surgical instrumentation.pptx

Surgical Instrumentation

http://nursinglectures.blogspot.com

nursinglectures.blogspot.com

IMPORTANT TERMS

Atraumatic Dilation Dissection Grasping Retraction Sharp Traumatic Trocar

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

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

•Bone Curette

•Mayo Scissors

•Metzenbaum Scissors

•Suture Scissors (Blunt /Blunt)

GRASPING & HOLDING

•Tissue Forceps•Smooth Forceps•Toothed Forceps•Allis Forceps•Babcock Forceps•Stone Forceps•Tenaculums•Bone Holders

GRASPING & HOLDING

•Rat-Toothed Tissue Forceps

GRASPING & HOLDING

•Allis Tissue Forceps

GRASPING & HOLDING

•Babcock Intestinal Forceps

GRASPING & HOLDING

•Backhaus Towel Clamps

CLAMPING & OCCLUDING

•Hemostatic Forceps•Hemostats•Crushing Clamps•Noncrushing Vascular Clamps

•Hemostatic Forceps•Hemostats•Crushing Clamps•Noncrushing Vascular Clamps- used to occlude peripheral or major blood vessels

•Pean Intestinal forceps

EXPOSING & RETRACTING

•BALFOUR ABDOMINAL RETRACTOR

•ARMY NAVY

FARABEUF Retractor

•GELPI Perineal Retractor

•Weitlaner Retractor

•Spay Hook

•Senn Retractors

•Finochietto Retractor

•Ribbon Retractor Click icon to add picture

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

SUTURING & STAPLING

•Terminal End Staplers•Internal Anastomosis Staplers•End-to-End Circular Staplers

VIEWING

•Speculums•Endoscopes•Hollow Endoscopes•Lensed Endoscopes

SUCTIONING & ASPIRATING

•Suction•Poole Abdominal Tip•Frazier Tip•Yankeur Tip•Autotransfusion•Aspiration•Trocar•Cannula

SUCTIONING & ASPIRATING

•Suction•Poole Abdominal Tip•Frazier Tip•Yankeur Tip•Trocar•Cannula

DILATING & PROBING

MEASURING

ACCESSORY INSTRUMENTS

MICROINSTRUMENTATION

Powered Surgical Instruments

DRILLBURRBLADEREAMERABRADER

AIR-POWEREDELECTRICALLY POWERED

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

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

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

LASER SURGERY

•Light amplification by stimulated emission of radiation (LASER)

•Types of LASES = ARGON, CARBON DIOXIDE, HOLMIUM, KRYPTON, NEODYMIUM, PHOSPHATE, RUBY/XENON

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)

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

Free Nursing Lectureshttp://nursinglectures.blogspot.com

surgical instrumentation.pptx

hemostatic

end circular

clamping amp

exposing amp

grasping amp

suturing amp

suctioning

tip

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