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In this paper, I have described the ways in which the surgeons do practical reasoning when they recognize and identify certain blood vessels or organ location. Because the structures of the human body configuration is fairly complicated and not identical among different persons, the recognition and identification of the structures beforehand is very important from a medical safety purpose. In order to resolve this practical problem, by using a locational formulation in a spatio-temporal way, the speakers are demonstrating their recognizing of the object here-and-now. In addition, through the gestural practices of inviting others to see and examine the same objects, the recipient’s agreement/disagreement has been also made relevant, which is also crucial for medical safety.