-
Video 1: Greeting the patient and marking the skin.
View More ….Highlights: This short video clip emphasizes the importance for the patient and the family to meet the surgeon on the day of surgery in this case in the pre-op area. For safety reasons, this is also the ideal time for the surgeon to review the chart and images and mark the skin for incision for the planned procedure in this case basilic vein transposition (BVT). With proper workups including physical examination and pre-operative ultrasound scanning, the authors seldom deviate from the planned surgery.
-
Video 2: Optimize patient position on the operating room table.
View More ….Highlights: This video demonstrates the importance to optimize position of the patient on the operating table to minimize the stress on the surgeon’s neck and back. This is especially important for the BVT procedure as dissection requires good exposure to the axillary area
-
Video 3. Re-marking skin in the OR after skin prepping.
View More ….Highlights: After sterile prepping in the operating room the skin marks tend to fade or disappear, and remarking is often needed. Operating style and technique vary between institutions and settings. This case represents a teaching institution where the surgeon is a 4th year surgical resident, and the assistant is the faculty. (This “hierarchy” situation becomes obvious in later video clips for the attuned observer).
-
Video 4. Skin incision
View More ….Highlights: The skin incision is best started in the upper arm towards the axilla. As the dissection is extensive meticulous hemostasis is mandatory with appropriate use of electrocautery, bipolar cautery device and suture ligation as needed.
