Tips and Tricks on ALVO OTs  Application

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Knee operation in supine position needs specialized and safe patient positioning. The adjustable attachment used for meniscus surgery (4-09-017) with multi-position clamp and removable leg plate is a way to obtain a well-fitting and unlimited access for the surgeon. Easy support assembly and wide range adjustment reduce preparation time and – as a consequence – increase clinical safety. Anatomical patient positioning is achieved by application of gel mattresses. Correct anti-decubitus protection cannot be forgotten – always protect the head, pelvic area, and heels.

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neurosurgery.

Minimum height adjustment that Alvo Rapsodia is offering is strongly desirable in any type of neurosurgery. We’re presenting the table parked in beach chair position exposing the cervical part of the spine safely while fixing head with DORO® System and the articulated headrest is serving as a reliable hand and tooling support. Adding steep Trendelenburg position that ALVO tables are offering brings the load off the pelvis and turns the patient backside, closer to the surgeon for the ergonomic approach. The anatomical correct positioning of the arms is reached with the use of 4-09-011 ALVO Arm supports while secured with the range of cuffs and straps.

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lateral position

Deep flexion, low height and ergonomic tilt adjustment distinguishing ALVO Rapsodia 4-05 are making it highly efficient for invasive surgery in lateral position (e.g. kidney surgery). Pair of 4-09-016 side supports can be used to hold the patient’s back while 4-09-019 pubic support secures the front, targeting the pubic bone. In some circumstances, the additional operating field access around the table is required. If so, think smart, use the vacuum mattress – body geometry stays retained, but mostly – the point forces are transferred to the form of continuous support across the full length of back. Full length of distal operating table side is now to accommodate the staff and tooling.

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ophthalmological procedures

In ophthalmological procedures, it is vital to allow non-limited access to the patient’s eyes area. Ergonomic specialized headrest (4-09-040) offers optimal support and head positioning for gentle surgical interventions. Operator’s hands’ support (4-09-044) is highly recommended to provide stable and comfortable operation and reduce fatigue and increase the precision of movements. The longitudinal shift of the table top and flexible height adjustment of the Alvo operating tables improve ergonomics of surgical positioning and create the most comfortable set-up for the operator, while seated.

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Modular tabletop

Modular tabletop of the ALVO Rapsodia 4-05 is the most universal pick. Semi-back plate allows to connect upper limbs orthopedic device 4-09-046 with removable side padding for shoulder area exposure and helmet-type rest for head stabilization. Proper beach chair-executed positioning and selection of padding is to protect from negative decubitus ulcers risk. Top to be shifted from distal to proximal end taking advantage of the high longitudinal adjustment value of 42 cm for a better approach. A wide range of height adjustment makes the product the best selection for both sitting and standing surgical preferences.

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supine position for gynecology

In modified supine position for gynecology and urology procedures, to gain access to the pelvic area, patient legs are stretched on Goepel crutches or stirrups and Trendelenburg position is applied. Arms are supported with arm boards, in proper supine position. Due to Trend position, set for shoulder supports or Trendelburg set should be used. Patient limbs need to be protected from additional pressure that could occur on the edge of supports. Pelvic area needs to be protected with gel pad, lower back section needs to be lifted slightly after lower limb transfer to decrease leftover pressure in the lower back structure.

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pressure distribution in the supine position

When we talking about pressure distribution in the supine position, we simply can’t ignore correct head positioning.
Various procedures require different shapes of gel mattresses, however, all of them disperse the pressure over a bigger area.
This helps protect patient occiput area from decubitus ulcers and potential hair loss. Gel headrests could also help to hold the patient head in appropriate position and disperse extension of the cervical spine.

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heels during surgery

The most critical area of the patient body exposed to pressure ulcers during surgery is heels. A very limited volume of tissue creates a lot of pressure in this area. In the supine position, gel heel pads should be used. Proper heel pads not only distribute pressure well. They prevent foot over-rotation and over-extension of Achilles tendon & anterior talofibular ligament.
Application of flat bottom chest rolls underneath the knees prevents hyperextension of the joint.

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patient positioning

To gain access to the patient body, personnel needs to abduct the patient upper limb from the torso. When abduction is not greater than 45 degrees, arm pronation is anatomically correct. If the expected angle exceeds that value, upper limb needs to be rotated to supination, to respect joints mobility. Three points determined by shoulder, elbow, and wrist should slightly rise up. The wrist should be supported while the edge of the arm board should steer clear from the elbow, to prevent ulnar nerve compression.

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Supine position

Supine position is most common but the proper application might be an art. Today’s point of focus is the head. Use the gel padding to improve – check the spine cord curve and make sure it’s cervical part is naturally bent according to patient’s individual anatomy – it also protects the trapezius muscles and plexus cervicalis from overstretching. The U-shaped positioner is relieving the pressure off the occiput taking care of hair roots and preventing the head from rolling from the surgical table if lateral tilt is applied. Also, the longitudinal forces are now out of the sternum.

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How to prevent complications accumulation due to body heat losses?

hypothermia operating tables

During perioperative period, hypothermia poses a serious clinical problem for more than half of the patients under surgical treatment. Central body temperature drop is strongly connected to the use of anesthetics, that impairs patient’s thermoregulation abilities. Vasodilation of precapillary vessels leads to heat redistribution from central body compartment to peripheral body compartments.