Tag Archives: Preoperative

PUBLISHED: Male Foley Catheter Placement and Removal for Surgery

Male Foley Catheter Placement and Removal for Surgery
Bel Capati, RNShirin Towfigh, MD
Beverly Hills Hernia Center

Foley catheter insertion is a fundamental medical procedure that is routinely performed across a wide range of clinical specialties. The placement of a Foley catheter remains one of the most commonly executed interventions in the field of medicine. Foley catheter placement is a common medical procedure performed to assist in bladder drainage and management. This procedure is indicated for a variety of reasons, including the need to monitor urine output during surgery, the management of urinary retention or incontinence, and the facilitation of accurate measurement of urine output in critically ill patients.

The procedure is often performed before surgical interventions to ensure the bladder is emptied, reducing the risk of complications such as bladder distension or injury during the operation. Foley catheterization is a critical component of the care provided to patients undergoing surgical interventions. The procedure requires careful attention to detail and the implementation of proper sterile techniques to ensure patient safety and optimal outcomes. This video provides a step-by-step demonstration of Foley catheterization in a male patient, highlighting the importance of this procedure for medical personnel.

PUBLISHED: Cystoscopy and Placement of Ureteral Stents: Preoperative for HIPEC Surgery

Cystoscopy and Placement of Ureteral Stents: Preoperative for HIPEC Surgery
Francis McGovern, MD
Massachusetts General Hospital

This video provides a comprehensive overview of the prophylactic ureteral stenting and cystoscopy performed on a patient with advanced metastases of appendiceal cancer who is scheduled for cytoreduction and hyperthermic intraperitoneal chemotherapy. The video focuses on urethral instrumentation, identification of ureteral orifices, stent placement, and subsequent bladder inspection. The patient’s preoperative evaluation had revealed no evidence of ureteral involvement with the tumor.

The cystoscopic technique employed in this case allowed the surgeons to visualize the bulbar urethra, sphincter, and prostatic urethra, illustrating the step-by-step process of advancing into the bladder. Next, the vesical trigone is identified, aiding in the visualization of the ureteral orifices. The careful placement of stents into both ureters is demonstrated. No resistance was encountered in the process of stent placement, suggesting no involvement of the ureters with the tumor. A thorough bladder inspection revealed no unusual findings such as abnormal lesions, masses, or other pathology. The stents were secured with silk sutures to prevent inadvertent dislodgement.

PUBLISHED: Epidural at T9-T10: Preoperative for HIPEC Surgery

Epidural at T9-T10: Preoperative for HIPEC Surgery
Xiaodong Bao, MD, PhD
Massachusetts General Hospital

Heated Intraperitoneal Chemotherapy (HIPEC) coupled with cytoreduction is increasingly being used to treat isolated peritoneal dissemination of intra-abdominal malignancies. Cytoreductive surgery (CRS) is initially performed using either a conventional open or laparoscopic approach. CRS includes removal of the main tumor, excision of any other visible tumors, peritonectomy, omentectomy, and intestinal resections, if necessary. Following CRS, a chemotherapeutic solution is administered at a temperature of 40 to 41.5 °C. Infusing chemotherapy immediately following CRS facilitates a uniform distribution of the solution throughout the entire peritoneal cavity. This strategy prevents localized spread that may arise from postoperative adhesion formation, ensuring that peritoneal surfaces are exposed to a concentrated chemotherapy dose while minimizing systemic toxicity.

Epidural analgesia provides effective pain management and is generally well tolerated by patients undergoing CRS in conjunction with HIPEC. This video provides a comprehensive step-by-step demonstration of the entire procedure. The epidural injection involves the delivery of anesthetic solution to the epidural space surrounding the spinal cord within the vertebral column, inducing anesthesia in the spinal segments below the site of catheter placement.