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Normal lab values
- Sugar - 3.5-7 mmol/L (X18 mg%)
- Urea - 1.6-7 mmol/L (X6 mg%)
- Creatinine - 40-95 micro mol/L (X0.01131 mg% (1/88.5))
- Calcium - 2.1-2.6 mmol/L (X4 gm%)
- Bilirubin - 3-21 micromole/L (X17.1 )
- Serum plasma and other fluids
- - Normal <30 U/L
- - Suspect - 30-40
- - Strong suspect - 40-60
- - Positive - >60
- CSF only
- - Normal <10
- - Positive >10
- Contains EDTA (ethylenediaminetetraacetic acid)
- Full blood count (FBC)
- Erythrocyte sedimentation rate (ESR)
Golden yellow vial
- These bottles are used for a huge variety of tests requiring separated serum for analysis, including biochemistry, endocrinology, oncology, toxicology, microbiology and immunology.
- Used for haematology tests involving the clotting system, which require inactivated whole blood for analysis.
- Contains buffered sodium citrate.
- Tests - PT/INR, APTT, D-dimer
Circular stapler Size (Covidon)?
Diameter - 27mm-30mm ?
Stapler used in total gastrectomy - 25 mm diameter
- Procedure for Prolapse and Hemorrhoids (PPH) - 33 mm diameter size with either 3.5 mm or 4.8 mm staples.
- Ligating dividing stapler (LDS)
- Thoracoabdominal (TA) stapler
- Gastrointestinal anastomosis (GIA) stapler
- End-to-end anastomosis (EEA) stapler
- Intestinal linear anastomosis (ILA) stapler
What is TA stapler?
TA staplers are commonly utilized for lung lobectomy, liver lobectomy, and partial gastrectomy, although there are multiple other uses.
What is GIA stapler?
- The GIA stapler is a linear device with two interlocking pieces.
- The GIA stapler places two double rows of staggered B-shaped stables 3.5mm apart and then incises in between.
- It is used most often in combination with a TA stapler to create functional end-to-end anastomoses.
- GIA stapler used in endoscopic procedure are Endo-GIA staplers.
Size of GIA stapler (Covidon)?
GIA Linear Cutting Stapler is available in the following lengths: 60mm, 80mm, 100mm.
Each of the lengths can fire either a 3.8mm (Blue)or 4.8mm (Green) staple height cartridge.
The 2.5mm (White) staple height, vascular load option, is only available in the 60mm length.
The instrument must be able to compress the tissue comfortably down to the closed staple height prior to firing so for the different staple heights, the maximum tissue thickness should be as follows:
- 2.5mm Staples – 1mm closed height / tissue thickness (60mm length only)
- 3.8mm Staples – 1.5mm closed height / tissue thickness
- 4.8mm Staples – 2.0mm closed height / tissue thickness
What is EEA stapler?
The EEA stapler places a circular double-row of staples. The EEA stapler is ideal for creating inverting end-to-end or end-to-side anastomoses. A circular blade within the cartridge resects the redundant inverted tissue to create a new lumen. This stapler is most commonly utilized in veterinary surgery to perform subtotal colectomy in cats. However, the size availability and somewhat difficult application of the EEA stapler limits its use.
IV calula size - color coding?
- Grey - 16G
- Green - 18G
- Red - 20G
- Blue - 22G
- Yellow - 24G
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- 1. Natural absorbable sutures:
- − Plain and chromic catgut
- 2. Synthetic absorbable sutures:
- − Polyglycolic acid (dexon)
- − Polyglactin 910 (vicryl) - Violet
- − Polydioxanone suture (PDS)
- − Polyglycolic Acid Suture (Dexon) - Green
- − Polyglecaprone 25 (monocryl)
- − Monosyn
- 1. Natural nonabsorbable sutures:
- − Linen thread
- − Silk.
- 2. Synthetic nonabsorbable sutures:
- − Polypropylene (prolene)
- − Monofilament polyamide (ethilon)
- − Polyester (ethibond)
- − Nylon.
Monofilament and polyfilament sutures?
- Monofilament sutures:
- • Sutures consisting of a single strand of fiber are called monofilament sutures.
- • These sutures are smooth and strong.
- • Chance of bacterial contamination is less.
- • The disadvantage is that knot tied may become loose.
- • Polypropylene, Polyamide, Catgut, Monocryl, Polydioxanone, Polyglactin finer sizes 6/0-9/0.
- Polyfilament sutures:
- • Sutures consisting of multiple strands braided together are called polyfilament sutures.
- • They are easier to handle and the knot tied does not slip.
- • The disadvantage is that the bacteria may lodge in the crevices of the sutures so these sutures are not suitable in presence of infection, e.g. silk, linen, polyglycolic acid, polyglactin 910, braided polyamide and braided polyester.
Characteristics of Catgut?
- Derived from the submucosa of sheep's intestine or serosa of cattle's intestine. It is 99% collagen.
- Absorption rate depends on the size of the catgut and whether it is plain or chromicised
- Plain catgut - loses 50% tensile strength in tissues in 3 days and loses all tensile strength in 15 days, gets absorbed in tissues within 60 days.
- The chromic catgut - loses 50% tensile strength in 7 days and loses all its tensile strength in 28 days, gets absorbed in tissues in 90–100 days.
- In presence of infection the catgut gets absorbed earlier.
Characteristics of Vicryl suture?
- Also called as Polyglactin 910 Sutures
- Polyglactin 910 are synthetic absorbable polyfilament sutures. The finer polyglactin sutures5–0, 6–0 are available as mono-filament sutures and are used in vascular surgery.
- These sutures maintains tensile strength in the tissues for about 28–30 days and get absorbed in 80–90 days
When a suture is attached to an eyeless needle, it is called an atraumatic suture.
What is PDS?
This is a synthetic, delayed absorbable, monofilament suture.
- It maintains tensile strength for a longer periods for about 56 days.
- The suture is absorbed by hydrolysis and complete absorption occurs in about 180–210 days (6–7 months).
Sterlization of laparoscopic telescope? :
- Chemical sterilization:
- • 2% glutaraldehyde solution for 4 hours for sterilization and 20 minutes for disinfection.
- Gas sterilization:
- • Ethylene oxide: Keeping in ETO chmaber for 12 hours
- • Plasma sterilization.
What are the advantages of carbon dioxide for use during laparoscopic surgery?
- Carbon dioxide is an inert, noncombustible gas.
- Electrocautery may be safely used as CO2 does not support combustion.
- Carbon dioxide is a highly diffusible and soluble gas. As the carbon dioxide is absorbed from the peritoneal surface, it remains in soluble form in blood as carbonic acid.
- In the lung the carbonic acid splits into water and CO2 and the CO2 gas from the alveloi may be removed by hyperventilating by the anesthetist.
Equipments used in Laparoscopic surgery?
- Trocar and Cannula
- Maryland Dissector
- Endograsping Forceps - toothed/non-toothed
- Endoscissors: Curved Bladed/Straight Bladed
- Suction Irrigation Cannula
- Endoscopic Diathermy Hook and spatula
- Endoscopic Clip Applicator
- Endoscopic Crocodile Forceps - to remove gall bladder
- Endoscopic Spoon Forceps - for picking up spilled out stones
- Endo Needle Holder
- Liga Clip