MBBS STUDENTS UNDER GRADUATES ..WITH USES PROPERTIE IMAGES......FOLEYS CATHETER MALECOTS CATHETER ARTERY FORCEPS SMALL MEDIUM LARGE RETRACTOR KELLYS SURGERY SURGICAL INSTRUMENTS MBBS STUDENTS UNDERGRADUATES SUTURE MATERIALS MAYOS SCISSORS MBBS STUDENTS UNDER GRADUATES .......LISTERS SINUS FORCEPS....RIGHT ANGLED FORCEPS....KOCHERS CLAMP...suture material suture removal Jolls thyroid retractor .....WITH USES PROPERTIE IMAGES......FOLEYS CATHETER MALECOTS CATHETER ARTERY FORCEPS SMALL MEDIUM LARGE RETRACTOR KELLYS SURGERY SURGICAL INSTRUMENTS MBBS STUDENTS UNDERGRADUATES SUTURE MATERIALS MAYOS SCISSORS ..FOLEYS CATHETER ....3 WAY 2WAY RYLES TUBE.........HILTONS METHOD ..ALLIS .... MOSQUITO . LANES FORCEPS ....Lanes twin anastomosis clamp......MALECOTS CATHETER.. ARTERY FORCEPS..... SMALL MEDIUM LARGE ......RETRACTOR ....KELLYS ....SURGERY SURGICAL INSTRUMENTS MBBS STUDENTS UNDERGRADUATES..... SUTURE MATERIALS.... MAYOS SCISSORS
...........................MBBS STUDENTS UNDER GRADUATES ..COMPARISON WITH IMAGES NOTES FROM LECTURE CLASSES.............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
17. Artery forceps / haemostat
•
•
•
Small mosquito / Halsted
Medium spencer well
Large bailey forceps
Suturing
Catch hold of bleeding ponts
Straight/curved
TONY 2010 MBBS
34. Cheatles forceps
• No lock
•
•
Heavy metallic with curved
uses
blades
• Used to pick sterilized instruments & drapes to avoid touching
• Transfering from one tray to another
• Kept in savlon
TONY 2010 MBBS
47. T tube use
• After exploration of the common bile duct, a T-tube may be inserted
into the duct which allows bile to drain
•
•
while the sphincter of Oddi
Once the sphincter relaxes,
and into the duodenum. To
is in spasm postoperatively.
bile drains normally down the bile duct
assist choleresis, it is often advisable
which•
•
to convert the
also facilitates
lumen of
removal
the limb of the T into a gutter,
TONY 2010 MBBS
48. Removal
• Kept for 7-10 days
Cholangiogram b4 removal•
• To see there is free
retained stones
flow of bile into the duodenum and that there are no
• Just pull to remove .
TONY 2010 MBBS
49. Cuffed endotracheal tube
To maintain airway
6.5-8.5 (size)
• Cuff
•
•
Px aspiration
To keep it in position
• Filled with air (not with NS as it may aspirate if
ruptures)
Uncuffed in paeds
In head injury (GCS <8)
•
•
TONY 2010 MBBS
50. Ryle's tube
105-110 cm
Dia 10 12 14 16
Barium / pb shots at tip radiopaque detect location
Blue line radio opaque
Multiple side holes } drainage
4 markings (dist in cm 4m upper incisor)
40 cm gastroesophageal jn
50 cm body of stomach
60 cm pyloric region
70 cm 1st part of duodenum
TONY 2010 MBBS
51. Ryles tube
• In
• Therapeutic
•
•
•
•
•
Feeding } comatosed pts
Aspiration } GOO intestional obstn,perforn
Saline load test } GOO
esophageal varices
Poisoning except acid poisoning
• Diagnostic
• Gastric fn test
Prohylactically in gastrectomy•
c/I
•
•
# of cribriform platemeningitis
TONY 2010 MBBS
55. 2 way Foleys catheter DRAINAGE PORT
.r::/
j_/�':...---INFLATABLE BALLOON
INSERT INTO
·.
URETHRAAND
INTO URINARY
BLADDER
) ANCHORS DEVICE
IN BLADDER··
TO
COLLECTION
DEVICE
FILL WITH-�
FLUID TO
INFLATE
BALLOON..
