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What is the goal of surgery?
to correct disease state or tissue abnormality by physical intervention
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Surgery is traumatic. How do we minimize trauma?
select proper instruments, sutures, suture materials
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What are the purposes to surgical instruments?
- holding
- manipulating
- clamping
- retracting
- cutting
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What are the LVT's responsibilities for instruments?
order, clean, care for, packs, passes, and uses
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What kind of finish are on surgical instruments?
dull finish to reduce glare off of them from under the lights
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What kind of protective coating is put on the instruments and why is it put on them?
- chromium oxide coating
- prevents corrosion of stainless steel
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Which kind of instruments are the best? Okay? Worst?
- Best: German instruments
- Okay: Pakistani or Polish
- Worst: Chinese
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What is a box lock?
- holds two pieces together
- one shank passes through a slot in the other shank
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What are the different types of surgery?
- electrosurgery
- radiosurgery
- cryosurgery
- laser surgery
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What is elecrosurgery?
cuts or coagulates by passage of electrical current through a small point of contact with tissue
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What is radiosurgery?
- simialr to electrosurgery
- uses radiowaves instead of electricity to cut
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What is cryosurgery?
removal of tissue masses by rapid freezing or slow thawing
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When does the tissue slough during cryosurgery?
7 - 10 days
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What is a scapel?
primary cutting tool
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What are the two scapels we mainly use?
- #3 for small animal
- #4 for large animal
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How do we use a scalpel?
- draw across tissue with one long controlled stroke
- avoid stabs or making a series of short strokes
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What are the different types of point classifications?
- sharp - sharp
- sharp - blunt
- blunt - blunt
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What is sharp dissection?
cutting tissue with scissors
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What is blunt dissection?
insert points into tissue, spread jaws apart
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How do you hold scissors?
- thumb and middle finger through rings to first joint
- index finger on shaft
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How do we know if scissors are sharp enough?
should be able to cut through 4 layers of gauze
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Describe general operating scissors.
- all purpose
- sharp-sharp, sharp-blunt, blunt-blunt
- straight or curved
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Describe metzenbaum scissors.
- long shanks, short blades
- delicate
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Describe mayo scissors
- shorter shank
- longer blade
- heavier than metzenbaum
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Describe wire cutting scissors
- not the same as wire cutters
- short, heavy, serrated
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Describe suture removal scissors.
- Littauer suture removal scissors
- "hooked" - thin point to pass under sutures
- for removing sutures
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Describe bandage scissors.
- Lister bandage scissors
- "knobbed" - flat, blunt tip on lower blade
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What are thumb forceps?
similar to tweezers
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What are the two types of tips for thumb forceps?
- rat tooth: large teeth
- mouse tooth: small teeth
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How do you hold a thumb forcep?
like a pencil
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What are the different type of thumb forceps?
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What are hemostat used for?
- hold tissue
- clamp blood vessels
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Describe a mosquito hemostat.
- small and delicate
- about 3 inches long
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Describe kelly hemostat.
- tips halfway grooved
- "kelly is a nice girl, she doesn't go all the way"
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Describe crile hemostats.
- smaller than kelly hemostat
- tips fully grooved
- "crile goes the extra mile"
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Describe carmalt hemostats.
- big hemostat
- for crushing
- longitudinal grooves on tips
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Describe angiotribe hemostats.
- long, strong, evil looking
- deep longitudinal grooves with opposing ridge
- for crushing tissue and blood vessels
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What are the different types of tissue forceps?
- allis forceps
- alligator forceps
- sponge forceps
- towel clamps
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Describe allis forceps.
- maximum holding
- can be traumatic
- not used on skin
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Describe alligator forceps
- long shanks
- tiny jaws
- for grasping through narrow openings
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Describe sponge forceps
open grooved rings at tips
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Describe towel clamps
- holds drapes onto patient
- curved tips that join at points
- clamp minimum skin at 45 degree angle to incision
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What are the different type of towel clamps?
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What are needle holders for?
for ligating and suturing
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What are the different types of needle holders?
- Mayo-Hegar - plain
- Olsen-Hegar - scissors
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What are rectractors used for?
used to improve exposure of surgical field with minimual trauma
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What are the different retractors?
- hand-held
- self-retaining
- snook hook
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What are the different orthopedic instruments?
- chuck and key: for intramedullary pinning
- bone-cutting forceps: look like wire cutters
- rongeurs: forceps with heavy, sharp, cupped tips for cutting bone
- bone-holding forceps: kern
- trephine: cylindrical blade, T handle, used for drilling out bone
- osteotome and mallet: double beveled chisel
- bone rasp:
- Gigli wire saw:
- bone curette: scrape bone
- pins, screws, plates:
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general operating scissors
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Name the parts from top to bottom
- tip
- jaws
- box lock
- shanks
- ratchets
- finger rings
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littauer suture removal scissors
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mayo-hegar needle holders
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olsen-hegar needle holders
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self retaining retractors
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