常用外科手术器械及其使用.ppt

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1、College of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural University第六章第六章 手术基本操作技术手术基本操作技术手术种类繁多，范围、大小和复杂程手术种类繁多，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本操作的熟练

2、程度及其理论的掌握理论指导下的不断实践，是唯一的正理论指导下的不断实践，是唯一的正确途径。确途径。稳、准、巧、轻、快是基本要求。稳、准、巧、轻、快是基本要求。Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural University内 容 提 纲l l第一节第一节第一节第一节 常用外科

3、器械及其使用常用外科器械及其使用常用外科器械及其使用常用外科器械及其使用l l第二节显露第二节显露第二节显露第二节显露l l第三节第三节第三节第三节 止血止血止血止血l l第四节第四节第四节第四节 缝合缝合缝合缝合l l第五节第五节第五节第五节 拆线拆线拆线拆线l l第六节第六节第六节第六节 打结打结打结打结l l第七节第七节第七节第七节 引流引流引流引流Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary

4、 MedicineShandong Agricultural UniversityShandong Agricultural University（一）种类（一）种类4 4、6 6、8 8号刀柄配号刀柄配19192424号刀片。号刀片。3 3、5 5、7 7号刀柄配号刀柄配1010、1111、1212、1515号刀片号刀片专用手术刀，如眼科刀等。专用手术刀，如眼科刀等。高频电刀。高频电刀。第一节第一节 常用外科器械及其使用常用外科器械及其使用一、手术刀一、手术刀Copyright All reserved,MA WM PhDCollege of Animal Science and Veter

5、inary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural UniversitySharp scalpel with disposable1 10 0号号号号小小小小圆圆圆圆刃刃刃刃1 11 1号号号号角角角角形形形形尖尖尖尖刃刃刃刃1 12 2号号号号号号号号弯弯弯弯形形形形尖尖尖尖刃刃刃刃1 15 5号号号号小小小小圆圆圆圆刃刃刃刃3 3号刀柄号刀柄号刀柄号刀柄8 8号刀柄号刀柄号刀柄号刀柄Copyright All

6、reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural UniversityHandlesCopyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Ve

7、terinary MedicineShandong Agricultural UniversityShandong Agricultural UniversityHandles Blades Blades#10,11,12,15 fit the#3 handle,#22,#23 fit Blades#10,11,12,15 fit the#3 handle,#22,#23 fit the#4 handle,commonly used for large animals.the#4 handle,commonly used for large animals.Copyright All rese

8、rved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural UniversityDisposable ScalpelCopyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science

9、 and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural UniversityElectrosurgical scalpelCopyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural Unive

10、rsity（二）手术刀的使用（二）手术刀的使用装刀片法装刀片法取刀片法取刀片法视频026Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural University装装刀刀片片Copyright All reserved,MA WM PhDCollege of Animal Scienc

11、e and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural UniversityThree basic grips for holding the scalpelPencil gripFingertip gripPalm gripCopyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineColleg

12、e of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural UniversityScalpels Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural

13、UniversityThe scalpel is held with thumb,middle and ring finger while the index finger is placed on the upper edge to help guide the scalpel.Long gentle cutting strokes are less traumatic to tissue than short chopping motions.Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary M

14、edicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural UniversityThe scalpel should never be used in a stabbing motion The scalpel should never be used in a stabbing motion Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary

15、 MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural University二、二、surgical scissors组组织织剪剪剪剪线线剪剪Commonly used surgical scissorsCopyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Vet

16、erinary MedicineShandong Agricultural UniversityShandong Agricultural UniversityClassification by type of pointsAll types of scissors can have blunt or sharp blades(A:Sharp:Sharp,B:Blunt:Blunt).Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science

17、 and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural UniversityAll types can have either straight or curved blades Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural Universi

18、tyShandong Agricultural UniversityMayo and Metzenbaum Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural UniversityMayo scissors(B)are used for cutting heavy fascia an

19、d sutures.Metzenbaum scissors(A)are more delicate than Mayo scissors.Metzenbaum scissors are used to cut delicate tissues and scissors have a longer handle to blade ratio.Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary Medicin

20、eShandong Agricultural UniversityShandong Agricultural University执剪的方法执剪的方法剪线的方法剪线的方法视频027 Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural University三、三、tissue forc

21、epsA.Different tissue forcepsB.Pencil grip for thumb forcep in useC.Palmed position for thumb forcep being carriedCopyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural Un

22、iversityThumb forceps are held like a pencil Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural UniversityThumb Forceps are not held like a knife Copyright All reserve

23、d,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural University镊镊子子在在手手术术中中的的使使用用视频028 Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Scie

24、nce and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural University四四、止止血血钳钳五五、持持针针钳钳Hemostatic forcepsNeedle holderCopyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural Universi

