what happens in the operating room
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WHAT HAPPENS IN THE
OPERATING ROOM
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SURGICAL SCRUBBING
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GOWNING
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GLOVING
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PREPARING THE MAYOSTAND
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PREPARING THEINSTRUMENTS
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TOWEL CLAMP
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Towel clamp
used to maintain surgical towels and drapes in the
correct position during an operation
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hemostats straight & curved
used in almost any surgical procedure, to control
bleeding
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Allis clampUse- for Grasping. Often used for grasping soft tissue such as
breast tissue or bowel tissue
Found in minor and major packs
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Needle holder Used to hold a suturing needle for
closing wounds during suturing and
surgical procedures.
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Tissue Forceps (toothed)Use - Grasping
- Often used for grasping fascia during the closure of abdominal
surgery or for closure and suturing of large orthopedic
procedures such as total knee and total hip replacement surgery.
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TISSUE WITHOUT TEETH
• Used to hold tissue in l!"e #hen!l$in% sutu&es
• Used to %entl$ 'o(e tissues out o)
the #!$ du&in% e*lo&!to&$ su&%e&$• Used to inse&t !"+in% into o& &e'o(eo,-e"ts )&o' dee "!(ities
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Bl!dde& Ret&!"to&
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Lo!d the S"!lel #ith theBl!de
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Scalpel Holder
• Holds s"!lel ,l!de
• A"ts !s ! h!ndle
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Mets !nd M!$o
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et!enbaum "cissors
. Met/
Use . Cuttin%
. The 'ost "o''on s"isso&s use )o& "uttin% tissue0
0
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#ur$ed ayo "cissors
Use . Cuttin%
Co''on to 'ost su&%i"!l t&!$s1 used )o&"uttin% dense tissue #he&e 'et/ s"isso&s !&e
too deli"!te0
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Mayo straight Scissors or SutureScissors
Use . Cuttin%
. Gene&!l u&ose !nd sutu&e "uttin%
s"isso&s1 no&'!ll$ not used on tissue0
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B!si" Inst&u'ents
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OTHER INSTRUMENTS
• Deendin% on the t$e o) su&%e&$ to,e e&)o&'ed
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Army Navy Retractor or US Retractor
Use% Tissue o& Bone Ret&!"tion0
2ound in ,oth '!-o& !nd 'ino& o&thoedi" !nd %ene&!lsu&%e&$ t&!$s 0
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Bacoc!
Use . G&!sin%
2o& %&!sin% so)t tissue o&,o#el0
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"ea!ey Forceps or "ea!ey#sUse . G&!sin%
. One o) the 'ost "o''on su&%i"!l )o&"es1 used)o& %&!sin% so)t tissue1 ,lood (essels !nd ,o#el0
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Mi*te&
• The$ !&e 'ost )&e3uentl$ used )o&"l!'in%1 dissection1 o& %&!sin%tissue0
• Mi*te& Ri%ht An%le Forceps !&e!(!il!,le in 'ultile len%ths !ndh!(e se&&!tions the enti&e len%th o)
the -!#0
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Mayo Bodywall Retractor
Used )o& Ret&!"tion
. 2o& &e"t&!tion in l!&%e !,do'in!lsu&%e&ies0
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&dson 'ipolar Forceps
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Richardso$ Retractor
Use % used to &et&!"t dee !,do'in!l o& "hest in"isions0
A(!il!,le in 'ultile si/es !s #ell !s sin%le !nd dou,leended0 This is one o) the 'ost "o''on %ene&!lsu&%e&$ &et&!"to&s0
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'alfour retractor Used to hold oen !,do'in!lin"isions du&in% ! l!!&oto'$0
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%eitla$er sel'retai$i$gdesigned for use in the following surgical
specialties% peripheral $ascular surgery
in the carotid, subcla$ian, femoral,popliteal and tibial regions. "pinal surgery
in the cer$ical and lumbar regions.
Orthopedic surgery in shoulder and hip
procedures. General surgery for inguinal
hernia, appendectomy and many minor
procedures
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(ein retractor
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#ur$ed crile
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Curved Rochester-PeanForceps
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Te$aculum
Used to grasp and hold tissues. &lso used to hold
tissues steady for surgical procedures, to holdtissues out of the way, or to grasp tissues for the
purpose of manipulating them
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olyp orcepUsed to grasp. Used in )*# surgery
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Ute&ine !"+!%in% )o&"e
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ratt dilatorsused to widen the opening of the
cer$i+. Used in surgeries on genitalia
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"eaver
Used for etracting &$ailable in multiple widths and common to many
surgical trays for general, orthopedic and G surgery.
