Fig. 6.1
Standard operating room
6.1.2 Patient Table and Apparatus
The patient table should be located in the centre of the operating room and immediately below the room lighting system. All the instruments and devices required by the anaesthesia team should be placed close to the head section of the patient table (Fig. 6.2).
Fig. 6.2
Standard anesthesia equipment
Standard surgery table: many specialists prefer a shoulder table for shoulder arthroscopy. However, it is possible to implement this procedure on a standard surgery table, but the midsection of the table must be adjustable and able to be raised mean 40–60° (Fig. 6.3). When using a standard surgery table, some additional apparatus is required to fix the patient to the table and provide a safe surgical procedure. In cases where a standard surgery table is to be used, the stage of fixing the head of the patient to the table is critical. Care and attention must be given to this stage.
Fig. 6.3
Standard surgery table
Side support bars: these are necessary to hold the patient stable on the table during the surgical procedure (Fig. 6.4).
Fig. 6.4
Side support bars
Trunk attachment belt: this is necessary to keep the patient stable on the table during the shoulder manipulation by holding the trunk during the surgical procedure (Fig. 6.5).
Fig. 6.5
Trunk attachment belt
Leg attachment belt: these are necessary to hold the patient stable on the table during the surgical procedure by binding the legs (Fig. 6.6).
Fig. 6.6
Leg attachment belt
Silicone support below the thigh and calf: by providing support below the thighs and calves during the surgical procedure, these are necessary to prevent the patient from slipping down (Fig. 6.7).
Fig. 6.7
Silicone support below the thigh and calf
Forearm holder: this is necessary to provide patient comfort when the vascular route is opened by the anaesthetist and during monitoring and fixing of the non-operated upper extremity to the table (Fig. 6.8).
Fig. 6.8
Forearm holder
Shoulder table: this is used by many specialists for shoulder arthroscopy procedures. It is assembled by removing the adjustable head section of a standard surgery table and placing a shoulder table into the grooves (Fig. 6.9a–c).
Fig. 6.9
Shoulder table
The shoulder table can comfortably accommodate the patient in a sitting position (Fig. 6.10a, b); with apparatus which can be removed, the shoulder to be operated on can be easily taken into the space (Fig. 6.11a, b), and because of the adjustable head apparatus, the patient experiences less postoperative head and neck pain, and thus the case is more comfortable for both surgeon and patient.
Fig. 6.10
The shoulder table taking into a sitting position
Fig. 6.11
Remove the back shoulder support aparatus of the shoulder table
Head holder: this is a fixed part of the shoulder table. With the head holder apparatus, the head of the patient can be distanced from the shoulder to be operated on, and the cervical region is fixed in a safer manner. The apparatus is held with loops below the chin and across the cheeks (Fig. 6.12). Thus, the head of the patient is prevented from slipping within the apparatus during shoulder manipulation in the surgical procedure.
