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Rapid and simple slush preparation for hypothermic renal surgery
RAPID AND SIMPLE SLUSH PREPARATION HYPOTHERMIC WILLIAM
RENAL SURGERY
J. CROMIE,
STEVAN STREEM,
FOR
M.D.
M.D.
From the Division of Urology, Albany Medical Center, Albany, New York
In the era of intrarenal surgery, the necessity has arisen for renal vascular control with adjunctive regional hypothermia. While the intraoperative surgical techniques have evolved dramatically, the ability to produce ice slush of the proper-consistency and-in adequate volume at the appropriate time has proved cumbersome.
In most hospitals, dry ice is readily available from the clinical laboratory department. The dry ice is placed in a stainless steel basin in the operating room. A second, smaller stainless steel bowl or kidney basin is placed within the larger receptacle, surrounded and in contact with the dry ice until the inside bowl becomes “frosty” (Fig. 1A). Next, lactated Ringers or
FIGURE 1. (A) SmaUer stainless steel bowl surrounded by dry ice in larger basin Cfi‘ost will fin-m on inner basin). (B) Nor-mu1saline or lactated ringers solution poured into inner bowl. (C) Formation of ice slush in inner bowl after stirring.
When the need for a kidney splitting approach is known preoperatively, slush has been made available by freezing normal saline suitable for intravenous use for twelve to twentyfour hours. On occasion, however, the decision for an anatrophic approach is made intraoperatively. The following represents a safe, simple, and rapid method we use routinely for the production of saline slush.
UROLOGY
/ JANUARY1932
/ VOLUMEXIX,NUMBERl
normal saline is placed within the smaller bowl and stirred gently (Fig. 1B). After approximately five minutes, the formation of a delicate ice slush will be noted, very much the consistency of a “snow cone” (Fig. 1C). This procedure can be repeated as many times as required for the surgical procedure. Albany,
New York 12208 (DR. CROMIE)
85
RENAL SURGERY
J. CROMIE,
STEVAN STREEM,
FOR
M.D.
M.D.
From the Division of Urology, Albany Medical Center, Albany, New York
In the era of intrarenal surgery, the necessity has arisen for renal vascular control with adjunctive regional hypothermia. While the intraoperative surgical techniques have evolved dramatically, the ability to produce ice slush of the proper-consistency and-in adequate volume at the appropriate time has proved cumbersome.
In most hospitals, dry ice is readily available from the clinical laboratory department. The dry ice is placed in a stainless steel basin in the operating room. A second, smaller stainless steel bowl or kidney basin is placed within the larger receptacle, surrounded and in contact with the dry ice until the inside bowl becomes “frosty” (Fig. 1A). Next, lactated Ringers or
FIGURE 1. (A) SmaUer stainless steel bowl surrounded by dry ice in larger basin Cfi‘ost will fin-m on inner basin). (B) Nor-mu1saline or lactated ringers solution poured into inner bowl. (C) Formation of ice slush in inner bowl after stirring.
When the need for a kidney splitting approach is known preoperatively, slush has been made available by freezing normal saline suitable for intravenous use for twelve to twentyfour hours. On occasion, however, the decision for an anatrophic approach is made intraoperatively. The following represents a safe, simple, and rapid method we use routinely for the production of saline slush.
UROLOGY
/ JANUARY1932
/ VOLUMEXIX,NUMBERl
normal saline is placed within the smaller bowl and stirred gently (Fig. 1B). After approximately five minutes, the formation of a delicate ice slush will be noted, very much the consistency of a “snow cone” (Fig. 1C). This procedure can be repeated as many times as required for the surgical procedure. Albany,
New York 12208 (DR. CROMIE)
85