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Uteri$e curette
used to remo$e tissue or growths from a body
ca$ity. /his uterine curette is inserted into the
uterine ca$ity and the wall of the ca$ity is
scraped.
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Blade s!i$ lade
Used to make incision
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*elpi
Used to retract usually on a spine
surgery
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+ocher ,lamp
Used to control bleeding. 0t is straight
haemostat with interlocking teeth on the tip
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-agi$al speculum weightedUsed to retract $aginal orifice during
$aginal surgery
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Su&%i"!l inst&u'ents
Cuttin% !nd Disse"tin%
G&!sin% !nd Cl!'in%
Ret&!"tin%P&o,in% !nd Dil!tin%
C tti d Di ti
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Cutting and DissectingInstruments
• !&e sh!& !nd !&e used to "ut ,od$ tissue o&su&%i"!l sulies0
Knife Handle, Scissors(left to right)
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Scalpel Holder
• Holds s"!lel ,l!de
• A"ts !s ! h!ndle
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Scalpels and blades
• 7 handle with ! blade "deep #ni$e% . Used to"ut dee1 deli"!te tissue0
• & handle with ' blade "inside #ni$e5 6 Usedto "ut sue&7"i!l tissue0
• ( handle with )' blade "s#in #ni$e% - Used to"ut s+in0
#7, #3, #4(left to right)
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S"!lel %&is
• 2in%e&ti %&i.!l$in% do#n#!&d&essu&e )&o'
inde* )o& s+inin"ision
• Pen"il %&i.'otion
"o'es )&o' thethu', !nd inde*)o& &e"isein"isions
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Suture scissors
• Straight *a+o scissors . Used to "ut sutu&e !ndsulies0 Also +no#n !s8 Sutu&e s"isso&s0
E98 St&!i%ht M!$o s"isso&s ,ein% used to "ut sutu&e0
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Suture Scissors
Isis Sutu&e s"isso&s
Used to &e'o(e sutu&esBl!de h!s ,e!+ o& hoo+to slide unde& sutu&es
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,ister andage Scissors
Used to &e'o(e ,!nd!%es !nd d&essin%s
P&o,e ti is ,lunt: inse&ted unde& ,!nd!%es #ith&el!ti(e s!)et$
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.issue scissors
Sh!&;Sh!& S"isso&sUsed to "ut !nd disse"t tissue
Both ,l!de tis !&e sh!&
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.issue scissors
Sh!&;Blunt S"isso&s
Used to "ut !nd disse"t )!s"i! !nd 'us"leOne ,lunt ti !nd one sh!& ti
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Holding surgical instruments
• Co&&e"t use in(ol(es%&!sin% #ith thethu', !nd <.th 7n%e&1usin% the =.&d 7n%e&
)o& ,!l!n"e !nd inde*)o& o&ient!tion
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.issue scissors
Cu&(ed Blunt;BluntS"isso&s
Both ,l!de tis !&e ,lunt
C!n ,e "u&(ed o&
st&!i%ht.
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Coole$ !&te&ioto'$ s"isso&s
• Used )o&lon%itudin!l!&te&ioto'$
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/mputation instruments
• Se"i!l "uttin% inst&u'ents used in!'ut!tions )o& 'us"le !nd ,one
A'ut!tion s!#
A'ut!tion +ni)e
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/mputation instruments
• Gi%li s!#.used )o&"uttin% the ,one
• Pe&"$ !'ut!tion&et&!"to&
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0rasping1 clamping1 occluding instruments
• These ist&u'ents !&e used to %&!s1i"+ u1hold !nd '!niul!te tissues1tools !nd '!te&i!ls0
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.owel Clamp
Adds #ei%ht to d&!es !nd to#els to ensu&e the$st!$ in l!"e
Allo# e*osu&e o) the oe&!ti(e site
en%lish to#el "l!'
B!"h!us to#el "l!' S"h!edel to#el "lis
l l
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To#el Cl!'
• Do$en to#el "l!'
• En%lish to#el"l!'
