Perioperative/Perianesthesia Nursing Specialty

Surgical nurse

Perioperative and Perianesthesia Nursing at Mayo Clinic in Rochester encompasses many surgical specialties. Between Mayo Clinic's two Rochester-based hospitals (Mayo Clinic Hospital, Methodist Campus and Mayo Clinic Hospital, Saint Marys Campus), approximately 200 surgical procedures are performed daily in nearly 100 operating rooms.

Mayo Clinic has a multidisciplinary, team-oriented work environment that presents opportunities which may rarely be experienced elsewhere. The range of specialties offers a career-enhancing setting for the professional nurse.

Cardiac

Cardiac surgery provides direct patient care to patients ranging from neonates to geriatrics. Outstanding patient care is delivered through a highly integrated and cooperative effort between nursing staff, physicians and other allied health professionals.

Coronary bypass grafts, valve repairs and replacements and congenital anomaly repairs comprise the bulk of cardiac surgery procedures.

Colon and Rectal

A multidisciplinary team cares for patients undergoing colon and rectal surgeries. Patients range generally from adolescents to geriatric.

Technology used in this specialty includes digital video capture of images from laparoscopic and colonoscopic procedures, powered surgical stapling devices, ligature and harmonic scalpel.

Common procedures include: procotologic (hemorrhoidectomy, internal sphincterotomy, repair of anal fissures), laparoscopic (laparoscopic-assisted resections of the small bowel and colon) and "open" surgical procedures (total colectomy or total proctocolectomy, low anterior resection, hemicolectomy and ileal pouch anal anastomosis).

 

General Surgery

The Perioperative Teams in General Surgery care for patients requiring procedures of the neck, breast, stomach, small bowel, liver, pancreas and spleen.

Procedures include: partial or total thyroidectomy; parathyroidectomy; sentinel node biopsy with lymphoscintigraphy; breast procedures including biopsy, lumpectomy or mastectomy; gastric resection; gastric bypass procedures; hepaticojejeunostomy; distal pancreatectomy; pancreaticoduodenectomy (Whipple procedure) with Roux En Y anastomoses; splenectomy; and both anterior and posterior approach adrenalectomy. Liver resection procedures include segmentectomies and right or left hepatectomy. Laparoscopic procedures include inguinal hernia repair, cholecystectomy, splenectomy, adrenalectomy and lymph node biopsy prior to liver resection.

Gynecologic, Reproductive Endocrinology and Infertility

Staff care for patients of all ages. Technology used includes laser procedures, hysteroscopic and laparoscopic procedures with digital capture and video capability.

Reproductive Endocrinology procedures treat endometriosis, assist patients who have been unable to conceive, and are used for tubal ligation.

Gynecology procedures include dilatation and curettage, thermoablation of endometrial tissue, colposcopy, microscopic laser procedures, vaginal and total abdominal hysterectomy procedures and various procedures for urinary incontinence.

Many gynecologic procedures are used to treat malignancies. These include unilateral or bilateral salpingo-oophorectomy, radical hysterectomy, debulking for treatment of ovarian cancers, anterior or posterior pelvic exenteration with vaginal reconstruction. Some patients may be candidates for intraoperative radiation therapy.

Neurosurgery

Neurosurgery consists of 6.5 operating rooms and a Gamma Knife Suite for surgical care of adult and pediatric patients. Approximately 6,000 neurosurgical procedures and nearly 450 Gamma Knife procedures performed annually. A complement of RNs, LPNs and CSTs provide the teamwork necessary for quality surgical care.

Specialties within neurosurgery include: spine (cervical and lumbar), microvascular, stereotactic, pediatrics, tumor, pain, radiosurgery and peripheral nerve.

Orthopedics

Through interdependent, multidisciplinary teams, the orthopedic section includes the following specialties: spine; hand, foot, shoulder and elbow; pediatric and adolescent reconstruction; trauma; total joint replacements; orthopedic oncology and intraoperative radiation; adult reconstruction; arthroscopy; cast room procedures; microvascular; and sports injuries. The orthopedic area incorporates the latest technology and prosthetic implants.

