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Employees August 10, 2009

Nurses play key role in groundbreaking surgery

Nurses played a key role in a new, groundbreaking procedure at Yale-New Haven Hospital that many surgeons consider to be the next frontier in minimally invasive surgery. YNHH was the first hospital in the United States to perform an appendectomy with no abdominal incision, removing a patient’s appendix through a small incision in her vagina.

In advance of the first case, perioperative nurses worked closely with surgeon Kurt Roberts, MD, to develop procedural steps and a surgeon’s "menu," the preference sheet containing comprehensive information about supplies, equipment, medications and care instructions.

Nurses helped determine the protocol and assisted in mock surgery to identify issues. About 16 nurses supported the actual procedure in various roles from pre-op through post-op. The operation is the latest advance in a growing surgical field called natural orifice transluminal endoscopic surgery (NOTES), in which surgery is performed through the body’s natural openings. It is also an example of how new, minimally invasive surgeries are challenging staff at all levels.

"The need for nurses to possess strong technical skills in this current healthcare environment is critical to supporting innovation," said Ena Williams, RN, director of nursing, Perioperative Services. "When combined with strong clinical expertise, these skills can make a difference in the success of a patient’s procedure and ultimate recovery."

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