Figure 1410

After the induction of anesthesia, the anesthesia team places a double- or triple-lumen central venous access catheter, usually via the internal jugular vein. While that is taking place, the surgical team places a retention catheter (usually 20F with a 5-mL balloon), fills the bladder to 30 cm H2 pressure or 250 mL (whichever occurs first), connects the catheter to a three-way system or clamped urinary drainage system, and places the clamp(s) within reach of the anesthesiologist for control during the operation. The preoperative antibiotic is administered by the anesthesia team. The surgical team shaves both sides of the patient's abdomen from just above the umbilicus to the distal edge of the mons pubis. The skin is wiped with alcohol, and the nursing team completes the skin preparation. The skin over both iliac fossae is prepared in the event an unexpected vascular contraindication is detected on the chosen side. If immunosuppressant therapy has not been administered, the anesthesia team begins that protocol.

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