Surgical Instruments

Transcription

1 Surgical Instruments

2 Instruments Instruments are classified by their function Cutting & Dissecting Grasping & Holding Clamping & Occluding Exposing & Retracting Suturing & Stapling Viewing Suctioning

3 Instruments Dilating & Probing Measuring Microinstruments Powered instruments

4 Cutting & Dissecting

5 Cutting & Dissecting Cutting instruments have sharp edges. They are used to dissect, incise, separate, or excise tissue. Most instrument sets will include #3 and #7 knife handles & suture, curved mayo, metz and tenotomy scissors.

6 Knife Handles Come in various widths & lengths Blades are attached by slipping the slit in the blade into the groove on the handle #7 #4 #3

7 Knife Blades Blades with numeric prefix of 1 (e.g., 10, 11, 12, 15) fit #3 or #7 handles Blades with the numeric prefix 2 (e.g., 20, 21, 22, 23, 24) fit #4 handles

8 Knife Blades #10 are used for large skin incisions #15 are used for short shallow incisions #11 are used for initial skin puncture of tiny deep incisions #10 #15 #11

9 Other Knife handles Long handles are used inside deep incisions (e.g., open abdominal cases) Beaver knifes are used for small delicate cases

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12 Scissors Blades of scissors may be straight, angled, or curved Tips may be pointed or blunt, handles may be long or short Should be used only for their intended purpose

13 Straight Mayo (Suture) Scissors

14 Bandage/Dressing Scissors

15 Tissue/Dissecting Scissors

16 Curved Mayo Scissors

17 Metzenbaum Scissors

18 Tenotomy scissors

19 Iris Scissors

20 Other cutting Instruments

21 Ronguer

22 Osteotome

23 Curette

24 Freer Elevator

25 Rasp

26 Grasping & Holding

27 Grasping & Holding These instruments are used to grasp tissue and hold it in place without injuring surrounding tissues Forceps can be ringed or the thumbed variety

28 Grasping & Holding Most instrument sets will include kocher, allis, babcock, adson, tissue, debakey forceps, sponge sticks & towel clips.

29 Forceps

30 Kocher

31 Allis

32 Babcock

33 Sponge Stick

34 Towel Clip

35 Adsons

36 Tissue

37 Ferris Smith

38 DeBakey

39 Russians

40 Clamping & Occluding

41 Clamping & Occluding These instruments are used to apply pressure Some clamps are designed to crush the structure when applied Others are noncrushing and are used to occlude or secure tissue

42 Clamping & Occluding Most instrument sets will include mosquito, crile, kelly, tonsil, peon, and right angle clamps.

43 Anatomy of a Clamp

44 Mosquito

45 Crile

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47 Kelly

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49 Tonsil

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51 Peon

52 mosquito crile kelly tonsil peon

53 Right Angle

54 Non-crushing Clamps

55 Bowel Clamp

56 Vascular Clamp

57 Bulldogs

58 Exposing and Retracting

59 Exposing and Retracting Used to pull Soft tissue and muscle aside to expose surgical site 2 types: Hand held Self retaining

60 Exposing and Retracting Most instrument sets will include small hand held, army-navy, malleable, weitlaner, and richardson retractors.

61 Hand Held Retractors

62 Skin Hooks

63 Senn

64 Cushing Vein Retractor

65 Volkman

66 Army-Navy

67 Malleable (Ribbon)

68 Richardson

69 Kelly

70 Harrington

71 Deaver

72 Self Retaining Retractors

73 Weitlaner

74 Cerebellar

75 Gelpi

76 Balfour

77 Bookwalter

78 Suturing and Stapling

79 Suturing and Stapling Needle holder sizes vary according to type of needle used Most instrument sets will have webster, crilewood, and mayo hegar type needle holders.

80 Suturing and Stapling Clip appliers place individual staples, available in reusable and disposable Disposable staplers

81 Needle Holders

82 Webster

83 Crilewood

84 Mayo Hegar

85 Castroviejo

86 Skin Stapler

87 Weck Hemoclip Applier

88 Ligaclip Applier

89 Staplers

90 Viewing

91 Viewing Surgeons can examine body cavities, hallow organs, or structures with viewing instruments Procedures may be performed through them

92 Nasal Speculum

93 Vaginal Speculums

94 Rectal Speculums

95 Rigid Endoscope

96 Laparoscopic Trocars

97 Laparoscopic Instruments

98 Thorascopic Trocars

99 Arthroscopy Cannulas

100 Cystoscopy Sheath

101 Camera & Light Cord

102 Flexible Bronchoscope

103 Flexible Ureteroscope

104 Proctoscope

105 Suctions

106 Yankauer

107 Frazier

108 Poole

109 Probes & Dilators

110 Uterine Dilators

111 Uterine Sound

112 Urethral Sounds

113 Lacrimal Duct Probe

114 Vascular Tunnelers

115 Measuring

116 Rulers

117 Depth Gauge

118 Total Hip Trials

119 Microinstruments

120 Castroviejo Needle Holder

121 Micro Scissors

122 Bishop Harman Forceps

123 Powered Instruments

124 Powered Instruments 3Types Battery powered Air powered Electric powered

125 Stryker System 5

126 Midas Rex

127 TPS System

128 Arthroscopic Shaver

129 Minor Set

130 Major Set/Lower Tray

131 Major Set/Upper Tray

132 Major Retractor Set

133 Care & Handling of Instruments

134 Handling instruments Instruments are placed firmly into the surgeon s palm in such a manner that it is ready of immediate use. Ringed instruments are handed with the box locks closed. Curved instruments are passed with the curve in the direction of intended use.

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138 To facilitate suturing the needle is secured about 1/8 inch down from the tip of the needle holder and about a third of the distance from the eye or swaged end

139 Care of Instruments During the procedure, used instruments should wiped with a damp sponge or placed in a basin of sterile distilled water.

140 Care of Instruments Do not saline on instruments. Do not allow blood to dry on instruments. Saline & blood can damage instrument surfaces causing corrosion and pitting.

141 Care of Instruments Flush suction tips with sterile distilled water periodically to keep lumens patent. Flush all lumened instruments thoroughly at the end of case to prevent blood from drying inside lumens.

142 Care of Instruments Powered hand pieces and batteries should not be immersed in liquid as this could damage internal mechanisms.