Post on 14-Nov-2014
description
ن�ك�م� م� ن�وا آم ال�ذ�ين الل�ه� ع� ف ير�ات� ج در ال�ع�ل�م أ�وت�وا ال�ذ�ين وب�ير خ ل�ون تع�م ا ب�م الل�ه� "و
الرحمن الله بسمالرحيم
الله صدقالعظيم
آية المجادلةسورة 11رقم
انقطع آدم ابن مات إذاصدقة ثالث من إال عمله
به أوجاريه ينتفع أو علمله يدعو صالح ولد
الله صلى الله رسول قالوسلم عليه
الله صلى الله رسول صدقوسلم علية
/. جمال. د اموسى الهضمى ابراهيم الجهاز جراحة أستاذ
والمناظيرطنطا جامعة الطب كلية
د إعدا
1-Mosquito forceps:
Used for:
Haemostasis,
in catching of small vessel as, subcutaneous or sub-mucosal vessels before ligation or cauterization.
Blade
Shaft
Handle
Joint
Lock
Straight Curved
2- Artery forceps: •*Used for.•# Haemostasis, In catching of medium sized vessels as subcutaneous or epiploic vessels during spleenectomy before its ligation.•# Parietal peritoneum elevation before its opening in abdominal operations.
Blade
Shaft
Handle
Straight Curved
What is the difference between the Mosquito & Artery ?
3- Clamp forceps:
•Used for Haemostasis in catching of large size vessels as,• spleenic during spleenectomy & renal during nephrectomy before their ligation.
Blade
Shaft
Handle
Straight Curved
What is the difference between this instruments?
Clamp Artery Mosquito
Large Medium Small
4-Kocher
forceps:
*Used for
*Grasping tough structures as tendon, sheath or muscle.
*Crushing the base
of the appendix in appendectomy.
Lock
Teeth
Blade
Joint
Shaft
Handle
What are the differences between Artery & Kocher?
1- Length of blade.
2- Teeth.
3- Depth of serration.
5- Needle holder:
*Grasp the needle
for stitching
Blade
Shaft
Handle
What are the differences between artery and needle holder:
•1 -length of the blade in relation to shaft.
•2 -Corrugation of the blade
Artery Needle holder
Artery Needle holder
6- Moynihan
(Cholecystectomy artery:)
•Used in
Grasping the cystic vessels & cystic duct before their ligation during cholecystectomy operation.
Blade
Shaft
Handle
Curved artery Moynihan Obtuse Right
What is the difference between Moynihan and artery curve?
7- Intestinal clamps:
Grasp the intestinal loop in resection anastomosis.
A- Non crushing intestinal type )flat thin blade(
• Differ from artery in blade length in relation to shaft & Corrugation of shaft
Blade. Flat-Thin-Non crushing
Blade
Shaft
Handle
Straight or curved
B- Crushing
intestinal clamp
Intestinal clamps
C-Gastric clamp:
Joint
Blade
D-Double Gastric clamp
Gastrointestinal clamps
8-Allis forceps:
*Used for
- Catching the skin as in scalp incision, thyroid surgery
-Meso-appendix in appendectomy
-Edge of bowel in bowel anastomosis
Blade
Shaft
Handle
Blade Toothed Closed at the tip only
What are the differences between artery & Allis blade?
1 -Space after closure.
2 -Teeth on tip of Allis
Blade ) short, shallow
Depression in between.)
Artery Allis
Blade
9- Babcock forceps:
•Encircling structures as
vas and ureter.
•Catch structures as
appendix and bowel wall
Blade
Blade
Shaft
Handle
What are the differences between Allis and
Babcock
blade?
10- Towel clips:
*For grasping the edge of the towel over the patient after skin sterilization.
Pin pointed end of the blade
Blade
Shaft
Handle
* Another type of towel clips
11- Tongue grasper .
Used for traction of the tongue outwards
Blade
Blade Joint Shaft Lock Handle
1- Stone forceps
( Ureteric, biliary and Bladder):
•Used for
Stone extraction from the ureter, common bile duct and urinary bladder.
Ureteric & Billiary Bladder
Scope on
blade
Shaft
Handle
What are the differences between ureteric & bladder forceps?
2- Scissors:
Used for.
*Tissue dissection.
*Tissue cutting
*Opening peritoneum.
*Stitch removal
Tissue Stitches
Blade
Joint
Shaft
Handle
3- Bone cutting forceps.
Used for.
1- Cutting ribs.
2-Cutting small bones.
3-Circumcision.
Blade
Joint
Spring
Handle
4-Crocdyle forceps
Joint
Blade
5- Procto-scope
(Ano-scope)
Used for.
*Inspection of the anal canal & lower rectum before or during anal operations
Blade
Handle
Joint
1-Retractores:
*Retraction of the abdominal wall.
*Liver retractors.
*Retraction of viscera.
To open surgical field.A- Hand (Non-self
Retaining).
1- Skin retractors
2 -Muscle retractors:
3- Abdominal wall retractors:
4- Liver or visceral retractors:
B- Self
retaining retractors
Blades
Lock
Other types Self retaining retractors
2- Dilators:
A- Urethral
- Ureteric
- Billiary
Rounded blunt tip
Tip
Shaft
Base
B-Hegar,s dilator.
With double size end
C- Hegar (Fenton) dilator.
With one size end.
Tip Base
3 -Tissue forceps:
A- Non toothed
for catching fine structure as intestine, bladder or tube.
B- Toothed
for catching tough structure as skin, tendon or muscle.
Toothed
4- Fistulae director:
Insertion inside
•fistulae tracts before fistulotomy.
• Inside constricting hernia ring.
• Its handle )base( may used in tie tongue
Tip
Shaft (grove)
Base
5- Scalpel handle.
For scalpel insertion
6- Rib dissector:
*For separation of the rib from its bed
Encircling the rib
Handle
7-Periosteal elevator:
*For elevation of periosteum as in amputation and skull surgery.
Sharp edge
Handle
8- Aneurysm needle:
*For encircling vessel or tubular structure with a thread.
Opening for thread insertion
9- Curette spoon (Bone curette).
*Curettage for chronic ulcer, sinus or chronic osteomyelitis
Handle
Spoon
Spoon
9- Circumcision device
1 -Corrugated rubber drain:
*Advantages.
Simple, Not expensive .
*Disadvantages.
Introduce infection and we can not measure the amount of discharge.
2- Vacuum drain (Negative pressure):
*Closed system ,
not introduce infection from outside
* measure the amount of discharge .
*But may lead to
visceral injury if present intra-peritoneal by negative suction and expensive.
*Other types of drain:
--Sump drain
-- Tube drain
-* Indications of drains?
-* Time of drain removal?
3 -Fluid infusion set:
•For intravenous infusion of any fluid as glucose and saline.
•*Another type for blood with large needle and filter inside its
bulb.
Needle
Bulb
Lock
4-Blood infusion set
Needle
Bulb
Lock
What are the differences between fluid & blood infusion set ?
1- Needle
2- Filter
5-Selocet (infusion set for neonates & children)
6-Catheters:
A- Foley )self retaining(.
With double or triple ways .
Left inside the bladder for
time.
B- Nelaton. Removed after evacuation of the bladder.
C- Depezer catheter.
head
7- Rayel tube:•For gastric aspiration.
•After laparotomy
• Intestinal obstruction
• After anastomosis
Catheter
Distal )inner( end
Proximal )outer( end
Difference between Rayel and Nelaton catheter?
Vertical limb
Horizontal limb
8- T- tube
*Indications.
*Time of removal.
Inside common bile duct
Are you know this instruments?