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7/25/2019 Basic Surgical Instruments Gk
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Surgical Instrumentation
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IMPORTANT TERMS
• Atraumatic• without trauma
• Traumatic•
Causing Injury by penetration or crushing• Dilation
• Enlarging an opening in a progressive manner
•
Dissection• Process of separating tissues through anatomic
planes by using sharp or blunt instrumentation
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IMPORTANT TERMS
• Grasping• Holing in a traumatic or atraumatic manner
• !etraction•
stabili"ing a tissue layer in a safe position fore#posure of a part
• $harp• Instrument with a cutting ege or pointe tip%s& that
is use to cut or issect tissue
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IMPORTANT TERMS
• Trocar • A evice use for penetration of tissue layers' It is
commonly use for percutaneous enoscopy' It is
use as a temporary pathway for gases( other
instrumentation( or the removal of an organ orsubstance'
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CLASSIFICATION OF
INSTRUMENTS• Cutting anDissecting
• Grasping an Holing
• Clamping an
)ccluing
• E#posing an
!etracting
• $uturing an $tapling• *iewing
• $uctioning an Aspirating
• Dilating an Probing
• +easuring
• Accessory
Instruments
• +icroinstrumentation
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CUTTING AND
DISSECTING
,SCALPELS, Insert -lae using a HEAVY
HEMOSTAT of KELLY CLAMP,.o' /0 -1ADE use +)$T
)2TE.,.o' // -lae,.o' /3 -lae,.o' /4 -lae,.o' 35 -lae
,6.I*E$,$CI$$)!$,-).E Cutters an Debul7ing
Tools,-iopsy 2orceps an Punches
,Curettes,$nares,-lunt Dissectors
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• $calpels %isposable& Av'6nives%reusable&( )rtho( G$( Amputation
• Hanle 8 9 -lae 30:38 %$I;E$&
•-lae 30 9 Initial for $6I. 7nife
• -lae /0 9 most common
• -lae // 9 *ascular( To puncture Aorta( To cut
bloo vessel
• -lae /3 9 EE.T( Tonsilectomy
• -lae /4 9 Plastic( Peia
• -one Cutters 9 to Cut !I-$( TH)!AC)T)+<
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CUTTING AND
DISSECTING
•Bone Curette• used by )rtho( .euro
$urgeon for
1aminectomy
•+aybe straight or
angulate%spine surgery&
1aminectomy 9 1amina
removing of
intervertebral is7( to
remove tissues( ebris(
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CUTTING AND
DISSECTING
•Mayo Scissors•Tough tissues(
curve mayo( ob:
gyn%to cut
ligaments&
•Metzenbaum
Scissors
•elicate tissues(Plastic surgeon(
Intestine( elicate
tissue
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CUTTING AND
DISSECTING
•Suture ScissorsB!unt "B!unt#
•.ursing $cissor 9 -lunt=Pointe
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GRASPING &
OLDING
•Tissue $orce%s•Smoot& $orce%s
•Toot&ed $orce%s
•A!!is $orce%s
•Babcoc' $orce%s
•Stone $orce%s
•Tenacu!ums
•Bone Ho!ders
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GRASPING &
OLDING
•(at)Toot&ed Tissue $orce%s•General $urgery $7in
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GRASPING &
OLDING
•A!!is Tissue$orce%s
•To grasp )-
tissues
%atraumatic& ( APrepair
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GRASPING &
OLDING
•Babcoc' *ntestina! $orce%s
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GRASPING &
OLDING
•Bac'&aus To+e! C!am%s•Towel clips on the eges of
rapes( hie the towel clamps
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CLAMPING &
OCCLUDING
•Hemostatic 2orceps•Hemostats
•Crushing Clamps
•.oncrushing *ascular Clamps
+ost commonly use( to clamp
bloo vessels
6ocher an )schner forceps
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CLAMPING &
OCCLUDING
•Pean Intestinal forceps•Intestinal = serrations is hori"ontal
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CLAMPING &
OCCLUDING
•Hemostatic 2orceps•Hemostats
•Crushing Clamps
•.oncrushing *ascular Clamps
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CLAMPING &
OCCLUDING
•Hemostatic 2orceps•Hemostats
•Crushing Clamps
•.oncrushing *ascular Clamps
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E!POSING &
RETRACTING
•-A12)>! A-D)+I.A1
!ET!ACT)!,1aparotomy
,!etractors assist inthe visuali"ation of
the operative fiel
while preventing
trauma to other
tissues
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E!POSING &
RETRACTING
• A!+< .A*<
2A!A-E>2 !etractor
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E!POSING &
RETRACTING
•GE1PI Perineal!etractor
,$elf retraining
,-iopsy ( $7in
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E!POSING &
RETRACTING
•?eitlaner !etractor
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E!POSING &
RETRACTING
•$pay Hoo7•-one hoo7( s7in
hoo7( to retract s7in
eges uring a wie
flap issection( such
as a face:lift or
mastectomy'
$ome have styles of
hoo7s that have ball
tips( which causesless trauma to tissues
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E!POSING &
RETRACTING
•
$enn !etractors
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E!POSING &
RETRACTING
•2inochietto!etractor
•2or sternotomy (
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SUTURING &
STAPLING
•
.eele Holers•Tungsten Carbie @aws
•Crosshatche $errations
•$mooth @aws
•$taplers
•Clip Appliers
