Functional Endoscopic Sinus Surgery (FESS) Set Up
It’s been a few years (literally) since I have scrubbed a FESS, I’ve typically been the circulator- see my ‘easy’ RN FESS Set up here. Well, assignments changed and I ended up scrubbing the case. It was scheduled as a straightforward FESS, no septoplasty, no turbinectomy, no balloon dilation. Easy, right? Yes, but it took me a bit to remember which instruments this surgeon wanted, and after I completed the set up- I went and ‘phoned a friend’ to check my set-up. I had a few too many things, and was surprisingly only missing one instrument! I was pretty shocked honestly. So, for this, I’ll share what I started with, and what I actually needed.
FESS Mayo Stand Set Up
Top: Left to Right
left, straight & right scissors
left & right backbiters
straight & up biters
Ferris-Smith Fragment forceps (not the same as Ferris-Smith Tissue Forceps)
Gruenwald forceps
Middle: trackable suction, with tracking wire (blue) attached, Kerrison (up, medium), various nasal speculums
Bottom: ball probe, seeker, raytecs
*NOT MY MAYO STAND
After I had another scrub check my set-up, I ended up removing the scissors, the speculums, and the seeker. My tray felt empty! I added one instrument, which was a frontal curette.
The picture to the right is the mayo stand set up of the surgical tech that trained me in ENT— BIG difference? There is a handful of instruments on this persons set up that were for a septoplasty which I did not need (until later in the case when he added a septo to the procedure). The surgical tech that trained me in ENT was also a nurse and was the most knowledgeable CST/RN— if you had an instrument question, she had the answer. If you needed help with just about anything, she was your resource. I learned SO much from her and I am thankful to have had her guidance!
Also, notice all that tape??? Yikes.
FESS Back Table Set Up
Trays: Sinus pan, Nose pan, surgeon specific specials (cobra, giraffe, frontal sinus instruments)
Tray: Pitcher with two 20cc syringes and blunt hypos for irrigation, raytecs, kidney basin with trackable suctions, back of tray- various unused forceps, front of tray- various Kerrisons
Needle box, #15 blade on long knife handle (comes in pack, didn’t need for FESS, but luckily had it ready when he added a septo), 2 markers, 2 trackable pointers, 0 and 30 degree scope with endoscrub sheath and tubing, ½” x 2” cottonoids, ½“ x 3” cottonoids, gown and gloves
Not pictured: Ring stand basin- camera, light cord, microdebrider with 4mm tricut blade, suction tubing x 2, 2 sticky velcro cord organizers (we call them a ‘strip-t’, but I’m not sure if that’s their actual name). Split drape, 3 towels.
As I mentioned early on, we ended up adding a septoplasty to this procedure after we started, luckily I had everything already that was needed except for Doyle splints and the suture which were both already in the room! Here is my septoplasty set up.
