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General Surgical Instruments

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General Surgical Instruments. Retractors. Supplemental Instruments. Retractors. Army-Navy Retractor ... cysts may require the use of these instruments. ... – PowerPoint PPT presentation

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Title: General Surgical Instruments


1
General Surgical Instruments
  • Retractors
  • Supplemental Instruments

2
Retractors
3
Army-Navy Retractor
  • Used in narrow incisions with ½ to 1½ of depth
    (appendectomy, breast biopsy). It is made to
    retract the edges of the wound and provide
    optimal visibility for the surgeon. They are
    used in pairs to provide traction and counter
    traction. They are held in place during the
    procedure by the tech or surgical assistant.

4
Gelpi Retractor
  • This is a self-retaining retractor with sharp
    single point tips. It is used when all hands are
    busy or two handheld retractors are not enough to
    provide good exposure. The Gelpi is used to hold
    two edges apart while another pair of retractors
    holds edges in the perpendicular direction.

5
Goulet Retractor
  • This retractor is used in mid-sized incisions
    (inguinal hernia, breast biopsy) to provide good
    visualization of surgical site. They are used in
    pairs in opposition to each other.

6
Senn Retractor
  • Small retractors used in small superficial
    incisions (carpal tunnel, podiatry cases). They
    are used in pairs to pull back the skin edges of
    the wound and provide visibility during the
    procedure. One end is a small three pronged rake
    that penetrates into the tissue preventing
    slipping out of position. This end might
    puncture blood vessels or rip gloves so care must
    be used when handling them. The other end of the
    retractor is a miniature right angle that may be
    used in small incisions that might be close to
    blood vessels or nerves.

7
Abdominal Fisch
  • Used when closing major abdominal incisions. It
    lays over the abdominal contents, protecting the
    organs while the abdominal wall is sutured
    closed. The ring on the cord is left hanging on
    the outside of the incision, while the blue
    bendable portion is left on the inside. Before
    the last few stitches are placed, the cord is
    pulled and the fisch collapses and is pulled out.
    Miscellaneous.

8
Balfour and Bladder Blade
  • This is a self retaining retractor for large
    abdominal incisions. The blades on the Balfour
    can often be exchanged for shallower ones for
    thinner people. Pass the Balfour to the surgeon
    with the blades together and pointing down into
    the abdomen. Once that piece is in place, pass
    the bladder blade which the surgeon will attach
    to the wing nut devise. This allows traction
    from three different directions at the same time
    leaving the scrub crews hands free for other
    tasks.

9
Deaver Retractor
  • Common retractor used in major abdominal
    procedures. Comes in several different widths.
    May also be used during vaginal procedures.

10
Green Retractor
  • Used to retract skin and fatty layers of the
    abdomen or similar surfaces.

11
Harrington or Sweetheart Retractor
  • Especially useful for retracting the liver. The
    broad smooth surface of the heart shaped blade
    gently holds the fragile liver, while the indent
    at the top of the heart straddles the
    gallbladder.

12
Parker Retractor
  • Small narrow retractor used to hold apart the
    skin and abdominal tissues of small incisions.
    It is often used in pediatric procedures.

13
Pratt Rectal Speculum
  • This retractor is used for rectal procedures
    especially hemorrhoidectomy. It must be
    lubricated with KY Jelly before it is inserted
    and then the screw is twisted to spread the
    speculum open.

14
Rake Retractors
  • Used to retract the skin. Could be used in
    Mastectomy, or orthopedic procedures. They come
    with two or up to six teeth which could be sharp
    or blunt.

15
Ribbon or Malleable Retractor
  • This retractor can be bent into any form
    necessary and then reshaped. Widths may be
    between ½ and 3. It may also be used instead
    of an abdominal fische for closing abdominal
    incisions.

16
Richardson Retractor
  • This is a very common retractor used in most
    major abdominal procedures. They come in several
    widths. Select the one that matches the
    thickness of the patient from the skin to the
    peritoneum.

17
Vein Retractor
  • This retractor is used to retract veins or
    similar small quantities of tissue.

18
Supplemental Instruments
19
Clip Appliers
  • These non-disposable clip appliers are to be
    loaded with disposable metal clips. They are
    easiest to load when held in a pencil position
    and pressed down directly over the clip. Care
    must be used in handling the instrument with a
    clip in place as they may easily be pinched
    closed and the clip will fall out. They are used
    to quickly seal off blood vessels in very
    vascular fields. They save the time needed to
    tie off each vessel using suture. Miscellaneous

20
Doyens Curved Intestinal Clamp
  • The long flexible jaw of this clamp allows the
    surgeon to clamp completely across bowel, holding
    it firmly without damaging the tissue. The long
    tip makes it fairly flexible.

21
Straight Bowel Clamp
  • This is a gentle clamp that will reach all the
    way across the widest points of the bowel. Its
    long tip makes its hold tender. This clamp is
    the same in function as the Doyans clamp. The
    surface of the jaw is slightly different but they
    are used in the same way. Both clamps come in
    straight or curved varieties.

22
Pennington Clamp
  • The triangular tip is useful for clamping broad
    fragile surfaces such as the lung or a hemorrhoid.

23
Poole Suction Tip
  • This suction tip is used to suction large amounts
    of fluid from the abdomen. The large number of
    small holes allow the fluid to be evacuated, but
    will not allow bowel or omentum to be caught in
    the tip. This can be a problem with most other
    tips. A yankauer tip should be used during the
    majority of the case until it is time to
    irrigate. At that time the tip should be
    exchanged for the poole. It can be separated
    into two pieces for cleaning. It belongs to the
    miscellaneous category.

24
Probe and Groove Director
  • Used to follow sinus tracts or to probe depths of
    abscesses. Peri-rectal abscess and pilonidal
    cysts may require the use of these instruments.
    Miscellaneous category.

25
EEA Sizers
  • These sizers are used to dilate and fit two ends
    of intestine together during a bowel resection.
    Once they come in contact with the inside of the
    bowel, they are contaminated and must be kept
    separate from the rest of the sterile field.
    Miscellaneous.
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