•Terminal En $taplers
•Internal Anastomosis $taplers
•En:to:En Circular $taplers
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SUTURING &
STAPLING
A neele holer shoul not beplace on a magnetic pa( because
it may become magneti"e'
Tungsten Carbie jaws 9 eliminate
the twisting an turning of the
neele
Crosshatching 9 provies a
smoother surface an prevents
amage to the neele
$mooth jaws 9 use with small
neeles such as those use for
plastic surgery
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SUTURING &
STAPLING
•
Terminal En $taplers•Internal Anastomosis $taplers
•En:to:En Circular $taplers
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"IE#ING
•
$peculums•Enoscopes
•Hollow Enoscopes
•permits viewing in a forwar
irection( with a light carrier
supplie by a fiberoptic cable
provies illumination
•1ense Enoscopes•have either rigi or fle#ible
sheaths( use in combination with
vieo assiste technology( can
recor action vieos an still igital
photography
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SUCTIONING &
ASPIRATING
•
$uction•$uction evices remove bloo an
other fluis from a surgical or
ental operative fiel'
•>se in abominal laparatomy or
within a cavity with copious
amounts of flui' The outer filter
shiel prevents the ajacent
tissues from being suctione in to
the apparatus'
•Poole Abominal Tip
•2ra"ier Tip
•<an7eur Tip
• Autotransfusion• Aspiration
•Trocar
•Cannula
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SUCTIONING &
ASPIRATING
•$uction•Poole Abominal Tip
•2ra"ier Tip : for brain(
spinal( plastic( or
orthopeic proceures(
use when encountering
little or no flui
•<an7eur Tip :$tanar tip
for suctioning' Has an
angle for mouth an throat(
also useful for visuali"ation
of rupture aneurysm•Trocar
•Cannula
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DILATING & PRO$ING
Probing instruments areuse to enter natural
openings( such as the
common bile uct( or
fistulas
Dilating instrumentse#pan the si"e of an
opening( such as the
urethra or cervical os
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MEASURING
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ACCESSOR%
INSTRUMENTS
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MICROINSTRUMENTATION
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Poere' Surgical
Instruments
DRILLBURR
BLADE
REAMER
ABRADER
AIR-POWERED
ELECTRICALLY
POWERED
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HANDLING
INSTRUMENTS
•StandardizedBASIC sets
•Scrub Personcounts ALL
instruments, sharpand sponges withthe CIRCULATOR
•Hande Loose
InstrumentsSEPARATELY
•Sort b!
CLASSIFICATION
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an'ling INSTRUMENTS 'uring SURGER%
•"now the NAME and USE
• Hande INDIVIDUALLY
• Use #or the INTENDED
purpose
• Use o# HAND SIGNALS
• Short INSTRUMENTS $Super%cia &or'
• LONG Instruments $ DEEP
• PASS instrumentsDECISIVELY and FIRMLY
• FREE-HAND TECHNIQUE
• &atch the sterie %ed #orLOOSE instruments
•&ith a MOIST, SPONGEwipe bood and organicdebris #rom instrumentsusing a DEMINERALIED
STERILE, DISTILLED H!"
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an'ling INSTRUMENTS 'uring SURGER%
•
Instruments are maintaine an sterili"e priorto use'
• $urgical instruments must be 7ept clean uring
a proceure' This is accomplishe by carefully
wiping them with a moist sponge an rinsingthem freuently in sterile water' Perioic
cleaning uring the proceure prevents bloo
an other tissues from harening an becoming
trappe on the surface of an instrument'
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ELECTROSURGER%
,*,*T*AL Incision is mae bya SCALPEL
,Doubling the current
increases the heat prouce
fourfol
,A(-O, Enhance E$> Tip
is hel at B0 egree angle(
causing 1E$$ Tissue
Damage
,B.//*,- 9 the process ofcoagulating the *E$$E1$
,B.// shoul not e#cee
more than 0 SECO,1S
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Electrosurger( )recautions
•
E$> shoul not -E >$ED in the mouth( trachea(aroun the HEAD( or in the pleural cavity
• ECG electroes shoul be place as far as
possible( ->!.$ can occur
• !ings an jewelry shoul be remove
• D).T >$E 2lammable agents
• D) not immerse an active electroe in liui
• D!< $ponges can IG.ITE• Investigate a repeate reuest for more current
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LASER SURGER%
• 1ight amplification by stimulate emission of
raiation %1A$E!&
• Types of 1A$E!$ A!G).( CA!-).
DI)IDE( H)1+I>+( 6!<PT).(
.E)D<+I>+( PH)$PHATE( !>-<=E.).
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PATIENT SAFET% in LASERS
Eyes an Eyelis shoulbe aeuately protecte
%aluminum foil( moist
pas&
Antiseptics must be.).2lammable
!ectum shoul be
pac7e with a+)I$TE.ED sponge to
prevent escape of
+ETHA.E gas
Anesthetic Agents shoulbe .).Combustible
2le#ible metallic or
insulate silicone
enotracheal tubes
?ear high filtration
+A$6$ for C)3 laser
ablation such asconylomata %*enereal
warts&
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A'*antages o+ LASERS
Precise C).T!)1 ACC>!ATE incision Access to HA!D to
!EACH areas
%enoscopes(rhoium reflector
mirrors&>nobstructe view of
the surgical site
+inimal T!A>+A totissuesD!<( -looless
$>!GICA1 2iel
+inimal THE!+A1effect
!euce !I$6 for
I.2ECTI).
Prompt Healing!euce
)PE!ATI.G Time