1. what is the incision and position for and inguinal hernia
    • position is supine
    • incision is inguinal- oblique
  2. time out (5 things)
    • correct patient
    • correct site
    • correct procedure
    • correct time
    • correct dr.
  3. starting from the skin
    • hand dr. #3 knife handle to make the incision into the skin
    • have the bovie and lap ready
    • debakey and metz for the subq
    • hand retractors to the dr. assint.
    • for fascia- hand 2kochers folled by the curved mayo with rathtooth
    • hand kelly to split the muscle
  4. exposure are and when hernia is exposed
    • locate the spermatic cord, then soak the penrose in saline and hand it over with the pean to retract
    • 2kellys tent the hernia sac and cut with metz
    • blunt dissect away from organs with finger or peanuts
    • push the contents back in
    • with a pean clam @base of sac and cut out sac (or use 4kellys to tent sac
    • purse string suture with a 2-0 or 3-0
  5. continue the exposure section
    • reinforce with a prolene or surgical steel mesh
    • irragate with basotracine suntion and poole suction
  6. closing
    • peri- 2-0 sh
    • muscle and fascia 0 ct1
    • subq- 3-0 or ct-1
    • skin is dr. preference (staples most likely)
    • then dresings (abd)
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