Otorhinolaryngology/Oral/Ophthalmology

Staff provide highly specialized, age-specific care in a collaborative environment. Surgical procedures vary from minor outpatient procedures to major surgical procedures which incorporate advanced technologies.

Surgeries include: tonsillectomy, adenoidectomy, laryngoscopy, septoplasty, neck dissection, free flap, cochlear implants and acoustic neuroma resections.

Oral surgeries consist primarily of odontectomies, LeFort procedures and osseointegration.

Ophthalmology surgeries are generally related to muscle repair, corneal transplants, orbital decompression, phacoemulsification and dacryocystorhinostomy.

Perianesthesia

Perianesthesia nursing at Mayo Clinic specializes in the preoperative and postoperative Phase I and Phase II care of the surgical patient.

The preoperative and postoperative patient teaching and nursing interventions are focused on the needs of the surgical patient from admission to discharge. The Phase I perianesthesia setting provides specialty care for all surgical specialties with an emphasis on airway stabilization, hemodynamic monitoring, and pain and nausea management while patients recover from anesthesia. Preoperative and Phase II care focus on the preparatory and learning needs of surgical patients as they prepare for surgery and for discharge.

Plastic Surgery

Plastic surgery services are provided for patients according to their needs and age. An interdependent, multidisciplinary team approach is used to provide optimal care for each patient. The plastic surgery section specializes in the areas of cosmetic, microvascular, reconstructive and hand procedures for both outpatients and inpatients.

Thoracic/Vascular

Mayo Clinic Hospital, Saint Marys Campus provides vascular and thoracic care predominantly to adult and geriatric patient populations. This specialty uses technology such as robotics, video-assisted procedures and minimally invasive procedures.

The vascular specialties include procedures such as: abdominal aortic artery repair, peripheral bypass procedures, aortoilliac and renal bypass procedures. In collaboration with Radiology, endovascular (EVT) procedures are also performed.

Thoracic specialty procedures include thoracoscopy, laparoscopic procedures, thoracotomy with lobectomy and bronchoscopy.

Transplant Surgery

Mayo Clinic in Rochester has the largest transplant program in the United States. Types of transplants include kidney, pancreas, liver, heart, lung and cornea transplants and bone marrow harvests for autologous bone marrow transplant. The majority of transplantation surgery in surgical services involves solid organ transplants.

Transplant procedures are performed as routine, pre-listed surgical procedures and by specialty on-call teams as organs become available.

Trauma/Critical Care

Saint Marys is a Level I trauma facility. The Trauma and Critical Care Surgery service provides care for trauma, emergency abdominal and elective general surgery cases. A combination of approximately 2,700 open and laparoscopic procedures is performed annually. A multidisciplinary team approach is used to provide 24-hour coverage and optimal patient care.

Urology

Urology cares for patients in the pediatric to geriatric age groups undergoing a variety of procedures involving the kidneys, ureters, bladder, prostate, urethra and penis.

Cystoscopic procedures include cystoscopy, biopsy and fulguration of bladder lesions and transurethral resection of the prostate or localized bladder tumors. Retrograde exam of the ureters, placement of ureteral stents, and various laser procedures are also performed in conjunction with cystoscopic procedures. Transurethral needle ablation therapy is used to treat benign prostatic hypertrophy.

Procedures performed to treat prostate cancers include cryotherapy and brachytherapy procedures for localized prostate cancers, radical retropubic prostatectomy or suprapubic prostatectomy for other prostate cancers. Surgical treatments of renal tumors include partial or radical nephrectomy either as an open or laparoscopic procedure. Bladder cancers may be treated with cystoprostatectomy with creation of a urinary diversion (ileal or colonic conduit or a neobladder).

Urologic prostheses procedures include placement of inflatable penile prosthesis and placement of genitourinary sphincters.

Technologies used in this specialty include Argon beam coagulator, high-powered lasers, harmonic scalpels and robotic-assisted laparoscopic procedures.