As an operating room nurse, I was able to assists a couple of DIEP procedures.

A lot of people undergo this procedure and they are wondering on what really happens during the entire operation.

In this post, I will share with you the entire process on the nurses side of the surgery.

HOW NURSES PREPARE FOR THE DIEP SURGERY?

On the day of the procedure, we do an early team brief. Afterwards, we started opening all the needed instruments, equipment and consumables.

There are two scrub nurses during this procedure.

One will scrub in the bottom part where the surgeon will carefully look for the perforators while the other one will scrub on the top part or where the anastomosis will happen.

While one nurses started opening some stuff, the other one will start to do surgical scrubbing so they can arranged and do a pre op counts.

There are also a lot of instruments that will be used so you should do all of those things in a fast pace.

Once the scrub nurses are settled and the whole theatre room is ready, we will then collect the patient from the admitting area.

Once the patient is in the room, the anesthetist then will do the WHO safety checklist and put her to sleep. Now, this is the part where most people are most curious about.

WHAT HAPPENS ONCE THE PATIENT IS ASLEEP?

Once she is asleep, the nurses then wheeled in there surgical trolley from the preparation area to the theatre room. We then do the WHO safety checklist.

We will then expose the area and start the skin preparation and draping while the rest of the surgical team starts doing surgical gloving and gowning.

Once everyone is settled the draping is done, the diathermy is connected. The surgeon then will tell us that we will start now the incision.

WHAT ARE THE IMPORTANT THINGS NURSES SHOULD REMEMBER WHEN ASSISTING DIEP PROCEDURES?

• When the surgeon ask you to hold the flap never let it go. If you need to prepare something tell the doctor so they can secure the flap for you.

• Liga clips are mostly used especially when they are looking for perforators make sure you load them properly.

• The most crucial time is when they will start to raise the flap. You need to make sure that you are ready during this time. Surgeons will always inform that they are about to raise the flap and if you “the nurses” are ready.

• Micro instruments are used. Make sure you clean them before you give it to the surgeon.

• Venous coupling device is one of the important instruments during the micro surgery part. Make sure that your coupler device is working .

• Asked the surgeon if they want the flap to be weigh or not so you can prepare a sterile area for the scale.

• When the surgeon is doing the micro surgery bit, their line of vision is limited so be careful when giving them the instruments.

• Let the surgeon double check the infiltrations that they you will used. This is not just for you but most of all for your patients.

• Keep all your micro instruments until the very end of the procedure. You do not know what will happen as they are suturing or closing the wound.

• Counting… Make sure you are serious with your counting. This your responsibility.

There are a lot of patient who undergoes this operation. You as a nurse, it is your responsibility to prepare for this procedure. We may not be perfect but a good preparation will result to a good flow of the operation.