25、tyShandong Agricultural University持针钳在手术持针钳在手术中的应用中的应用Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural UniversityClassification by size and shape and size of tipsHem

26、ostatic forceps and hemostats may be curved or straight.Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural UniversityKelly Hemostatic Forceps and Mosquito Hemostats Ke

27、lly Hemostatic Forceps and Mosquito Hemostats Both are transversely serrated Both are transversely serrated Mosquito hemostats(A)are more delicate Mosquito hemostats(A)are more delicate than Kelly hemostatic forceps(B).than Kelly hemostatic forceps(B).Copyright All reserved,MA WM PhDCollege of Anima

28、l Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural UniversityMosquito hemostats(A)have a smaller,finer tip Comparison of Kelly and Mosquito tips Copyright All reserved,MA WM PhDCollege of Animal Science and Veterina

29、ry MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural UniversityCarmalt 视频029 Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural University

30、Shandong Agricultural UniversityMayo-Hegar Heavy,with mildly tapered jaws.No cutting blades.Heavy,with mildly tapered jaws.No cutting blades.Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural Univers

31、ityShandong Agricultural UniversityOlsen-Hegar Includes both needle holding jaw and scissors blades.Includes both needle holding jaw and scissors blades.The disadvantage to having blades within the needle The disadvantage to having blades within the needle holder is the suture material may be accide

32、ntally cut.holder is the suture material may be accidentally cut.Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural University六、六、surgical needles1.needle point 2.need

33、le body 3.needle length 4.needle diameter 5.needle chord length 6.needle ridusABCB.conventional cuttingB.conventional cuttingC.reverse cuttingC.reverse cuttingA.The shape of the point A.The shape of the point and body of nocuttingand body of nocuttingCopyright All reserved,MA WM PhDCollege of Animal

34、 Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural University七、七、retractorRib retractorRib retractorAbdominalAbdominalPerinealPerinealCopyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineC

35、ollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural UniversitySenn Blades at each end.Blades at each end.Blades can be blunt Blades can be blunt(delicate)(delicate)or sharp(more traumatic,used for or sharp(more traumatic,used for fascia).fascia).Copy

36、right All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural UniversityHohmanLevers tissue away from bone during orthopedic procedures.Copyright All reserved,MA WM PhDCollege of Ani

37、mal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural UniversityWeitlaner Ends can be blunt or sharp.Has rake tips.Ratchet to hold tissue apart.Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary

38、 MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural UniversityGelpiHas single point tips.Ratchet to hold tissue apart.Has single point tips.Ratchet to hold tissue apart.Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinar

39、y MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural University创创钩钩在在手手术术中中的的应应用用视频030 Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural U

40、niversityShandong Agricultural University创钩的使用创钩的使用Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural University创钩的使用创钩的使用Copyright All reserved,MA WM PhDCollege of An

41、imal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural University创钩的使用创钩的使用Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Ag

42、ricultural UniversityShandong Agricultural University八、八、towel forcep视频031 Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural University九、九、tissue forcepsCopyright All

43、 reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural UniversityForceps:Forceps:consist consist of of two two tines tines held held together together at at one one end end with with a

44、 a spring spring device device that that holds holds the the tines tines open.open.Forceps Forceps can can be be either either tissue tissue or or dressing dressing forceps.forceps.Dressing Dressing forceps forceps have have smooth smooth or or smoothly smoothly serrated serrated tips.tips.Tissue Ti

45、ssue forceps forceps have have teeth teeth to to grip grip tissue.tissue.Many Many forceps forceps bear bear the the name name of of the the originator originator of of the the design,such as Adson tissue forceps.design,such as Adson tissue forceps.Copyright All reserved,MA WM PhDCollege of Animal S

46、cience and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural UniversityRat Tooth:A Tissue ForcepsInterdigitating teeth hold tissue without slipping.Used to hold skin/dense tissue Copyright All reserved,MA WM PhDCollege of Animal

47、 Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural UniversityAdson Tissue ForcepsSmall serrated teeth on edge of tips.The Adsons tissue forceps has delicate serrated tips designed for light,careful handling of tissue

48、 Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural UniversityAllis:An Intestinal Tissue ForcepsInterdigitating short teeth to grasp and hold bowel or tissue.Slightly

49、traumatic,use to hold intestine,fascia and skin Copyright All reserved,MA WM PhDCollege of Animal Science and Veterinary MedicineCollege of Animal Science and Veterinary MedicineShandong Agricultural UniversityShandong Agricultural UniversityBabcock:An Intestinal Tissue Forceps More More delicate de

50、licate than than Allis,Allis,less less directly directly traumatic.traumatic.Broad,Broad,flared flared ends ends with with smooth smooth tips.tips.Used Used to to atraumatically hold viscera(bowel and bladder).atraumatically hold viscera(bowel and bladder).Copyright All reserved,MA WM PhDCollege of