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Son%e 2o&"es
Used to hold %!u/es3u!&es o& son%e to
>'o u? the su&%i"!l site @!#s !&e se&&!ted
T ) 2
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T&!ns)e& 2o&"es
When ste&ile1 t&!ns)e&
)o&"es:
• !&&!n%e ite's onste&ile t&!$
• t&!ns)e& ite's toste&ile 7eld
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Forceps
An!to'i"!l )o&"es• Used to hold tissue in l!"e #hen !l$in%
sutu&es• Used to %entl$ 'o(e tissues out o) the #!$
du&in% e*lo&!to&$ su&%e&$• Used to inse&t !"+in% into o& &e'o(e
o,-e"ts )&o' dee "!(ities
F
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Forceps
Su&%i"!l )o&"es
Used )o& %&!sin% !ndholdin% tissue1 'us"le o&s+in su&&oundin% ! #ound
Sin%le toothed on oneside: 7ts ,et#een t#oteeth on the othe& side
A(!il!,le !s * o&
*= o& =*<In"! o pensa 2na"vasculara%
2
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2o&"es
• DeB!+e$ (!s"ul!&)o&"es.used )o&deli"!te h!ndlin%o) tissue in(!s"ul!& su&%e&$
2 i
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2o&"es %&!sin%
• Pen"il %&i )o&%&!sin% !nd'!niul!tin%tissues
Cl
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Clamps
• Pean "l!' used%&!sin% (!&ioustissues !nd"l!'in% ,lood(essels0 It h!sse&&!ted ,l!des0
Cl
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Clamps
• Mos3uito
• H!lsted
Cl
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Clamps
• A 3ocher is used to %&!s he!($ tissue0 M!$!lso ,e used !s ! "l!'0 The -!#s '!$ ,est&!i%ht o& "u&(ed #ith se&&!ted ,l!des !ndinte&lo"+in% teeth !t the tis0
Cl
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Clamps
• A *iculic4 is used to %&!s he!($ tissue0 M!$!lso ,e used !s ! "l!'0 The -!#s !&e "u&(ed#ith se&&!ted ed%es onl+ on the tips !ndinte&lo"+in% teeth0
Di ti i t t
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Disse"tion inst&u'ents
• Dise"to& &i%ht!n%le "l!'5. ! de%&ee ti !n%le"l!' used )o&dissecting tissues!nd maneuveringthreads #ith
se&&!ted ,l!des
Se"i!l "l!'s
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Se"i!l "l!'s
• Museu* "l!'.)o&%&!sin% the ute&us
Se"i!l "l!'s
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Se"i!l "l!'s
• S"h&odde& B&!un.si'il!& to Museu*1)o& %$ne"olo%i"!l&o"edu&es
Se"i!l "l!'s
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Se"i!l "l!'s
• D!&ti%ue "l!'.)o& %&!sin% !nd '!neu(e& o) the
entire uterus
Se"i!l "l!'s
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Se"i!l "l!'s
• Lo(el!"e "l!'.)o&%&!sin% !nd'!neu(e& o) thelung
Special Clamps
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Special Clamps
• A Collin clamp "encoeur1 ringedgallbladder % is used)o& %&!sin% !nd
'o,ili/in% st&u"tu&es%!ll,l!dde&1 ,&e!st1he'o&&hoids5
Special Clamps
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Special Clamps
• A abcoc# is used to %&!s deli"!te tissueintestine1 )!lloi!n tu,e1 o(!&$50 A(!il!,le insho&t !nd lon% si/es0
Se"i!l "l!'s
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Se"i!l "l!'s
• Des5ardin )o&"es.)o& %&!sin% !nde*t&!"tion o) stones %!ll,l!de&1+idne$5
Se"i!l "l!'s
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Se"i!l "l!'s
• Fl!''e& st&!i%ht intestin!l"l!'.lon%itudin!lse&&!ted ,l!des
• An%led intestin!l "l!'
Hemostatic clamps
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Hemostatic clamps
Fell$ He'ost!t
Used to "l!' s'!ll (essels o& hold tissue
@!#s !&e !&ti!ll$ se&&!ted
Cu&(ed o& st&!i%ht
6ascular surger+ Hemostatic
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g +clamps
• Satins#+ "l!'s !&e desi%ned to !&ti!ll$o""lude the #!ll o) ! (essel o(e& ! dist!n"e
6ascular surger+
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g +Hemostatic clamps
• Diet&i"h ,ulldo%"l!'
• De,!+e$ (!s"ul!&"l!'
