常用外科手术器械及其使用.ppt

Copyright Allreserved MAWMPhD 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 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 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 Sharpscalpelwithdisposable 10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 Handles Copyright Allreserved MAWMPhD HandlesBlades Blades 10 11 12 15fitthe 3handle 22 23fitthe 4handle commonlyusedforlargeanimals Copyright Allreserved MAWMPhD DisposableScalpel Copyright Allreserved MAWMPhD Electrosurgicalscalpel Copyright Allreserved MAWMPhD 二 手术刀的使用 装刀片法 取刀片法 视频026 Copyright Allreserved MAWMPhD 装刀片 Copyright Allreserved MAWMPhD Threebasicgripsforholdingthescalpel Pencilgrip Fingertipgrip Palmgrip Copyright Allreserved MAWMPhD Scalpels Copyright Allreserved MAWMPhD Thescalpelisheldwiththumb middleandringfingerwhiletheindexfingerisplacedontheupperedgetohelpguidethescalpel Longgentlecuttingstrokesarelesstraumatictotissuethanshortchoppingmotions Copyright Allreserved MAWMPhD Thescalpelshouldneverbeusedina stabbing motion Copyright Allreserved MAWMPhD 二 surgicalscissors 组织剪 剪线剪 Commonlyusedsurgicalscissors Copyright Allreserved MAWMPhD Classificationbytypeofpoints Alltypesofscissorscanhavebluntorsharpblades A Sharp Sharp B Blunt Blunt Copyright Allreserved MAWMPhD Alltypescanhaveeitherstraightorcurvedblades Copyright Allreserved MAWMPhD MayoandMetzenbaum Copyright Allreserved MAWMPhD Mayoscissors B areusedforcuttingheavyfasciaandsutures Metzenbaumscissors A aremoredelicatethanMayoscissors Metzenbaumscissorsareusedtocutdelicatetissuesandscissorshavealongerhandletobladeratio Copyright Allreserved MAWMPhD 执剪的方法 剪线的方法 视频027 Copyright Allreserved MAWMPhD 三 tissueforceps A DifferenttissueforcepsB PencilgripforthumbforcepinuseC Palmedpositionforthumbforcepbeingcarried Copyright Allreserved MAWMPhD Thumbforcepsareheldlikeapencil Copyright Allreserved MAWMPhD ThumbForcepsarenotheldlikeaknife Copyright Allreserved MAWMPhD 镊子在手术中的使用 视频028 Copyright Allreserved MAWMPhD 四 止血钳 五 持针钳 Hemostaticforceps Needleholder Copyright Allreserved MAWMPhD 持针钳在手术中的应用 Copyright Allreserved MAWMPhD Classificationbysizeandshapeandsizeoftips Hemostaticforcepsandhemostatsmaybecurvedorstraight Copyright Allreserved MAWMPhD KellyHemostaticForcepsandMosquitoHemostats Botharetransverselyserrated Mosquitohemostats A aremoredelicatethanKellyhemostaticforceps B Copyright Allreserved MAWMPhD Mosquitohemostats A haveasmaller finertip ComparisonofKellyandMosquitotips Copyright Allreserved MAWMPhD Carmalt 视频029 Copyright Allreserved MAWMPhD Mayo Hegar Heavy withmildlytaperedjaws Nocuttingblades Copyright Allreserved MAWMPhD Olsen Hegar Includesbothneedleholdingjawandscissorsblades Thedisadvantagetohavingbladeswithintheneedleholderisthesuturematerialmaybeaccidentallycut Copyright Allreserved MAWMPhD 六 surgicalneedles 1 needlepoint2 needlebody3 needlelength4 needlediameter5 needlechordlength6 needleridus A B C B conventionalcuttingC reversecutting A Theshapeofthepointandbodyofnocutting Copyright Allreserved MAWMPhD 七 retractor Ribretractor Abdominal Perineal Copyright Allreserved MAWMPhD Senn Bladesateachend Bladescanbeblunt delicate orsharp moretraumatic usedforfascia Copyright Allreserved MAWMPhD Hohman Leverstissueawayfromboneduringorthopedicprocedures Copyright Allreserved MAWMPhD Weitlaner Endscanbebluntorsharp Hasraketips Ratchettoholdtissueapart Copyright Allreserved MAWMPhD Gelpi Hassinglepointtips Ratchettoholdtissueapart Copyright Allreserved MAWMPhD 创钩在手术中的应用 视频030 Copyright Allreserved MAWMPhD 创钩的使用 Copyright Allreserved MAWMPhD 创钩的使用 Copyright Allreserved MAWMPhD 创钩的使用 Copyright Allreserved MAWMPhD 八 towelforcep 视频031 Copyright Allreserved MAWMPhD 九 tissueforceps Copyright Allreserved MAWMPhD Forceps consistoftwotinesheldtogetheratoneendwithaspringdevicethatholdsthetinesopen Forcepscanbeeithertissueordressingforceps Dressingforcepshavesmoothorsmoothlyserratedtips Tissueforcepshaveteethtogriptissue Manyforcepsbearthenameoftheoriginatorofthedesign suchasAdsontissueforceps Copyright Allreserved MAWMPhD RatTooth ATissueForceps Interdigitatingteethholdtissuewithoutslipping Usedtoholdskin densetissue Copyright Allreserved MAWMPhD AdsonTissueForceps Smallserratedteethonedgeoftips TheAdsonstissueforcepshasdelicateserratedtipsdesignedforlight carefulhandlingoftissue Copyright Allreserved MAWMPhD Allis AnIntestinalTissueForceps Interdigitatingshortteethtograspandholdbowelortissue Slightlytraumatic usetoholdintestine fasciaandskin Copyright Allreserved MAWMPhD Babcock AnIntestinalTissueForceps MoredelicatethanAllis lessdirectlytraumatic Broad flaredendswithsmoothtips Usedtoatraumaticallyholdviscera bowelandbladder Copyright Allreserved MAWMPhD SpongeForceps Spongeforcepscanbestraightorcurved canhavesmoothorserratedjaws Usedtoatraumaticallyholdviscera bowelandbladder Copyright Allreserved MAWMPhD 十 肠钳 Copyright Allreserved MAWMPhD DoyenIntestinalForceps Non crushingintestinaloccludingforcepswithlongitudinalserrations Usedtotemporarilyoccludelumenofbowel Copyright Allreserved MAWMPhD PayrPylorusClamps Acrushingintestinalinstrument Usedtooccludetheendofboweltoberesected Copyright Allreserved MAWMPhD Thethumbandringfingerareinsertedintotheringsofthescissorswhiletheindexandmiddlefingerareusedtoguidetheinstrument Theinstrumentshouldremainatthetipsofthefingersformaximumcontrol Copyright Allreserved MAWMPhD Thisisthewrongwaytoholdthescisso