surgical instrumentation.pptx
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IMPORTANT TERMS
Atraumatic Dilation Dissection Grasping Retraction Sharp Traumatic Trocar
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CLASSIFICATION OF INSTRUMENTS
Cutting and Dissecting
Grasping and Holding
Clamping and Occluding
Exposing and Retracting
Suturing and Stapling Viewing
Suctioning and Aspirating
Dilating and Probing Measuring Accessory
Instruments Microinstrumentation
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CUTTING AND DISSECTING
•SCALPELS• Insert Blade using a HEAVY HEMOSTAT of KELLY CLAMP•No. 10 BLADE used MOST OFTEN•No. 11 Blade •No. 12 Blade •No. 15 Blade•No. 23 Blade
•KNIVES•SCISSORS•BONE Cutters and Debulking Tools•Biopsy Forceps and Punches•Curettes•Snares•Blunt Dissectors
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CUTTING AND DISSECTING
•Bone Curette
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CUTTING AND DISSECTING
•Mayo Scissors
•Metzenbaum Scissors
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CUTTING AND DISSECTING
•Suture Scissors (Blunt /Blunt)
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GRASPING & HOLDING
•Tissue Forceps•Smooth Forceps•Toothed Forceps•Allis Forceps•Babcock Forceps•Stone Forceps•Tenaculums•Bone Holders
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GRASPING & HOLDING
•Rat-Toothed Tissue Forceps
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GRASPING & HOLDING
•Allis Tissue Forceps
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GRASPING & HOLDING
•Babcock Intestinal Forceps
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GRASPING & HOLDING
•Backhaus Towel Clamps
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CLAMPING & OCCLUDING
•Hemostatic Forceps•Hemostats•Crushing Clamps•Noncrushing Vascular Clamps
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CLAMPING & OCCLUDING
•Hemostatic Forceps•Hemostats•Crushing Clamps•Noncrushing Vascular Clamps- used to occlude peripheral or major blood vessels
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CLAMPING & OCCLUDING
•Pean Intestinal forceps
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CLAMPING & OCCLUDING
•Hemostatic Forceps•Hemostats•Crushing Clamps•Noncrushing Vascular Clamps
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CLAMPING & OCCLUDING
•Hemostatic Forceps•Hemostats•Crushing Clamps•Noncrushing Vascular Clamps
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EXPOSING & RETRACTING
•BALFOUR ABDOMINAL RETRACTOR
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EXPOSING & RETRACTING
•ARMY NAVY
FARABEUF Retractor
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EXPOSING & RETRACTING
•GELPI Perineal Retractor
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EXPOSING & RETRACTING
•Weitlaner Retractor
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EXPOSING & RETRACTING
•Spay Hook
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EXPOSING & RETRACTING
•Senn Retractors
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EXPOSING & RETRACTING
•Finochietto Retractor
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EXPOSING & RETRACTING
•Ribbon Retractor Click icon to add picture
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SUTURING & STAPLING
•Needle Holders•Tungsten Carbide Jaws•Crosshatched Serrations•Smooth Jaws•Staplers•Clip Appliers•Terminal End Staplers•Internal Anastomosis Staplers•End-to-End Circular Staplers
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SUTURING & STAPLING
•Terminal End Staplers•Internal Anastomosis Staplers•End-to-End Circular Staplers
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VIEWING
•Speculums•Endoscopes•Hollow Endoscopes•Lensed Endoscopes
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SUCTIONING & ASPIRATING
•Suction•Poole Abdominal Tip•Frazier Tip•Yankeur Tip•Autotransfusion•Aspiration•Trocar•Cannula
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SUCTIONING & ASPIRATING
•Suction•Poole Abdominal Tip•Frazier Tip•Yankeur Tip•Trocar•Cannula
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DILATING & PROBING
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MEASURING
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ACCESSORY INSTRUMENTS
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MICROINSTRUMENTATION
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Powered Surgical Instruments
DRILLBURRBLADEREAMERABRADER
AIR-POWEREDELECTRICALLY POWERED
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HANDLING INSTRUMENTS
•Standardized BASIC sets
•Scrub Person counts ALL instruments, sharp and sponges with the CIRCULATOR
•Handle Loose Instruments SEPARATELY
•Sort by CLASSIFICATION
•PROTECT Sharps
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Handling INSTRUMENTS during SURGERY
• Know the NAME and USE
• Handle INDIVIDUALLY
• Use for the INTENDED purpose
• Use of HAND SIGNALS
• Short INSTRUMENTS = Superficial Work
• LONG Instruments = DEEP
• PASS instruments DECISIVELY and FIRMLY
• FREE-HAND TECHNIQUE
• Watch the sterile field for LOOSE instruments
• With a MOIST, SPONGE wipe blood and organic debris from instruments using a DEMINERALIZED STERILE, DISTILLED H20
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ELECTROSURGERY
•INITIAL Incision is made by a SCALPEL
•Doubling the current increases the heat produced fourfold
•ARGON Enhanced ESU Tip is held at 60 degree angle, causing LESS Tissue Damage
•BUZZING – the process of coagulating the VESSELS
•BUZZ should not exceed more than 3 SECONDS
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LASER SURGERY
•Light amplification by stimulated emission of radiation (LASER)
•Types of LASES = ARGON, CARBON DIOXIDE, HOLMIUM, KRYPTON, NEODYMIUM, PHOSPHATE, RUBY/XENON
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PATIENT SAFETY in LASERS
Eyes and Eyelids should be adequately protected (aluminum foil, moist pads)
Antiseptics must be NONFlammable
Rectum should be packed with a MOISTENED sponge to prevent escape of METHANE gas
Anesthetic Agents should be NONCombustible
Flexible metallic or insulated silicone endotracheal tubes
Wear high filtration MASKS for CO2 laser ablation such as condylomata (Venereal warts)
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Advantages of LASERS
Precise CONTROL = ACCURATE incision
Access to HARD to REACH areas (endoscopes, rhodium reflector mirrors)
Unobstructed view of the surgical site
Minimal TRAUMA to tissues
DRY, Bloodless SURGICAL Field
Minimal THERMAL effect
Reduced RISK for INFECTION
Prompt Healing Reduced
OPERATING Time
THANK YOU
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