Surgical Instrument Tray Setup: How to Arrange the Mayo Stand and Back Table

Back table setup: the sterile inventory

The back table is the larger work surface where the main instrument set, drapes, sutures, sponges and supplies are opened and arranged. Group items by function and keep the same arrangement for each case type, for example cutting and dissection on one side, clamping and holding in the middle, retractors and suction at the far side, and sutures and needles near the nurse.

Open the sterile items in the order that the pack was prepared, follow aseptic technique, and keep the table covered only as long as needed. Consistency matters more than any specific rule: if the same nurse or a relief nurse can find every item by position, the surgical instrument set up is working.

Mayo stand setup: what goes within reach

The Mayo stand is a movable tray stand placed over the patient or close to the surgeon. It carries the instruments used constantly: scalpel, scissors, forceps, a few haemostats, needle holders and retractors for the opening phase. Keep sharps in a defined zone, with blades pointing away from the surgeon's hand and the nurse's hand.

Arrange instruments in the order they will be used and with handles toward the surgeon. Avoid overloading the tray, since both the stand's lifting capacity and the drape limit what it can hold. The Lojer electric Mayo table is offered with two worktop sizes, 700 x 500 mm and 640 x 400 mm, and its lifting capacity is 50 kg with the worktop straight and 30 kg when rotated.

• Place the scalpel and sharps in a fixed zone, away from the hand-off path.
• Put the most used instruments closest to the nurse, not the surgeon.
• Keep at least one free area for instruments returned during the case.

Instrument table arrangement by procedure phase

Think in phases: opening, dissection, haemostasis, main procedure and closure. Lay out the first-phase instruments on the Mayo stand and keep the rest on the back table in the order they will be needed. For a general surgery set, items such as kidney dishes, bowls and trays can be found in REDA's general surgery range, along with probes and needles.

Standardise set lists per procedure and share them with the whole team. A written layout diagram on the wall of the sterile corridor helps relief staff. For general set composition see the general surgery instrument set and the minor surgery set.

Counts, hand-offs and safety

Instruments, sponges and sharps are counted before the procedure, before closure of a cavity and at the end, following your hospital policy. Any change in staff should trigger a verbal count. Return used instruments to the same place on the table, so a missing one is visible at once.

For hand-offs, many hospitals use a neutral zone or a tray for sharps to avoid hand-to-hand passing. When passing, place the instrument firmly in the surgeon's palm in the position of use. Learn the names with how to learn surgical instruments, and for a refresher on grips see how to hold surgical instruments.

Choosing a Mayo stand and trays

Look at the height range, ease of movement and stable locking. A height-adjustable stand with foot control, like the Lojer one, lets the nurse change the height hands-free; its three antistatic castors with brakes allow safe movement around the room. Check worktop size against your largest tray and the stand's load limit.

Ask also about cleaning and compatibility with disinfectants used in your theatre. Beckfinity's specialists can advise on Mayo tables and instrument trays and prepare a quote; please confirm current MOHAP, DHA or DOH requirements for your facility.