for the anesthetist is made at the table’s foot to avoid “space” war with the surgeon’s team that includes surgical assistants and nurses. It will reduce congestion at the OR table.
5. Find out the surgeon’s preferences for posture during the surgical procedure. Does the surgeon like to stand or sit while operating? Some surgeons prefer to sit and operate. So, they require an additional secure table placed next to the OR table. They will place their elbow on the additional table to hold the camera and endoscope firmly and in correct position. While other surgeons prefer to stand in front of the video stand while operating.
6. Some sinusitis symptoms require delicate surgical procedures that cannot be performed without a team of two surgeons. During such procedures, one surgeon holds the camera and other one operates freely. A sitting arrangement is required near the head of the OR table for the surgeon who will hold the camera and endoscope steadily. The video screen is placed in such as manner so that both the surgeons can see the screen easily.
7. Position the video screen in such a manner so that the surgeon (s) can even maintain comfortable posture while watching the screen. Use a big screen with high resolution. For high quality image, install an equally good light source. The surgeon can thus see details of the surgery site clearly and easily. Most of the instruments shall be placed on the video stack for the convenience and reducing the instrument wear and tear.
8. Many instruments used in the surgery require cables that may disturb the surgeon. Clip the cables to the drapes to ensure that cable weight neither obstructs nor pulls the surgeon back or down. Use light cables and think carefully before arranging them.
9. A beamsplitter used for the surgery may cause fatigue and posture problems for the surgeon in future. Even the best quality beamsplitters minimize the reflected light and therefore produce poor quality images.
10. Keep enough space for ancillary staff that facilitate the surgery to heal the sinusitis symptoms.