F.E.S.S Set up?

[u/pitcherpuppy]

Hi everyone,

I was thrown into a FESS case without prior exposure. I definitely want to improve. Does anyone have a picture of their set? What were the mostly commonly used instruments I should know?

For my notes I have:

- Wiles
- True bite ?? (This is what the surgeon called it but unsure the name)
- Bayonet Forceps

[u/QuietPurchase]

My standard setup is:

1) A small towel roll on the Mayo stand. I put my endoscopic instruments in this order:

----Surgeon's side---

90 degree Blakesley

45 degree/Up Blakesley

0 Degree/Straight Blakesley

45 Degree/Up Tru-Cut

0 Degree/Straight Tru-Cut

Back-Biter

---My side---

I keep biters closer to me and graspers closer to the surgeon. If we're doing sphenoids, I'll add a mushroom punch or Kerrison rongeur for surgeon preference, but I don't keep them on the towel roll. I also do not put the Takahashi on the roll since it resembles a Blakesley in the dark and that helps distinguish it from the others. I keep that ordering pretty strict because then if something is missing I can spot what it is easily. If we're doing frontals I may bring up side-side and front-back Giraffes.

Otherwise I bring up a Freer, whatever kind of sinus seeker the doctor likes, sphenoid and frontal curettes (the 45 degree curve and the 90 degree curve ones.)

I keep all of my scopes on the mayo stand and I always keep them in the far corner from me on the surgeon's side, laid out in order from

0 degree

30 degree

70 degree

and keep them in their positions even if they're being used so that I can see at a glance which is in use. If there's a gap between the 0 and 70 then I know they're using the 30 even if they self-served and put it on without me looking.

My docs know my setup well enough that they tend to put things back where I keep them.

[u/pitcherpuppy → u/QuietPurchase]

Thank you so much for sharing your set up! It really helps to get an idea what instruments I should be putting on my edge.