Hemostatic clamps
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Hemostatic clamps
• A hemoclip applier with hemoclips !lies'et!l "lis onto ,lood (essels !nd du"ts #hi"h#ill &e'!in o""luded0
*anual retractors
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*anual retractors
• Wol+'!n &et&!"to&.)o&&et&!"tin% the S3I ed%es!)te& initi!l in"ision
*anual retractors
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*anual retractors
• 2!&!,eu) &et&!"to&.(!&ious tissue;o&%!n&et&!"to&
• L!n%en,e"+&et&!"to&
*anual retractors
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*anual retractors
• Is&!el &et&!"to&
*anual retractors
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*anual retractors
• Allison lung &et&!"to&.)o&&et&!"tin% the lung in "!&diotho&!"i"su&%e&ies
/bdominal manualRetractors
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/bdominal manualRetractors
• Do$en !,do'in!l&et&!"to&1 it "o'esin (!&ious len%hts!nd si/es
Retractors
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Retractors
• A malleable or ribbon &et&!"to& '!nu!l5 isused to &et&!"t dee #ounds0 M!$ ,e ,ent to(!&ious sh!es0
/utostatic retractors
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/utostatic retractors
• A 8eitlaner &et&!"to& sel).&et!inin%5 is used to&et&!"t sh!llo# in"isions0
/utostatic retractors
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/utostatic retractors
• 2ino"hetto.used intho&!"oto'$
/utostatic retractors
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/utostatic retractors
• Gosset.in el(i" su&%e&$
/utostatic retractors
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/utostatic retractors
• A al$our with bladder blade sel).&et!inin%5 isused to &et&!"t #ound ed%es du&in% dee!,do'in!l &o"edu&es0
/utostatic retractors
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/utostatic retractors
• Tho'son &et&!"to&
Probing and dilating
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instruments
• Dou,le ended&o,e
• Do$en &o,e
Probing and dilatingi
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instruments
N!s!l Se"ulu'
Used to s&e!d nost&ilsdu&in% e*!'in!tion
Probing and dilatingi
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instruments
• Si's Re"t!lse"ulu'
• Anos"oe
Probing and dilatingi
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instruments
• F&istelle& (!%in!lse"ulu'
Probing and dilating
i
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instruments
V!%in!l se"ulu'Used du&in%
%$ne"olo%i"!l e*!' o&&o"edu&e
Dil!tes the oenin% o)the (!%in!l "!(it$1!llo#in% )o& inse"tion o)the (!%in! !nd "e&(i*
2!"ilit!tes !""ess )o&o,se&(!tion !ndt&e!t'ent
Suturing instruments
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Suturing instruments
• S+in "lis• Cli )o&"es
• Needle holde&s
• Sutu&e '!te&i!lsneedle !ndth&e!d5
S#in clips and *ichel clamp
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S#in clips and *ichel clamp
Needle holde&s
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Needle holde&s
M!thieu He%!& B!&!3ue&
Needle holde& %&!s
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Needle holde& %&!s
Position o) needle
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Position o) needle
• An%led !t <de%&ees
• In the 'iddle
;=.&d o) theneedle
.+pes o$ needles
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.+pes o$ needles
• H!%edon• B!ssini
• At&!u'!ti"
• Intestin!l
• St&!i%ht
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• B!ssini."uttin%ed%e1 &e%ul!&e$ed1 h!l) "i&"le
• H!%edon.'i"&o oint s!tul! "u&(ed1 &e%ul!&e$ed1 =; "i&"le
.+pes o$ needles
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+p
• Non t&!u'!ti".&ound1 t!e&oint1 d&ill ended
• Intestin!l.&ound1 t!e& oint1 &e%ul!& e$e
.+pes o$ needles
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+p
• St&!i%ht.used )o&int&!de&'i"sutu&es
eedles
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• Des"h!'s
• Re(e&din
eedles-ligature conductors
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g
• Used )o& %uidin%the needles insutu&in%1 to
!(oid othe&tissue d!'!%e
*echanical suture
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• Line!& st!le&
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Bone su&%e&$
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% $
• Chisel !nd'!llet
• Pe&ioste!l
ele(!to& 6Do$en1Se',
• Ri,."uttin%
she!&s Geit/5• Bone."uttin%
2o&"es.Lue&
• Vol+'!n "u&ette
Bone "hisel !nd '!llet
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Periosteal elevator
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• Do$en
• Se',
Rib shears
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• Geit/ &i, she!&s.)o& "uttin% &i,s intho&!"oto'$
Bone."uttin% )o&"es
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%
• Lue&
• Stille.Lue&
Curette
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• Wol+'!nn.
F&!'e& slint
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• 2le*i,le1 used )o&te'o&!&$i'o,ilis!tion