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💢➖Surgical Instrumentation:
An Interactive Approach2 Powered Instruments Powered surgical instruments have historically cor- responded with surgical needs, predominantly in procedures involving bone.
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🔹➖This progression has been important because the complexity of these have required the use of different types of im- plants.
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🔹➖The use of power instruments decreased the use of manual instruments thereby reducing surgery time and improving overall outcomes. Pow- ered surgical instruments are used to perform orthopedic; neurosurgery; ear, nose, and throat (ENT); and oral procedures as well as procedures on other bodily systems. These devices perform cutting, driving, drilling, and reaming and are driven by batteries, compressed gas, and electrical power. Each instrument consists of one or more hand- pieces and related accessories as well as disposable
instruments should not be submerged in fluid or placed on top of other instruments. Power sources to these instruments should be disconnected or removed before the cleaning process begins. PARTS OF AN INSTRUMENT The overall design of an instrument is dependent on what function it will perform
♻️➖All instruments have a basic standard design and will be modified according to function and type. Components of this basic design include
♦️➖ handles, ratchets, shanks, joints, jaws or blades, and tips . Finger rings are on the proximal end and is the handle area of the instrument. Above the rings are shanks that define the length of the instru- ment, which is determined by the depth of the wound. Above the rings, attached to the shank may be ratchets that allow for the jaws to be closed and locked on tissues. Between the shanks and the jaw is the joint, which is where the two halves of the instrument are joined to permit for opening and closing
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These joints are either a box lock or a screw joint. Beyond the joint are the jaws, which are the working portion of the instru- ment. The inner jaws, tips, and the shape deter- mine how and on what tissues the instrument is used. Ringed instruments are placed in the palm of a surgeon’s hand with the working end up
Tissue forceps have a spring action joint at the distal end that holds the instrument open until compressed
The handle grip is where the sur- geon’s fingers are placed. The shanks determine the length of the forceps. The jaws and the tips are the working end of the forceps; these are deter- mined by the type of tissue that is being grasped Tissue forceps are held between the thumb and index finger with the distal joint end resting on the top of the hand like a pencil. should be periodically irrigated with a syringe and sterile water to remove trapped blood and debris. Saline should not be used to wipe, rinse, or soak instrument
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🔹➖Exposure to saline will cause corro- sion and pitting. After the surgical procedure, all disposable sharps and blades should be removed and dis- carded in a sharps container Instruments should be opened, disassembled, and submerged in wa- ter or enzymatic solution. The instruments should be placed in the solution so that they do not be- come entangled or damaged. Heavy instruments should be placed first, and lighter, more delicate ones should be placed on top. Sharp edges or tips should be placed so that they do not endanger the personnel who will be cleaning them. Deli- cate instruments, rigid endoscopes, cameras, and fiberoptic light cords should be separated to pre- vent damage. All cords should be loosely coiled.
Power saws and drills should never be immersed in solutions
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♻️➖Microsurgical Instruments Microsurgical instruments are delicate. Proper care and handling are essential to prevent damage.
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➖ Generally, special storage containers are used to protect the instruments. These racks keep the instruments separate and help in iden- tification by providing a place to
BY تقنيات العمليات الجراحيةo.t.t
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