农学]常用外科手术器械及其使用

农学]常用外科手术器械及其使用

第六章手术基本操作技术手术种类繁多，范围、大小和复杂程度不同，但基本操作技术是相同的手术顺利完成，一定意义上取决于基本操作的熟练程度及其理论的掌握理论指导下的不断实践，是唯一的正确途径。稳、准、巧、轻、快是基本要求。Copyright©Allreserved,MAWMPhD\n内容提纲第一节常用外科器械及其使用第二节　显露第三节止血第四节缝合第五节拆线第六节打结第七节引流Copyright©Allreserved,MAWMPhD\n（一）种类4、6、8号刀柄配19~24号刀片。3、5、7号刀柄配10、11、12、15号刀片专用手术刀，如眼科刀等。高频电刀。第一节常用外科器械及其使用一、手术刀Copyright©Allreserved,MAWMPhD\nSharpscalpelwithdisposable10号小圆刃11号角形尖刃12号号弯形尖刃15号小圆刃3号刀柄8号刀柄Copyright©Allreserved,MAWMPhD\nHandlesCopyright©Allreserved,MAWMPhD\nHandlesBladesBlades#10,11,12,15fitthe#3handle,#22,#23fitthe#4handle,commonlyusedforlargeanimals.Copyright©Allreserved,MAWMPhD\nDisposableScalpelCopyright©Allreserved,MAWMPhD\nElectrosurgicalscalpelCopyright©Allreserved,MAWMPhD\n（二）手术刀的使用装刀片法取刀片法视频026Copyright©Allreserved,MAWMPhD\n装刀片Copyright©Allreserved,MAWMPhD\nThreebasicgripsforholdingthescalpelPencilgripFingertipgripPalmgripCopyright©Allreserved,MAWMPhD\nScalpelsCopyright©Allreserved,MAWMPhD\nThescalpelisheldwiththumb,middleandringfingerwhiletheindexfingerisplacedontheupperedgetohelpguidethescalpel.Longgentlecuttingstrokesarelesstraumatictotissuethanshortchoppingmotions.Copyright©Allreserved,MAWMPhD\nThescalpelshouldneverbeusedina"stabbing"motionCopyright©Allreserved,MAWMPhD\n二、surgicalscissors组织剪剪线剪CommonlyusedsurgicalscissorsCopyright©Allreserved,MAWMPhD\nClassificationbytypeofpointsAlltypesofscissorscanhavebluntorsharpblades(A:Sharp:Sharp,B:Blunt:Blunt).Copyright©Allreserved,MAWMPhD\nAlltypescanhaveeitherstraightorcurvedbladesCopyright©Allreserved,MAWMPhD\nMayoandMetzenbaumCopyright©Allreserved,MAWMPhD\nMayoscissors(B)areusedforcuttingheavyfasciaandsutures.Metzenbaumscissors(A)aremoredelicatethanMayoscissors.Metzenbaumscissorsareusedtocutdelicatetissuesandscissorshavealongerhandletobladeratio.Copyright©Allreserved,MAWMPhD\n执剪的方法剪线的方法视频027Copyright©Allreserved,MAWMPhD\n三、tissueforcepsA.DifferenttissueforcepsB.PencilgripforthumbforcepinuseC.PalmedpositionforthumbforcepbeingcarriedCopyright©Allreserved,MAWMPhD\nThumbforcepsareheldlikeapencilCopyright©Allreserved,MAWMPhD\nThumbForcepsarenotheldlikeaknifeCopyright©Allreserved,MAWMPhD\n镊子在手术中的使用视频028Copyright©Allreserved,MAWMPhD\n四、止血钳五、持针钳HemostaticforcepsNeedleholderCopyright©Allreserved,MAWMPhD\n持针钳在手术中的应用Copyright©Allreserved,MAWMPhD\nClassificationbysizeandshapeandsizeoftipsHemostaticforcepsandhemostatsmaybecurvedorstraight.Copyright©Allreserved,MAWMPhD\nKellyHemostaticForcepsandMosquitoHemostatsBotharetransverselyserratedMosquitohemostats(A)aremoredelicatethanKellyhemostaticforceps(B).Copyright©Allreserved,MAWMPhD\nMosquitohemostats(A)haveasmaller,finertipComparisonofKellyandMosquitotipsCopyright©Allreserved,MAWMPhD\nCarmalt视频029Copyright©Allreserved,MAWMPhD\nMayo-HegarHeavy,withmildlytaperedjaws.Nocuttingblades.Copyright©Allreserved,MAWMPhD\nOlsen-HegarIncludesbothneedleholdingjawandscissorsblades.Thedisadvantagetohavingbladeswithintheneedleholderisthesuturematerialmaybeaccidentallycut.Copyright©Allreserved,MAWMPhD\n六、surgicalneedles1.needlepoint2.needlebody3.needlelength4.needlediameter5.needlechordlength6.needleridusABCB.conventionalcuttingC.reversecuttingA.TheshapeofthepointandbodyofnocuttingCopyright©Allreserved,MAWMPhD\n七、retractorRibretractorAbdominal~Perineal~Copyright©Allreserved,MAWMPhD\nSennBladesateachend.Bladescanbeblunt(delicate)orsharp(moretraumatic,usedforfascia).Copyright©Allreserved,MAWMPhD\nHohmanLeverstissueawayfromboneduringorthopedicprocedures.Copyright©Allreserved,MAWMPhD\nWeitlanerEndscanbebluntorsharp.Hasraketips.Ratchettoholdtissueapart.Copyright©Allreserved,MAWMPhD\nGelpiHassinglepointtips.Ratchettoholdtissueapart.Copyright©Allreserved,MAWMPhD\n创钩在手术中的应用视频030Copyright©Allreserved,MAWMPhD\n创钩的使用Copyright©Allreserved,MAWMPhD\n创钩的使用Copyright©Allreserved,MAWMPhD\n创钩的使用Copyright©Allreserved,MAWMPhD\n八、towelforcep视频031Copyright©Allreserved,MAWMPhD\n九、tissueforcepsCopyright©Allreserved,MAWMPhD\nForceps:consistoftwotinesheldtogetheratoneendwithaspringdevicethatholdsthetinesopen.Forcepscanbeeithertissueordressingforceps.Dressingforcepshavesmoothorsmoothlyserratedtips.Tissueforcepshaveteethtogriptissue.Manyforcepsbearthenameoftheoriginatorofthedesign,suchasAdsontissueforceps.Copyright©Allreserved,MAWMPhD\nRatTooth:ATissueForcepsInterdigitatingteethholdtissuewithoutslipping.Usedtoholdskin/densetissueCopyright©Allreserved,MAWMPhD\nAdsonTissueForcepsSmallserratedteethonedgeoftips.TheAdsonstissueforcepshasdelicateserratedtipsdesignedforlight,carefulhandlingoftissueCopyright©Allreserved,MAWMPhD\nAllis:AnIntestinalTissueForcepsInterdigitatingshortteethtograspandholdbowelortissue.Slightlytraumatic,usetoholdintestine,fasciaandskinCopyright©Allreserved,MAWMPhD\nBabcock:AnIntestinalTissueForcepsMoredelicatethanAllis,lessdirectlytraumatic.Broad,flaredendswithsmoothtips.Usedtoatraumaticallyholdviscera(bowelandbladder).Copyright©Allreserved,MAWMPhD\nSpongeForcepsSpongeforcepscanbestraightorcurved,canhavesmoothorserratedjaws.Usedtoatraumaticallyholdviscera(bowelandbladder).Copyright©Allreserved,MAWMPhD\n十、肠钳Copyright©Allreserved,MAWMPhD\nDoyenIntestinalForcepsNon-crushingintestinaloccludingforcepswithlongitudinalserrations.UsedtotemporarilyoccludelumenofbowelCopyright©Allreserved,MAWMPhD\nPayrPylorusClampsAcrushingintestinalinstrument.Usedtooccludetheendofboweltoberesected.Copyright©Allreserved,MAWMPhD\nThethumbandringfingerareinsertedintotheringsofthescissorswhiletheindexandmiddlefingerareusedtoguidetheinstrument.Theinstrumentshouldremainatthetipsofthefingersformaximumcontrol.Copyright©Allreserved,MAWMPhD\nThisisthewrongwaytoholdthescissors.TheringfingershouldbeinsertedintotheringCopyright©Allreserved,MAWMPhD\nThisisalsothewrongwaytoholdthescissors.ThetipsofthescissorsshouldbepointingupwardsCopyright©Allreserved,MAWMPhD\n十一、器械的传递手术剪的传递Copyright©Allreserved,MAWMPhD\n持针钳的传递Copyright©Allreserved,MAWMPhD\nAnacceptablehandsignalforaneedleholderwithsutureAnacceptablehandsignalforthumbforcepCopyright©Allreserved,MAWMPhD\nＡ.AnacceptablesignalforscalpelAＢＢ.Anacceptablehandsignalforahemostat返回Copyright©Allreserved,MAWMPhD\nA、B.PassinganinstrumentpacktoascrubbedmemberoftheoperatingteamABC.AnacceptablewayofchangingpositionsduringasurgicalprocedureC返回Copyright©Allreserved,MAWMPhD