Draping Steps

1. Start with down sheet, 1 cm below the 10x10.

2. Place the bottom blue towel 1 cm cranial to the down sheet.

3. Position the top blue towel.

4. Place the lateral blue towel on the opposite side first with 4 cm ioban, bringing the extra ioban down onto the down drape.

5. Place the other lateral blue towel with 4 cm ioban on the surgery side, using the extra ioban for the down drape.

6. Drape with a lap drape that has circumferential pockets for irrigation, going slightly lateral to the surgery side to allow for a transforaminal approach. If also performing an interlaminar approach, ensure the midline is still visible.

7. Cover the C-arm on the opposite side.

8. Throw off suctions towards the suction machine; there will be three with tips cut off and clamps.

9. Measure suctions by placing them into the most southern part of the drape so that X-ray does not see them; clamp to towel, ensuring suction holes are not covered.

10. Cut two small holes in the cranial part of the pocket drape to feed suctions on each side through; the C-armor suction does not go through a hole.

11. Place one suction in the C-armor and one in each side of the pocket drape (three total).

12. Create a pocket for the Triggerflex on the opposite side of the surgeon on the patient’s shoulder blade.

13. Secure suctions with the right white Velcro.

14. Secure the Triggerflex and/or drill with the left Velcro.

15. Measure the Triggerflex and drill by placing the ends into the southern white Velcro or on the Mayo stand.

16. Assemble the drill:

    • Lubricate the drill bit with mineral oil.

    • Put the handpiece in the open position.

    • Connect the handpiece to the motor.

    • Twist the handpiece until it locks into place.

    • Insert the drill bit.

    • Twist the handpiece to the closed position.

    • Twist the support tube to lock it down.

    • Press the foot pedal slowly to test the drill.

17. Attach the light cord.

18. Attach a stopcock to the southernmost outflow of the scope.

19. Attach irrigation to the stopcock.

20. Prepare the scope condom for transforaminal approach:

    • Cut a small hole in the top of the condom and place it on the base; it should extend about 1 inch past the connection for the black cord.

21. White balance the camera (hold 'W') and ensure the zoom is appropriate; check the image quality.

22. Ensure the laser is on the field with a towel over the cord.

23. Place the last special clamp on the Mayo stand.

24. Cover the C-arm with a shower cap.

25. If using a retractor:

    • Attach the retractor clamp onto the clamp on the bed.

    • Position the arm of the retractor with the flat face facing out; angle the second arm at 45 degrees.