常用外科手術器械及其使用課件

第六章手術基本操作技術手術種類繁多，范圍、大小和復雜程度不同，但基本操作技術是相同的手術順利完成，一定意義上取決于基本操作的熟練程度及其理論的掌握理論指導下的不斷實踐，是唯一的正確途徑。穩(wěn)、準、巧、輕、快是基本要求。整理課件第六章手術基本操作技術手術種類繁多，范圍、大小和復雜程度內容提綱第一節(jié)常用外科器械及其使用第二節(jié)顯露第三節(jié)止血第四節(jié)縫合第五節(jié)拆線第六節(jié)打結第七節(jié)引流整理課件內容提綱第一節(jié)常用外科器械及其使用整理課件（一）種類4、6、8號刀柄配19~24號刀片。3、5、7號刀柄配10、11、12、15號刀片專用手術刀，如眼科刀等。高頻電刀。第一節(jié)常用外科器械及其使用一、手術刀整理課件（一）種類第一節(jié)常用外科器械及其使用一、手術刀整理課件Sharpscalpelwithdisposable10號小圓刃11號角形尖刃12號號彎形尖刃15號小圓刃3號刀柄8號刀柄整理課件Sharpscalpelwithdisposable1Handles整理課件Handles整理課件HandlesBladesBlades#10,11,12,15fitthe#3handle,#22,#23fitthe#4handle,commonlyusedforlargeanimals.整理課件HandlesBladesBlades#10,11,DisposableScalpel整理課件DisposableScalpel整理課件Electrosurgicalscalpel整理課件Electrosurgicalscalpel整理課件（二）手術刀的使用裝刀片法取刀片法視頻026整理課件（二）手術刀的使用裝刀片法取刀片法視頻026整理課件裝刀片整理課件裝刀片整理課件ThreebasicgripsforholdingthescalpelPencilgripFingertipgripPalmgrip整理課件ThreebasicgripsforholdingScalpels整理課件Scalpels整理課件Thescalpelisheldwiththumb,middleandringfingerwhiletheindexfingerisplacedontheupperedgetohelpguidethescalpel.Longgentlecuttingstrokesarelesstraumatictotissuethanshortchoppingmotions.整理課件ThescalpelisheldwiththumbThescalpelshouldneverbeusedina"stabbing"motion整理課件Thescalpelshouldneverbeus二、

surgicalscissors組織剪剪線剪Commonlyusedsurgicalscissors整理課件二、surgicalscissors組織剪剪線剪CommClassificationbytypeofpointsAlltypesofscissorscanhavebluntorsharpblades(A:Sharp:Sharp,B:Blunt:Blunt).整理課件ClassificationbytypeofpoinAlltypescanhaveeitherstraightorcurvedblades整理課件AlltypescanhaveeitherstraMayoandMetzenbaum整理課件MayoandMetzenbaum整理課件Mayoscissors(B)areusedforcuttingheavyfasciaandsutures.

Metzenbaumscissors(A)aremoredelicatethanMayoscissors.

Metzenbaumscissorsareusedtocutdelicatetissuesandscissorshavealongerhandletobladeratio.整理課件Mayoscissors(B)areusedfor執(zhí)剪的方法剪線的方法視頻027

整理課件執(zhí)剪的方法剪線的方法視頻027整理課件三、

tissueforcepsA.DifferenttissueforcepsB.PencilgripforthumbforcepinuseC.Palmedpositionforthumbforcepbeingcarried整理課件三、tissueforcepsA.DifferenttThumbforcepsareheldlikeapencil

