Tip: Before transferring the patient to the Hana^® table, it is recommended that the patient’s feet be secured into the boots.

• Apply web roll around the foot, then self-adherent wrap (Coban™) around the upper ankle.
• With the boot liner out of the shell, position the foot inside, making sure the heel sits all the way into the liner.

Note: Each side of the liner will wrap over the top of the foot and ankle.

• Have someone hold the boot open and slide the foot into the shell, and secure the buckle straps. With a properly sized boot, the toes will be slightly exposed.
• Test the stability of the boot on the foot by holding the ankle while pulling on the boot handle.
• Position the patient on the Hana^® table in preparation for surgery.

Tip: Typically, the patient’s arms are placed roughly perpendicular outward and not over the chest.

Note: Arms placed on the chest can interfere with femoral preparation later in the procedure.

• Ensure that the patient’s legs are parallel and in neutral position by lining up the leg spars of the Hana^® table (Figure 1).
• The patient’s legs can be raised 3-5 degrees with slight internal rotation.

Note: This will work with the diving board of the Hana^® table to help reduce lumbar lordosis.

• Slight gross traction can be added to the non-operative side (patient’s left, as shown in Figure 2).

Note: This will help stabilize the pelvis around the perineal post, especially when the operative leg is manipulated throughout the procedure.

Tip: Fine traction should be off when the procedure begins, unless the patient is very tall.

Tip: If Hana^® table leg spar is in the red zone, use the extension connector to the boot.

1.    Use a clear U drape (non sterile) around the operative area and towards the foot (Figure 3). A towel wrapped over each boot reduces the chance of perforation through the curtain.

2.    Place two extra large drapes over the lower extremities starting distal to operative area. Place two large drapes across the top of the patient (Figure 4).

3.    Staple three towels around the operative area, one on each side of the incision area and one medial to the incision area (Figure 5).

4.    Apply an impervious U drape with adhesive around the operative area and extending over the legs. Apply another in the opposite direction over the head.
5.    Place a split drape with adhesive proximal and distal to the operative area.
6.    Cover exposed skin with iodine incise drape (Figure 6).
 

7.    Cut a small hole in the drape for the femoral hook lift, place the hook bracket on the lift and seal with iodine incise drape (Figure 7).

1.    Apply half the blue drape, preferably with adhesive.

2.    Cover the armboards with two quarter sheets.

3.    Apply sterile hand towels with a stapler.

4.    Cut one long ioban drape so that two-thirds can be applied over the incision site.

5.    Cover the patient with a shower curtain drape.

6.    Take the remaining one-third ioban drape and cover the base of the table hook. Place the table hook over the drape.

Note: The OR is set up such that the instruments are on the operative side of the patient.

• Generally, the use of 2 back tables (A), 1 Mayo stand (B) and 1 basin stand (C) is sufficient, creating an L-shaped area.
• The C-Arm (D) is positioned on the non-operative side, perpendicular to the patient (Figure 8).
• A typical OR team will consist of the surgeon, physician’s assistant, anesthesiologist, scrub nurse, circulating nurse/table operator and X-ray technician.