Dr Aravind S Ganapath

Senior Resident
S VI Unit
 :

1. Bard Parker Handle

#3 Narrow nose, To hold # 10, 11, 12
length 5 inches. & 15.
#7 Narrow nose, To hold # 10, 11, 12
length 6 ½ inches. & 15.
#9 Narrow nose, To hold # 10, 11, 12
length 4 ½ inches & 15.
#4 Narrow nose, To hold # 20 & 21.
length 5½ inches
To grasp very delicate tissues, nerve, or blood
vessel for suturing, dissecting or excising.

Dissecting Forceps
 Tograsp heavy tissues while they are
being sutured, dissected or excised.
To grasp delicate tissues like appendix.
 Suture Materials

Absorbable Non Absorbable

Synthetic
Natural Synthetic Natural

Vicryl Prolene
Catgut Silk
POLYGLACTIN POLYPROPYLENE

Monocryl Nylon
poliglecaprone Polyamide

Polyglycolic Acid
(Dexon).

PDS
Polydixanone
 Suture Materials

Monofilament Poly filament

MONOCRYL Vicryl

Nylon Silk

Catgut

Prolene
POLYPROPYLENE
 Itwas invented by two groups of people one in
New York (NY)
and one in London (LON) hence the name NYLON
was born
 New York-LONDON -> NYLON.
Plain Catgut.
Plain indicates a surgical catgut that has
not been treated to lengthen its
absorption time
in the tissue. This suture is absorbed more
rapidly than treated suture.

Chromic Catgut.
Chromic surgical catgut has been treated
with chromic oxide so that it will delay its
rate of digestion or absorption.
Atraumatic- A suture material manufactured with a needle attached to it.
Langenbeck’s
 Indications
Acute Retention of Urine
To assess the Output in Burns and Comatosed
Pelvic Surgeries
Urological Surgeries
 How will you collect urine for Culture ?
Clamp the catheter for about 30 minutes
Wipe the tubing using the surgical spirit
Withdraw urine using a sterile syringe and needle just
like you withdraw blood from the veins.

 CleanIntermittent Self Catheterization ( CISC ) is the

procedure of choice for Chronic Retention of urine.

 Change the catheter once in 3 weeks.

Ryles tube
 Original tube by Ryle- rubber.
 Now plastic- PVC/portex
 105 cms
 Tip, body, base.
 3 lead shots at tip
 Radio opaque
 Easy passage through esophagus
 Sterilised by Ethylene oxide
 Markings
 40 cms- GE jn- 1 line
 50 cms- body – 2 lines
 55 cms- pylorus- 3 lines
 65 cms- duodenum- 4 lines
 Size –
 Adult – 16-18 french(1 Fr = 1/3 mm ext dm)
 Children- age + 16 / 2
 Length- nostril to ear to xiphoid.
Diagnostic
 Gastric function tests
 Hollander’s test for completion of vagotomy
 Insulin- hypoglycemia-intact vagus- acidity increase
 Diagnosis of tracheo esophageal fistula
 Baid test for pseudocyst of pancreas.
 Stomach pushed anteriorly- tube felt per abdomen
 Saline load test for GOO
 700 ml NS- 30 mins- >350 ml
 Pentagastrin test for ZES and achlorhydria.
Therapeutic
 a/c abdomen- obstruction/perforation-
decompression
 After abdominal surgery- decompress stomach &
give rest till peristalsis.
 Pyloric stenosis
 UGIB
 Paralytic ileus
 Feeding
 Polytrauma- decompress and prevent aspiration
 Gastric lavage in non corrosive poisoning.
 Acute corossive poisoning*
 # cribriform plate*
 After nasal surgery*
 Sterilization-all microbes + spores killed
 Disinfection- all microbes killed/removed
except spores
 Autoclaving- all metals except sharps-
steam(121oC) under high pressure for 30
minutes.
 Cidex- 2% gluteraldehyde- sharps- 4 hours
 EO- ethylene oxide- 12 hours
 Formalin chamber- laparoscope 1 hour