..,balloon•size
in French
scale
and milimeters .
bladder opening i
port····- urine
drainagei balloon portvolume of fluid recommended 10 infla1e balloon
mai1<ed
TONY 2010 MBBS
56. • Use 5 ml distilled water (NS will crystallise) for inflating balloon
TONY 2010 MBBS
57. 2 way Foleys catheter
• Uses
• Urological
•
•
•
•
•
Continous bladder drainage
Supra pubic drainage
Measure urine output
Urinary tract injury hematuria
Intravesical chemotherapy bladder ca
• Nonurological
• EASI
• Posterior epistaxis
• c/I
• Rupture of urethra(blood at the tip of meatus)
TONY 2010 MBBS
58. 3 way foleys catheter
• In hematuria
• Continous bladder irrigation to prevent
of urine
formation of clots blocking drainage
• Postoperative irrigation of bladder as In
•
•
TURP
Prostactic Sx
TONY 2010 MBBS
61. Malecot’s self retaining catheter
•
•
Indian red rubber (dermatitis )
Used in suprapubic cystotomy
•
•
Also in tube thoracostomy
In operative drainage of peritoneal cavity
TONY 2010 MBBS
75. Suture Materials
• Criteria
– Tensile strength
– Good knot security
– Workability in handling
– Low tissue reactivity
– Ability to resist bacterial infection
76. Types of Sutures
• Absorbable or non-absorbable (natural or synthetic)
• Monofilament or multifilament (braided)
• Dyed or undyed
• Sizes 3 to 12-0 (numbers alone indicate progressively
larger sutures, whereas numbers followed by 0 indicate
progressively smaller)
77. Non-absorbable
• Not biodegradable
and permanent
– Nylon
– Prolene
– Stainless steel
– Silk (natural, can
break down over
years)
• Degraded via
inflammatory
response
– Vicryl
– Monocryl
– PDS
– Chromic
– Cat gut (natural)
Absorbable
78. Natural Suture
• Biological
• Cause inflammatory
reaction
– Catgut (connective
from cow or sheep)
– Silk (from silkworm
fibers)
– Chromic catgut
Synthetic
• Synthetic polymers
• Do not cause
inflammatory response
– Nylon
– Vicryl
– Monocryl
– PDS
– Prolene
79. Monofilament
• Single strand of suture
material
• Minimal tissue trauma
• Smooth tying but more
knots needed
• Harder to handle due to
memory
• Examples: nylon, monocryl,
prolene, PDS
Multifilament (braided)
• Fibers are braided or
twisted together
• More tissue resistance
• Easier to handle
• Fewer knots needed
• Examples: vicryl, silk,
chromic
84. • Round-bodied needles
• gradually taper to a point, while triangular needles have
all three sides.
intestinal and cardiovascular surgery
Separate not to cut
cutting edges along
•
•
• Conventional cutting
• cutting edge facing the inside of the needle’s curvature,
• tough or dense tissue needs to be sutured, such as skin and fascia
reversed cutting
• cutting edge is on the outside
•
TONY 2010 MBBS
87. • Reverse Cutting
– Cutting edge on outside
of circle
– Skin
– Less traumatic than
cutting
88. Technique
The needle should be grasped in the tip of
the needle holder about 2/3 of the way
back from the point.
Grasping further back at the swaged end
tends to weaken the needle and its
attachment to the suture, and you are likely
to bend the needle.
TONY 2010 MBBS
89. • Hand-held straight needles
• skin, although today it is advocated that
reduce the risk of needle-stick injuries.
Half circle needles
• the gastrointestinal tract,
J-shaped needles
• vagina
quarter circle needles
• eye
compound curvature needles
• oral cavity,
needle holders should be used in all cases to
•
•
•
•
TONY 2010 MBBS
105. Proctoscope / kellys rectal speculum
• In
• Diagnostic
•
•
•
Piles / haemorrhoids } bulge in to cavity on retraction
Polyp
Ca anal canal / lower rectum
• Therapeutic
•
•
•
Injn of sclerosant
Excision of polyp
Drainage of abscess
• C/I
• In a/c fissure in ano } severe pain
TONY 2010 MBBS
106. Guedel airway
• Prevent tongue from falling backwards
• Opening } aspiration
TONY 2010 MBBS
109. Circular stapler
• End to end Intestinal anastomosis
Stapler haemorrhoidopexy
as in lower anterior resection
•
• 3rd 4th/ degree haemorrhoids
TONY 2010 MBBS