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9 Cards in this Set

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Tools order on the big table
Middle : towel clamps,doyen,scissors
Top, middle : saline, needle +suture material
Top, right : dressings + towels
Left, top to bottom :
Auto-retractors, retracting instruments, special instruments
Bottom, middle : forceps (anatomical+surgical), needle holders,
Bottom, right : haemostatic, peritoneal clamps
Tools order on the Sonnenburg table for VCD
Left side, operator (top to bottom) : scalepl, forceps (anat+surg), scissors(Cooper, Mayo)
Middle : Doyens (4-6), Towel clamps (4)
Middle, bottom : needle holder, needle, suture material
Middle, top, 1st assistant : forceps (anat+surg), Cooper scissors
Top, right : Hemostatic (Pean, Kocher, Mosquito)
Bottom, right : Cooper
>>> for VCD add :
2 rubber Peans, 2 dental forceps, Knee scissors, canule, infusion solution
Tools order on the Sonnenburg table for skin/muscle incision :
Left side, operator (top to bottom) : scalepl, forceps (anat+surg), scissors(Cooper, Mayo)
Middle : Doyens (4-6), Towel clamps (4)
Middle, bottom : needle holder, needle, suture material
Middle, top, 1st assistant : forceps (anat+surg), Cooper scissors
Top, right : Hemostatic (Pean, Kocher, Mosquito)
Bottom, right : Cooper
>>> for skin/muscle do not add anything
Tools order on the Sonnenburg table for Laparotomy :
Left side, operator (top to bottom) : scalepl, forceps (anat+surg), scissors(Cooper, Mayo)
Middle : Doyens (4-6), Towel clamps (4)
Middle, bottom : needle holder, needle, suture material
Middle, top, 1st assistant : forceps (anat+surg), Cooper scissors
Top, right : Hemostatic (Pean, Kocher, MOsquito)
Bottom, right : Cooper
>>> for Laparotomy add :
Peritoneal scissors for the operator, Peritoneal clamp below hemostatics, and use 6 Doyens and 6 towel clamps
Skin sutures (needle, suture material)
1/4, 3/8 cutting triangular needle, 1/0 or 0 nonabsorbable, mono/polyfilament (pref. poly)
Muscle sutures
Muscle - cutting needle 1/2,5/8
Suturing material : nonabsorbable/absorbable, polyfilament
Closure of abdominal cavity in 3 layers
Definition : closing each layer seperately (peritoneuum, muscle, skin).
Needles :
Peritoneum - serosal needle
Muscle - cutting needle 1/2,5/8
Skin - cutting needle, 1/4, 3/8
Suturing material :
Peritoneum - mono/pesudofilament, absorbable
Muscle - nonabsorbable/absorbable, polyfilament
Skin - nonabsorbable, mono/polyfilament (pref. poly)
Closure of abdominal cavity in 2 layers
Definition : closure of peritoneum and muscle together in one layer, and skin in second suture. Regard the 2nd layer of closing as MUSCLE.
Needles :
Skin - cutting needle, 1/4, 3/8
Muscle - cutting needle 1/2,5/8
Suturing material :
Muscle - nonabsorbable/absorbable, polyfilament
Skin - nonabsorbable, mono/polyfilament (pref. poly)
Steps of Venous Cut Down Technique
-->Modified Jackson position (pillow under shoulders)
1. Catheter preparation (check air bubbles)
2. Check infusion solution(expiration date)
---> Anesthesia
3. Skin incision, stop the bleeding
4. Exposure of the vein ((parallel spreading with Cooper scissors)
5. Isolate the vein between two ligatures (use anatomical forceps under it)
6. Perform the distal ligature
7. V-shape cut in the vein (w/knee scissors)
8. Insert catheter
9. Connect the infusion
10. U stitch
11. Closure of incision