Instrumentarul chirurgical

Generalitati
Totalitatea instrumentelor si dispozitivelor ce servesc la bunul mers al unei interventii chirurgicale Permit accesul in zone profunde, inaccesibile mainii chirurgului Au contribuit la scaderea traumatismului tisular si la miniinvazivitate: jackoscopie, laparoscopie
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Clasificare
Instrumente taietoare Instrumente de apucat si fixat Instrumente de sutura Departatoare Instrumente pentru chirurgia osoasa Instrumentar laparoscopic
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Instrumentele taietoare
Bisturiul rece Bisturiul electric Foarfecele

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Bisturiul
Simbol al actului chirurgical si al chirurgului, insa paradoxal, cel mai putin utilizat Priza Tipuri 1. Monobloc 2. Lama interschimbabila 3. Dispozabil Tipul adaptat nevoilor
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Foarfecele
Principalul instrument taietor in chirurgie Clasificare 1. De pansament Liston 2. De ata 3. De disectie: dreapta sau curba Priza: degete 1 si 4
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Foarfeca Liston de pansament

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Foarfeci de disectie

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Foarfeca dura, de ata

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Foarfeca de microchirurgie

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Bisturiul electric
Mod de functionare: taiere/coagulare Pe cale clasica sau laparoscopica

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Pensa anatomica
Prehensiune fina, in profunzime, lungimi diferite, fara dinti Mana stanga apuca, mana dreapta sectioneaza Particular in microchirurgie

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Pensa chirurgicala
Dura, cu dinti, lungimi diferite Piele, aponevroza, musculatura, bont vaginal

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Pense hemostatice
Pean Kocher Mosquito Halstedt

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Pensa Pean
Cea mai folosita in chirurgie Cremaliera autostatica Zimti transversali pe toata lungimea, FARA DINTI LA CAPAT- caracter atraumatic Drept sau curb
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Pensa Mosquito
Pensa Pean mica10cm, fina Chirurgia vasculara si tiroidiana

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Pensa Kocher
Pensa hemostatica dura, grosiera Zimti pe toata lungimea+2 dinti la capattraumatica Hemostaza pe structuri ferme: uter, muschi

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Pensa Halstedt
Kocher mic

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Pensa porttampon
Toaleta plagilor Asepsia campului operator

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Pensa Museux, de uter

Puternica, lunga, prevazuta cu dinti la capat+ cremaliera Pensa Chaputidentica dar mai mica, la excizia tu. Mici Pensa de plamanatraumatica
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Pense pentru fixarea campurilor

Carabus-delimiteaza campul operator Bachaus-izolarea tegumentului Doyen-izolare tegumentara la gusa Mikulicz-izolare peritoneudiferentierea de Kocher

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Bachaus

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Mikulicz

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Pense speciale atraumatice

En coeur-de limba sau de colecist Klammer intestinala Duodenala in L-de rect

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En coeur

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Klammer nu pe mezou!

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Alte pense
Dejardin-de calculi De cistic-ca un pean fin

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Instrumente se sutura
Portac Mathieu Portac Hegar Ac Reverdin Ac Deschamp Ac Hagedorn Ac Bassini Stapler
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Portac Mathieu
Grosier, sutura superficiala: piele musculatura, aponevroza Priza

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Portac Hegar
Suplu, sutura fina, in profunzime Priza

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Ac Reverdin
Grosier, 2 treceri prin tesut Chirurgia laparoscopica peretelui abdominal Buton si clapeta ce culiseaza
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Ac Deschamp-urechea la varf
Grosier, 2 traversari De dreapta si de stanga In combinatie cu sonda Payr

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Staplere
Linear/circular Dimensiuni variabile Clasic/laparoscopic Agrafe diferite Scurteaza durata, creste acuratetea Scoate factorul eroare umana din rata de fistule
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Departatoare
Farabeuff-2 lame Kocher-1 lama + maner Volkmann cu dinti Valve abdominale Autostatice vasculare Autostatic Gosset Autostatic Finochetto
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Farabeuff

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Kocher

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Volkmann

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Valva abdominala

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Autostatic vascular

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Gosset

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Finochetto

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Chirurgia laparoscopica

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 Dieffenbachbuldog, vase mici Satinski-clam puternic, vase mari

Pense atraumatice pentru chirurgia vascularaclampuri

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Chirurgia osoasa 1

Luer

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Chirurgia osoasa 2
Volkmann Gigli

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Sonde
Nelaton Pezzer Thiemann Foley

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Dren Kehr

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Ati inceput chirurgia cu dreptul !!!

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