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| Name | Bloodless Dacryocystorhinostomy (DCR) Surgery |
| Video Uploader | Video From EyeTuber |
| Upload Date | This Video Uploaded At 20-04-2015 00:26:54 |
| Video Discription | Well, almost bloodless! Here are a few tricks that can be done to have a Bloodless External DCR surgery: 1) A well-relaxed patient: A mild sedative on the day of surgery helps. 2) Blood pressure: Adequate control of blood pressure 3) Blood thinners: Stop all blood thinners 5 days prior, in consultation with Internist. 4) Good local anaesthesia (Xylocaine with adrenaline), even if you are performing it under GA 5) A slight head-up position during surgery helps prevent bleeding due to passive congestion. 6) Good nasal pack with Xylocaine and adrenaline; although I only use 3 Johnson buds. 7) Operating under surgical loupe magnification. This allows the visualization of fine blood vessels. 8) A good Monopolar and Bipolar cautery: Electrical, or Radiofrequency 9) Anatomy: There are specific locations where bleeding occurs: Orbicularis/Angular vessels/bony perforators/sac mucosa/nasal mucosa. Knowing these specific locations of bleeders will help you predict it and control it. 10) Blanching the nasal mucosa with Xylo+adrenaline injection just before the flap making (as shown in the video) helps relieve pain and allows bloodless flap. 11) Top up anaesthesia: Pain has to be controlled, to avoid the anxiety-induced rise in blood pressure. Use more local anaesthesia at specific points during surgery, or prefer GA (my personal choice). Thanks for watching. Dr Milind Naik, MD |
| Category | Education |
| Tags | Dacryocystorhinostomy (Medical Treatment) | DCR | External DCR | Bloodless Surgery | Nasolacrimal duct obstruction | Surgery (Medical Specialty) |
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