常用外科手术器械及其使用课件

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。整理课件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整理课件内容提纲第一节常用外科器械及其使用整理课件（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、手术刀整理课件（一）种类第一节常用外科器械及其使用一、手术刀整理课件Sharpscalpelwithdisposable10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号刀柄整理课件Sharpscalpelwithdisposable1Handles整理课件Handles整理课件HandlesBladesBlades#10,11,12,15fitthe#3handle,#22,#23fitthe#4handle,commonlyusedforlargeanimals.整理课件HandlesBladesBlades#10,11,DisposableScalpel整理课件DisposableScalpel整理课件Electrosurgicalscalpel整理课件Electrosurgicalscalpel整理课件（二）手术刀的使用装刀片法取刀片法视频026整理课件（二）手术刀的使用装刀片法取刀片法视频026整理课件装刀片整理课件装刀片整理课件ThreebasicgripsforholdingthescalpelPencilgripFingertipgripPalmgrip整理课件ThreebasicgripsforholdingScalpels整理课件Scalpels整理课件Thescalpelisheldwiththumb,middleandringfingerwhiletheindexfingerisplacedontheupperedgetohelpguidethescalpel.Longgentlecuttingstrokesarelesstraumatictotissuethanshortchoppingmotions.整理课件ThescalpelisheldwiththumbThescalpelshouldneverbeusedina"stabbing"motion整理课件Thescalpelshouldneverbeus二、

surgicalscissors组织剪剪线剪Commonlyusedsurgicalscissors整理课件二、surgicalscissors组织剪剪线剪CommClassificationbytypeofpointsAlltypesofscissorscanhavebluntorsharpblades(A:Sharp:Sharp,B:Blunt:Blunt).整理课件ClassificationbytypeofpoinAlltypescanhaveeitherstraightorcurvedblades整理课件AlltypescanhaveeitherstraMayoandMetzenbaum整理课件MayoandMetzenbaum整理课件Mayoscissors(B)areusedforcuttingheavyfasciaandsutures.

Metzenbaumscissors(A)aremoredelicatethanMayoscissors.

Metzenbaumscissorsareusedtocutdelicatetissuesandscissorshavealongerhandletobladeratio.整理课件Mayoscissors(B)areusedfor执剪的方法剪线的方法视频027

整理课件执剪的方法剪线的方法视频027整理课件三、

tissueforcepsA.DifferenttissueforcepsB.PencilgripforthumbforcepinuseC.Palmedpositionforthumbforcepbeingcarried整理课件三、tissueforcepsA.DifferenttThumbforcepsareheldlikeapencil

整理课件ThumbforcepsareheldlikeaThumbForcepsarenotheldlikeaknife

整理课件ThumbForcepsarenotheldlik镊子在手术中的使用视频028

整理课件镊子在手术中的使用视频028整理课件四、止血钳五、持针钳HemostaticforcepsNeedleholder整理课件四、止血钳五、持针钳HemostaticforcepsNe持针钳在手术中的应用整理课件持针钳在手术中的应用整理课件ClassificationbysizeandshapeandsizeoftipsHemostaticforcepsandhemostatsmaybecurvedorstraight.整理课件ClassificationbysizeandshaKellyHemostaticForcepsandMosquitoHemostatsBotharetransverselyserratedMosquitohemostats(A)aremoredelicatethanKellyhemostaticforceps(B).整理课件KellyHemostaticForcepsandMMosquitohemostats(A)haveasmaller,finertipComparisonofKellyandMosquitotips整理课件Mosquitohemostats(A)haveaCarmalt视频029

整理课件Carmalt视频029整理课件Mayo-HegarHeavy,withmildlytaperedjaws.Nocuttingblades.整理课件Mayo-HegarHeavy,withmildlyOlsen-HegarIncludesbothneedleholdingjawandscissorsblades.Thedisadvantagetohavingbladeswithintheneedleholderisthesuturematerialmaybeaccidentallycut.整理课件Olsen-HegarIncludesbothneed六、surgicalneedles1.needlepoint2.needlebody3.needlelength4.needlediameter5.needlechordlength6.needleridusABCB.conventionalcuttingC.reversecuttingA.Theshapeofthepointandbodyofnocutting整理课件六、surgicalneedles1.needlepoi七、retractorRibretractorAbdominal~Perineal~整理课件七、retractorRibretractorAbdomiSennBladesateachend.Bladescanbeblunt(delicate)orsharp(moretraumatic,usedforfascia).整理课件SennBladesateachend.BladeHohmanLeverstissueawayfromboneduringorthopedicprocedures.整理课件HohmanLeverstissueawayfromWeitlanerEndscanbebluntorsharp.Hasraketips.Ratchettoholdtissueapart.整理课件WeitlanerEndscanbebluntorGelpiHassinglepointtips.Ratchettoholdtissueapart.整理课件GelpiHassinglepointtips.Ra创钩在手术中的应用视频030

整理课件创钩在手术中的应用视频030整理课件创钩的使用整理课件创钩的使用整理课件创钩的使用整理课件创钩的使用整理课件创钩的使用整理课件创钩的使用整理课件八、towelforcep视频031

整理课件八、towelforcep视频031整理课件九、tissueforceps整理课件九、tissueforceps整理课件Forceps:consistoftwotinesheldtogetheratoneendwithaspringdevicethatholdsthetinesopen.Forcepscanbeeithertissueordressingforceps.Dressingforcepshavesmoothorsmoothlyserratedtips.Tissueforcepshaveteethtogriptissue.Manyforcepsbearthenameoftheoriginatorofthedesign,suchasAdsontissueforceps.整理课件Forceps:consistoftwotinesRatTooth:ATissueForcepsInterdigitatingteethholdtissuewithoutslipping.Usedtoholdskin/densetissue整理课件RatTooth:ATissueForcepsIntAdsonTissueForcepsSmallserratedteethonedgeoftips.TheAdsonstissueforcepshasdelicateserratedtipsdesignedforlight,carefulhandlingoftissue整理课件AdsonTissueForcepsSmallserrAllis:AnIntestinalTissueForcepsInterdigitatingshortteethtograspandholdbowelortissue.Slightlytraumatic,usetoholdintestine,fasciaandskin整理课件Allis:AnIntestinalTissueFoBabcock:AnIntestinalTissueForcepsMoredelicatethanAllis,lessdirectlytraumatic.Broad,flaredendswithsmoothtips.

Usedtoatraumaticallyholdviscera(bowelandbladder).

整理课件Babcock:AnIntestinalTissueSpongeForcepsSpongeforcepscanbestraightorcurved,canhavesmoothorserratedjaws.Usedtoatraumaticallyholdviscera(bowelandbladder).整理课件SpongeForcepsSpongeforcepsc十、肠钳整理课件十、肠钳整理课件DoyenIntestinalForcepsNon-crushingintestinaloccludingforcepswithlongitudinalserrations.Usedtotemporarilyoccludelumenofbowel整理课件DoyenIntestinalForcepsNon-crPayrPylorusClampsAcrushingintestinalinstrument.Usedtooccludetheendofboweltoberesected.整理课件PayrPylorusClampsAcrushingThethumbandringfingerareinsertedintotheringsofthescissorswhiletheindexandmiddlefingerareusedtoguidetheinstrument.Theinstrumentshouldremainatthetipsofthefingersformaximumcontrol.整理课件ThethumbandringfingerareThisisthewrongwaytoholdthescissors.Theringfingershouldbeinsertedint