整理課件ThumbforcepsareheldlikeaThumbForcepsarenotheldlikeaknife

整理課件ThumbForcepsarenotheldlik鑷子在手術中的使用視頻028

整理課件鑷子在手術中的使用視頻028整理課件四、止血鉗五、持針鉗HemostaticforcepsNeedleholder整理課件四、止血鉗五、持針鉗HemostaticforcepsNe持針鉗在手術中的應用整理課件持針鉗在手術中的應用整理課件ClassificationbysizeandshapeandsizeoftipsHemostaticforcepsandhemostatsmaybecurvedorstraight.整理課件ClassificationbysizeandshaKellyHemostaticForcepsandMosquitoHemostatsBotharetransverselyserratedMosquitohemostats(A)aremoredelicatethanKellyhemostaticforceps(B).整理課件KellyHemostaticForcepsandMMosquitohemostats(A)haveasmaller,finertipComparisonofKellyandMosquitotips整理課件Mosquitohemostats(A)haveaCarmalt視頻029

整理課件Carmalt視頻029整理課件Mayo-HegarHeavy,withmildlytaperedjaws.Nocuttingblades.整理課件Mayo-HegarHeavy,withmildlyOlsen-HegarIncludesbothneedleholdingjawandscissorsblades.Thedisadvantagetohavingbladeswithintheneedleholderisthesuturematerialmaybeaccidentallycut.整理課件Olsen-HegarIncludesbothneed六、surgicalneedles1.needlepoint2.needlebody3.needlelength4.needlediameter5.needlechordlength6.needleridusABCB.conventionalcuttingC.reversecuttingA.Theshapeofthepointandbodyofnocutting整理課件六、surgicalneedles1.needlepoi七、retractorRibretractorAbdominal~Perineal~整理課件七、retractorRibretractorAbdomiSennBladesateachend.Bladescanbeblunt(delicate)orsharp(moretraumatic,usedforfascia).整理課件SennBladesateachend.BladeHohmanLeverstissueawayfromboneduringorthopedicprocedures.整理課件HohmanLeverstissueawayfromWeitlanerEndscanbebluntorsharp.Hasraketips.Ratchettoholdtissueapart.整理課件WeitlanerEndscanbebluntorGelpiHassinglepointtips.Ratchettoholdtissueapart.整理課件GelpiHassinglepointtips.Ra創(chuàng)鉤在手術中的應用視頻030

整理課件創(chuàng)鉤在手術中的應用視頻030整理課件創(chuàng)鉤的使用整理課件創(chuàng)鉤的使用整理課件創(chuàng)鉤的使用整理課件創(chuàng)鉤的使用整理課件創(chuàng)鉤的使用整理課件創(chuàng)鉤的使用整理課件八、towelforcep視頻031

整理課件八、towelforcep視頻031整理課件九、tissueforceps整理課件九、tissueforceps整理課件Forceps:consistoftwotinesheldtogetheratoneendwithaspringdevicethatholdsthetinesopen.Forcepscanbeeithertissueordressingforceps.Dressingforcepshavesmoothorsmoothlyserratedtips.Tissueforcepshaveteethtogriptissue.Manyforcepsbearthenameoftheoriginatorofthedesign,suchasAdsontissueforceps.整理課件Forceps:consistoftwotinesRatTooth:ATissueForcepsInterdigitatingteethholdtissuewithoutslipping.Usedtoholdskin/densetissue整理課件RatTooth:ATissueForcepsIntAdsonTissueForcepsSmallserratedteethonedgeoftips.TheAdsonstissueforcepshasdelicateserratedtipsdesignedforlight,carefulhandlingoftissue整理課件AdsonTissueForcepsSmallserrAllis:AnIntestinalTissueForcepsInterdigitatingshortteethtograspandholdbowelortissue.Slightlytraumatic,usetoholdintestine,fasciaandskin整理課件Allis:AnIntestinalTissueFoBabcock:AnIntestinalTissueForcepsMoredelicatethanAllis,lessdirectlytraumatic.Broad,flaredendswithsmoothtips.

Usedtoatraumaticallyholdviscera(bowelandbladder).

