1.non-traumatic
2.used for holding soft tissues like ureter,
appendix
3.hold gut wall in colostomy
4.as a hemostat when bleeder is difficult to
pinpoint
----------deaver's
hold intra abd visceras
1.retract bladder walls
2.in appendicectomy to retract down the pelvic
structures
----------bulldog clamp
clamp larger vessels during surgery
----------right angled/ langenbeck's retractor
retraction of skin edges or big vessels n nerves
used in hernioplasty for superficial dissectn n
retractn
----------rampley's sponge holding forcep
cleaning the op field
for swabbing a cavity
for packing of cavities
mopping ooze from op area
hold soft hollow organs like GB
for blunt dissection at depth e.g perinephric fat
as an ovum forcep
-----------proctoscope
dx of piles, ulcers,growth of rectum
minor op like injections of piles,polypectomy,re
ctal biopsy
----------mayo's towel clamp
fix the drapes
fix suction tubings to drapes
hold ribs n is used for ribs elevation
hold n retract the cord during hernial repairs
-----------lane's forceps
holding tough and bulky tissue.... hold skin for
opposition.....to hold lymphnode for its biopsy
----------allis's tissue forceps
for holding thin but tough structures e.g skin,
deep fascia,rects sheath,sac of hydrocele
for holding fibrous capsule of structre
holding bladder neck
----------artery forceps
as a hemostat
pedicular clamp for spleen n kidney
crush the base of appendix
hold cut edges of fascia, aponeurosis,peritonm
open up abscess cavity
hold needles fr suturing
hold free ends of tension sutures
hold free ends of sutures left during int
anastomosis
hold the tape of abd packs to drapes
------------plain forceps
holding delicate strctres like peritoneum,vessels,
bowel wall
hold skin over face n carilage
dissect soft friable tissues
-----------toothed forceps
used to hold tough strctres like
skin,fascia,rectus sheath
------------skin hook retractor
retract skin edges while giving sub cutaneos
stitches
-----------morris' retractor
retract strong strctres like abd wall n
musculature
-----------non crushing int clamps
for resection-anastomosis of int in case of
strangulated hernia, injuries to gut,int fistula,int
growths
-----------lahey's forceps
uses:
1.used to dissect cystic duct n artery during
cholecystectomy
2.used in vagotomies to dissect vagus nerve
3.in thyroid surgery to ligate n dissect middle
thyroid vein, sup thyroid pedicle
-----------joll's thyroid retractor
used in thyroidectomy
self retaining
-----------kocker's
kocher'shemostatic forceps
hold retractng ends of vessels in tough fibrous
tissue in palm n soles
hold perforatng vessls in radicall mastectomy
MAIN USE IS FOR HOLDING SUPERFICIAL
THYROID VESSELS IN THYROIDECTOMY
------------cat paw retractor.
retraction of fascia of palm n soles
------------debakey's
to manipulate fine vessles in vascular surgery
------------bake's dilator
exploration of CBD n to assess the size of
duodenal ampulla
plus sphincterotmy
-------------nasogastric tube
surgical indications:
1.gastric decompression
2.gastric emptying before GI surgery to avoid
aspiration
-------------bone nibbler
to nibble away small pieces of bones in various
surgeries o extremeties n spine to smoothen the
bone surface
to take pieces of bone for biopsy
---------------ett
1. Cardiopulmonary Arrest
2. Patient in deep coma or unresponsive
3. Shallow or slow respirations (less than 8 per
minute)4. Progressive cyanosis
5. Gastric lavage / gavage
6. Surgical patients where body positioning or
facial contours preclude the use of a mask
7. To prevent loss of airway at a later time, i.e.
a burn patient who inhales hot gases may be
intubated initially to prevent his airway from
swelling shut.
CONTRAINDICATIONS FOR ENDOTRACHEAL
INTUBATION:
1.contraindications:Obstruction of the upper
airway due to foreign objects
2.cervical fractures
The following conditions require caution before
attempting to intubate:
1.Esophageal disease
2.Ingestion of caustic substances
3.Mandibular fractures
4.Laryngeal edema
5.Thermal or chemical burns
-----------------lung clamp
also known asThe Duval clamp
1. atraumatically and securely grasp lung tissue
2.The triangular shaped jaws of the Duval clamp
may be used during dissection of lymph nodes
to securely grasp the nodes
--------------foley's
indi
1.acute n chronic retention of urine
2.in surgery involving bladder n prostate
3.an all pelvic op
4.in all perineal op
5.in manag of incomplete rupture of urethra
6to instill urinary antisepticsor chemothara
agnts in diseased bladder
7to carry out cysto/urethrography
adults 18F
children 10 F or 8
--------------gigley saw
1. amputation 2. cut skull in burr hole
operation
--------------chest tube
1.Pneumothorax: accumulation of air or gas in
the pleural space
2.Pleural effusion: accumulation of fluid in the
pleural space
3.Chylothorax: a collection of lymphatic fluid in
the pleural space
4.Empyema: a pyogenic infection of the pleural
space
5.Hemothorax: accumulation of blood in the
pleural space
6.Hydrothorax: accumulation of serous fluid in
the pleural space
7.Postoperative: for example, thoracotomy,
oesophagectomy, cardiac surgery
Contraindications
refractory coagulopathy
diaphragmatic hernia
scarring in the pleural space (adhesions).
complications
(2 in, 2 out, 2 above,2 down)
1if inserted too above injury to brachial plexus
2.subcutaneous empysema if its inserted outside
the pleural space
3.damage to liver,spleen n diaphragm if its
inserted below the pleural space
4.if inserted too inside may damage
mediastinum n maj blood vessels
--------------bougie dilators
dilate urethrl stricture...dilate normal urethra
b4 cystoscopy
---------------tracheostomy tube
1. severe facial trauma, head and neck cancers
2. large tumors of the head and neck
3.. In the context of failed orotracheal or
nasotracheal intubation, either tracheotomy or
cricothyrotomy may be performed.
4. comatose patients, or extensive surgery
involving the head and neck
gen consideration
the tracheal opening shud be kept moist
otherwise it will lead to insensible fluid loss of
upto 1.5L/day
----------nelton drain
To prevent the accumulation of fluid (blood, pus
and infected fluids).
To prevent accumulation of air (dead space).
To characterise fluid (for example, early
identification of anastomotic leakage
drains should be removed once the drainage has
stopped or becomes less than about 25 ml/day
-------------laparoscopy
----------maryland dissector
dissection of calots triangle
--------alligator's forceps
to withraw the separated gallbladder via
umblical port
---------desjardin forceps
to remove stones from GB
--------grasper
grasper
it is inserted via 5 mm port in the
hypochondrium n is used in the manipulation of
GB during cholecystctmy
-------clip applicator
used for application of clips to cystic duct n
artery during dissection of calots triangle
-------L hook
used for cautery of liver bed n seperation of GB
from liver bed
sponge holding forceps continued
