Tuesday, December 27, 2016

General Surgery instruments special instruments 1








Special Instruments
To obtain tissue for histopathologic examination is an important part of a surgeon’s functions. Scrappings from cavities are obtained by Volkmann Scoop and Sims uterine curetMenghini needle and Silverman needle obtain access through unbroken skin and Walton rectal biopsy forceps and Chevalier Jackson biopsy forceps are for obtaining biopsy material under vision through proctoscope or a sigmoidoscope
     Biopsy instruments are used for obtaining material for histologic examination and those in use are:
•   Volkmann’s scoop  
•   Sim’s uterine curet  
•   Menghini needle  
•   Silverman needle  
•   Chevalier-Jackson biopsy forceps

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Sunday, December 18, 2016

General Surgery Instruments probes & dilaters






Probes and Dilators
Probes are used to gain entry to small (openings) to get information about their depth, direction and size; they are usually blunt ended. 
Dilators are used to investigate the patency and dilate hollow tubular passages. 
     Infection trauma and surgical accidents can result in healing by second intention in hollow organs this result in strictures. 
     In the past these strictures have been treated by dilatation. 
     The dilators have been made of metal or gum elastic. The agreed gauge has been utilized to ensure uniform size in all the sets. 
     This also helps the surgeon to choose the correct sized dilator. As dilatations are done gradually over a period of the time, the surgeon records the degree of dilatation achieved so as to start at the next level on the subsequent attendance. 
     Corticosteroids can also be used to minimum edema and fibrosis. 
     The dilators in use are:
     •   Lister 
     •   Clutton 
     •   Tuner-Warwick  
     •   Canny Ryall bougie 
     •   Jackson esophageal bougie  
     •   Neoplex  
     •   Bake’s bile duct 

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Wednesday, December 14, 2016

Genral surgery instruments skin hook retrators





Skin-Hooks and Retractors
Examples are:
•       Gillies skin hook
•       McIndoe skin hook
•       Kilner’s skin retractor
•       Alms skin retractor

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Wednesday, December 7, 2016

Geraral Surgery Instruments Self retaining retractors




Self-retaining retractors, i.e. Travers, Norfolk, Norwich, Balfours, Alms and Jolls have atleast two blades joined by a hinge joint or bar. It is thus possible to create lateral pressure against both margins of the wound. This helps to retain the retractor in position throughout the duration of the operation. 
         Thus freeing the hands of the assistant for assisting the surgeon in other ways. 
         Examples are:
         •       Travers (Fig. 8.98) 
         •       Norfolk (Fig. 8.99) 
         •       Balfour abdominal (Fig. 8.100) 
         •       Joll thyroid (Fig. 8.101).

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Thursday, December 1, 2016

Genral SURGERY INSTRUMENTS WOUND RETRACTORS








Wound Retractors
Good exposure is one of the requisites of successful surgery. Instruments designed specifically to improve exposure are called wound retractors. They can be hand-held or self-retaining. 
         The handle of the retractor is held by the assistant the retracting end is usually at a right angle to this. It smooth rounded with no sharp corner or edges to avoid injury to the tissues. The use of the retractor can be estimated from the depth to which this retracting end can go. 
         The varieties in use are: 
         •       Langenbeck  
         •       Ollier  
         •       Morris  
         •       Kelly  
         •       Deaver  
         •       Lloyd Davies  
         •       Czerny  
         •       Allison lung

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Tuesday, November 22, 2016

General Surgery Instruments Catheters & drains




Catheters
The Foley catheter is a plastic two-lumen tube with an inflatable balloon. The balloon is inflated via a small channel.
     Suprapubic cystostomy is an alternative way of draining the urinary bladder. The Malecot catheter is well suited for this purpose. It is a rubber or latex tube with two wings at the tip. The de Pezzer catheter is based on a similar principle except that instead of wings, it has a bulbous end which can be straightened and recoils back when the wire introducer is removed.
     The catheters used are:
        Foley 
        Gibbons 
        Malecot 
        DePezzer 
        Tiemann 
        Secured tube drains 

        Corrugated

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Wednesday, November 16, 2016

General Surgery Tubes 2


Nasogastric
Tubes may have to be passed into the stomach, or even beyond, for decompression, sampling or delivery of drugs or food. 
         Ryle’s tube is most commonly used for decompression of the stomach following abdominal surgery or for intestinal obstruction.
         The other tubes used are:
         •       Nasogastric  
         •       Sengstaken

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Wednesday, November 9, 2016

General Surgery Tubes Catheters




Tubes and Catheters and Drains
Tubes
Without endotracheal tubes modern anesthesia would be unthinkable. The traditional tubes of the Magill pattern are made of red mineralized rubber. Except for the smallest they all have an inflatable cuff near the distal tip to protect the lower respiratory tract form soiling as well as providing an air-tight seal. Each number refers to the internal diameter of the tube in millimeters.
         All tubes in the past have been made of rubber and have been recycled in practice by autoclaving. All these instruments and nasogastric tubes are now made of nonreactive plastic material and come presterilized in packs. These tubes are all disposable and thus do not require recycling. 
         The tubes in use are:
         •       Endotracheal  
         •       Uncuffed oral endotracheal tube  
         •       Negus tracheostomy  
         •       Chevalier Jackso.

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Wednesday, November 2, 2016

General Srgery Needle straight curved cutting edge


Needles (Straight and Curved) and Sutures
Round Bodied
Cutting  Cutting edge needles have sharp edges commencing at the point and prolonged along their shafts to help them penetrate dense tough tissues such as skin or tendon. Shapes of needles are shown i.
Sutures  Sutures may be organic, synthetic or metallic in origin. Their characteristics and indications are discussed in detail

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Wednesday, October 26, 2016

General Surgert Needle Holders






Needle Holders
Needle holders are modified box-lock forceps designed to hold curved needles. The surgeon should thus be able to manipulate the needle with ease during suturing near the surface (short needle holders) or at a depth (long).
     Since the function of needle holders is to grasp needles the instruments look like artery forceps:
1.  Serration at the tips to prevent slipping of needle.
2.  Shafts with rings for thumb and fingers.
3.  Locking device.
     Fine needle holders are damaged by large needles and small needles are damaged by large needle holders. The varieties in use are:
   Mayo needle holder 
   Gillies needle holder 
   Naunton Morgan needle holder 
   Kilner needle holder 
   Mayo-Hegar needle holder 
•   Microvascular (Doious) needle holder 

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