Monitor Patient for Immediate Post-Op Complications
15
Instruct patient on Post-Op Care
16
Schedule Follow-Up Appointment
17
Document Procedure in Patient's Medical Record
Obtain Patient Consent
Ensure that the patient gives their informed consent to undergo the dacryocystorhinostomy procedure. Clearly explain the risks, benefits, and alternatives to the procedure. Emphasize the potential relief from chronic tearing and the improved tear drainage that the procedure aims to achieve. Address any questions or concerns the patient may have and provide them with the necessary consent forms. Make sure the patient understands the procedure and what to expect before proceeding.
Arrange for Anaesthesia
Coordinate with the anesthesiologist to administer the appropriate anesthesia for the dacryocystorhinostomy procedure. Consider the patient's medical history, allergies, and any potential risks. Ensure that the patient is prepared for anesthesia by following the pre-anesthesia guidelines. Communicate any specific instructions or considerations to the anesthesiologist.
1
General Anesthesia
2
Local Anesthesia
3
Regional Anesthesia
4
Monitored Anesthesia Care
Apply Sterile Drapes and Prep Operative Site
Prepare the patient's surgical site for the dacryocystorhinostomy procedure. Use sterile drapes to ensure a clean and controlled environment. Follow standard protocols for prepping the surgical area, which may include scrubbing, shaving, and applying antiseptic solutions. Take special care to maintain a sterile field throughout the process.
1
Clean the surgical site with antiseptic solution
2
Place sterile drapes around the site
3
Ensure proper lighting and exposure
4
Verify surgical instruments and supplies
5
Confirm patient identification
Perform Lacrimal Sac Puncture with Trocar
Using a trocar, puncture the lacrimal sac to access the nasal cavity. This step allows for drainage and clearance of the blocked tear duct.
Confirm Access to Nasal Cavity
Ensure that access to the nasal cavity has been successfully achieved after puncturing the lacrimal sac. This step is crucial for the subsequent steps of the dacryocystorhinostomy procedure.
1
Access confirmed
2
Access not achieved
Approval: Access Verification
Will be submitted for approval:
Confirm Access to Nasal Cavity
Will be submitted
Insert Stent through Lacrimal Duct
Insert a stent through the lacrimal duct into the nasal cavity. The stent helps in maintaining the integrity of the newly created connection between the lacrimal sac and the nasal cavity.
Secure Stent in Place
Ensure that the stent inserted into the lacrimal duct is securely in place to prevent displacement or accidental removal. This step promotes proper healing and function of the newly created passage.
Create Surgical Flap on Lacrimal Sac
Create a surgical flap on the lacrimal sac to facilitate its attachment to the nasal mucosa. This step aims to ensure a secure and stable connection for proper tear drainage.
Suture the Lacrimal Sac to the Nasal Mucosa
Suture the lacrimal sac to the nasal mucosa, firmly anchoring it in place. This step promotes proper alignment and prevents complications such as leakage or displacement.
1
Absorbable sutures
2
Non-absorbable sutures
Remove Excess Bone in Nasal Cavity
Carefully remove any excess bone that may obstruct the newly created pathway in the nasal cavity. This step ensures clear passage for tear drainage.
1
Burr
2
Rongeur
3
Chisel
4
Osteotome
5
None
Position Patient for Post-Op Imaging
Position the patient appropriately for post-operative imaging, such as X-rays or CT scans. These imaging studies help in assessing the success of the dacryocystorhinostomy procedure.
1
X-ray
2
CT scan
3
Both
4
None
Approval: Post-Op Imaging Check
Will be submitted for approval:
Position Patient for Post-Op Imaging
Will be submitted
Monitor Patient for Immediate Post-Op Complications
After the completion of the dacryocystorhinostomy procedure, closely monitor the patient for any immediate post-operative complications. Promptly address any issues to ensure proper healing and patient well-being.
1
Pain assessment
2
Bleeding
3
Infection signs
4
Swelling evaluation
5
Eye movement evaluation
Instruct patient on Post-Op Care
Provide the patient with detailed instructions on post-operative care following the dacryocystorhinostomy procedure. Thoroughly explain how to care for the surgical site, manage pain, and recognize signs of complications.
Schedule Follow-Up Appointment
Arrange a follow-up appointment with the patient to assess the progress of the dacryocystorhinostomy procedure and address any concerns. This step ensures proper post-operative management and optimal outcomes.
Document Procedure in Patient's Medical Record
Accurately document the details of the dacryocystorhinostomy procedure in the patient's medical record. Include information such as the date, surgical techniques used, complications encountered, and post-operative instructions.
