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。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

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Copyright©Allreserved,MAWMPhD

HandlesCopyright©Allreserved,MAWMPhD

HandlesBladesBlades#10,11,12,15fitthe#3handle,#22,#23fitthe#4handle,commonlyusedforlargeanimals.Copyright©Allreserved,MAWMPhD

DisposableScalpelCopyright©Allreserved,MAWMPhD

ElectrosurgicalscalpelCopyright©Allreserved,MAWMPhD

（二）手术刀的使用装刀片法取刀片法视频026Copyright©Allreserved,MAWMPhD

装刀片Copyright©Allreserved,MAWMPhD

ThreebasicgripsforholdingthescalpelPencilgripFingertipgripPalmgripCopyright©Allreserved,MAWMPhD

ScalpelsCopyright©Allreserved,MAWMPhD

Thescalpelisheldwiththumb,middleandringfingerwhiletheindexfingerisplacedontheupperedgetohelpguidethescalpel.Longgentlecuttingstrokesarelesstraumatictotissuethanshortchoppingmotions.Copyright©Allreserved,MAWMPhD

Thescalpelshouldneverbeusedina"stabbing"motionCopyright©Allreserved,MAWMPhD

二、

surgicalscissors组织剪剪线剪CommonlyusedsurgicalscissorsCopyright©Allreserved,MAWMPhD

ClassificationbytypeofpointsAlltypesofscissorscanhavebluntorsharpblades(A:Sharp:Sharp,B:Blunt:Blunt).Copyright©Allreserved,MAWMPhD

AlltypescanhaveeitherstraightorcurvedbladesCopyright©Allreserved,MAWMPhD

MayoandMetzenbaumCopyright©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、

tissueforcepsA.DifferenttissueforcepsB.PencilgripforthumbforcepinuseC.PalmedpositionforthumbforcepbeingcarriedCopyright©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HemostaticforcepsNeedleholderCopyright©Allreserved,MAWMPhD

持针钳在手术中的应用Copyright©Allreserved,MAWMPhD

ClassificationbysizeandshapeandsizeoftipsHemostaticforcepsandhemostatsmaybecurvedorstraight.Copyright©Allreserved,MAWMPhD

KellyHemostaticForcepsandMosquitoHemostatsBotharetransverselyserratedMosquitohemostats(A)aremoredelicatethanKellyhemostaticforceps(B).Copyright©Allreserved,MAWMPhD

Mosquitohemostats(A)haveasmaller,finertipComparisonofKellyandMosquitotipsCopyright©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、surgicalneedles1.needlepoint2.needlebody3.needlelength4.needlediameter5.needlechordlength6.needleridusABCB.conventionalcuttingC.reversecuttingA.TheshapeofthepointandbodyofnocuttingCopyright©Allreserved,MAWMPhD

七、retractorRibretractorAbdominal~Perineal~Copyright©Allreserved,MAWMPhD

Senn

Bladesateachend.Bladescanbeblunt(delicate)orsharp(moretraumatic,usedforfascia).Copyright©Allreserved,MAWMPhD

HohmanLeverstissueawayfromboneduringorthopedicprocedures.Copyright©Allreserved,MAWMPhD

Weitlaner

Endscanbebluntorsharp.Hasraketips.Ratchettoholdtissueapart.Copyright©Allreserved,MAWMPhD

GelpiHassinglepointtips.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、tissueforcepsCopyright©Allreserved,MAWMPhD

Forceps:consistoftwotinesheldtogetheratoneendwithaspringdevicethatholdsthetinesopen.Forcepscanbeeithertissueordressingforceps.Dressingforcepshavesmoothorsmoothlyserratedtips.Tissueforcepshaveteethtogriptissue.Manyforcepsbearthenameoftheoriginatorofthedesign,suchasAdsontissueforceps.Copyright©Allreserved,MAWMPhD

RatTooth:ATissueForcepsInterdigitatingteethholdtissuewithoutslipping.Usedtoholdskin/densetissueCopyright©Allreserved,MAWMPhD

AdsonTissueForcepsSmallserratedteethonedgeoftips.TheAdsonstissueforcepshasdelicateserratedtipsdesignedforlight,carefulhandlingoftissueCopyright©Allreserved,MAWMPhD

Allis:AnIntestinalTissueForcepsInterdigitatingshortteethtograspandholdbowelortissue.Slightlytraumatic,usetoholdintestine,fasciaandskinCopyright©Allreserved,MAWMPhD

Babcock:AnIntestinalTissueForcepsMoredelicatethanAllis,lessdirectlytraumatic.Broad,flaredendswithsmoothtips.

Usedtoatraumaticallyholdviscera(bowelandbladder).

Copyright©Allreserved,MAWMPhD

SpongeForcepsSpongeforcepscanbestraightorcurved,canhavesmoothorserratedjaws.Usedtoatraumaticallyholdviscera(bowelandbladder).Copyright©Allreserved,MAWMPhD

十、肠钳Copyright©Allreserved,MAWMPhD

DoyenIntestinalForcepsNon-crushingintestinaloccludingforcepswithlongitudinalserrations.UsedtotemporarilyoccludelumenofbowelCopyright©Allreserved,MAWMPhD

PayrPylorusClampsAcrushingintestinalinstrument.Usedtooccludetheendofboweltoberesected.Copyright©Allreserved,MAWMPhD

Thethumbandringfingerareinsertedintotheringsofthescissorswhiletheindexandmiddlefingerareusedtoguidetheinstrument.Theinstrumentshouldremainatthetipsofthefingersformaximumcontrol.Copyright©Allreserved,MAWMPhD

Thisisthewrongwaytoholdthescissors.Theringfingershouldbeinsertedintothering