Vasectomy ring clamp (2)
Vasectomy dissector (1)
Mosquito forceps, curved (2 pair)
Mosquito forceps, straight (1 pair)
Iris scissors, straight (1 pair)
Needle driver (1 pair)
Nitrile exam gloves (1 pair)
Sterile gloves (3 pair per provider)
Sterile medium drape (3)
Suture: 4-0 vicryl (2)
Sterile towels (5 towels)
Cautery pen (1)
ChloraPrep 26 ml stick (1)
Foam tape (1 new roll)
Sterile 4x4 gauze (20)
1% lidocaine without epinephrine (1 vial with minimum 20mL remaining)
10 ml syringe (2)
18 gauge 1.5 inch needle (2)
27 gauge 1.5 inch needle (2)
15 Blade disposable scalpel (1)
Exam-room sheet (1 sheet)
Chux pads (2)
Formalin cups (2 cups)
Remove any unnecessary items from the room (stool, vitals machine)
Clean the room: wipe down all surfaces and wait the appropriate amount of contact time. Vacuum the floor.
Ensure the room temperature is set to 70 degrees Fahrenheit.
Turn on the surgical light.
Prepare a surgical tray in sterile fashion:
All sterile tools
Suture material, cautery pen, ChloraPrep stick, 10 cc syringes, 18 and 27 gauge needles (1 each)
Have all other equipment available on top of a chux pad, on top of the equipment drawers.
Check the patient in, and bring them to an exam room to review and sign the consent form. Once they have had a chance to ask any questions, bring them into the procedure room.
Make sure a chux pad is on the procedure table. Have the patient remove pants and underwear, and cover themselves with the sheet.
Have the patient apply foam tape to penis securing it against the abdomen.
Once provider enters, ensure TIMEOUT occurs.
Put on non-sterile gloves. Once provider starts, assist by elevating the scrotum while the provider sterilizes the skin with ChloraPrep. Provider will then place blue towels under and around the region, and finally cover the entire area with a a medium sterile drape to create a sterile field.