整理課件Babcock:AnIntestinalTissueSpongeForcepsSpongeforcepscanbestraightorcurved,canhavesmoothorserratedjaws.Usedtoatraumaticallyholdviscera(bowelandbladder).整理課件SpongeForcepsSpongeforcepsc十、腸鉗整理課件十、腸鉗整理課件DoyenIntestinalForcepsNon-crushingintestinaloccludingforcepswithlongitudinalserrations.Usedtotemporarilyoccludelumenofbowel整理課件DoyenIntestinalForcepsNon-crPayrPylorusClampsAcrushingintestinalinstrument.Usedtooccludetheendofboweltoberesected.整理課件PayrPylorusClampsAcrushingThethumbandringfingerareinsertedintotheringsofthescissorswhiletheindexandmiddlefingerareusedtoguidetheinstrument.Theinstrumentshouldremainatthetipsofthefingersformaximumcontrol.整理課件ThethumbandringfingerareThisisthewrongwaytoholdthescissors.Theringfingershouldbeinsertedintothering整理課件ThisisthewrongwaytoholdThisisalsothewrongwaytoholdthescissors.Thetipsofthescissorsshouldbepointingupwards整理課件Thisisalsothewrongwayto十一、器械的傳遞手術剪的傳遞整理課件十一、器械的傳遞手術剪的傳遞整理課件持針鉗的傳遞整理課件持針鉗的傳遞整理課件Anacceptablehandsignalforaneedleholderwithsuture

Anacceptablehandsignalforthumbforcep整理課件AnacceptablehandsignalforＡ.AnacceptablesignalforscalpelAＢＢ.Anacceptablehandsignalforahemostat返回整理課件Ａ.AnacceptablesignalforscaA、B.Passinganinstrumentpacktoascrubbedmemberoftheoperatingteam

ABC.Anacceptablewayofchangingpositionsduringasurgicalprocedure

C返回整理課件A、B.Passinganinstrumentpack第六章手術基本操作技術手術種類繁多，范圍、大小和復雜程度不同，但基本操作技術是相同的手術順利完成，一定意義上取決于基本操作的熟練程度及其理論的掌握理論指導下的不斷實踐，是唯一的正確途徑。穩(wěn)、準、巧、輕、快是基本要求。整理課件第六章手術基本操作技術手術種類繁多，范圍、大小和復雜程度內容提綱第一節(jié)常用外科器械及其使用第二節(jié)顯露第三節(jié)止血第四節(jié)縫合第五節(jié)拆線第六節(jié)打結第七節(jié)引流整理課件內容提綱第一節(jié)常用外科器械及其使用整理課件（一）種類4、6、8號刀柄配19~24號刀片。3、5、7號刀柄配10、11、12、15號刀片專用手術刀，如眼科刀等。高頻電刀。第一節(jié)常用外科器械及其使用一、手術刀整理課件（一）種類第一節(jié)常用外科器械及其使用一、手術刀整理課件Sharpscalpelwithdisposable10號小圓刃11號角形尖刃12號號彎形尖刃15號小圓刃3號刀柄8號刀柄整理課件Sharpscalpelwithdisposable1Handles整理課件Handles整理課件HandlesBladesBlades#10,11,12,15fitthe#3handle,#22,#23fitthe#4handle,commonlyusedforlargeanimals.整理課件HandlesBladesBlades#10,11,DisposableScalpel整理課件DisposableScalpel整理課件Electrosurgicalscalpel整理課件Electrosurgicalscalpel整理課件（二）手術刀的使用裝刀片法取刀片法視頻026整理課件（二）手術刀的使用裝刀片法取刀片法視頻026整理課件裝刀片整理課件裝刀片整理課件ThreebasicgripsforholdingthescalpelPencilgripFingertipgripPalmgrip整理課件ThreebasicgripsforholdingScalpels整理課件Scalpels整理課件Thescalpelisheldwiththumb,middleandringfingerwhiletheindexfingerisplacedontheupperedgetohelpguidethescalpel.Longgentlecuttingstrokesarelesstraumatictotissuethanshortchoppingmotions.整理課件ThescalpelisheldwiththumbThescalpelshouldneverbeusedina"stabbing"motion整理課件Thescalpelshouldneverbeus二、

surgicalscissors組織剪剪線剪Commonlyusedsurgicalscissors整理課件二、surgicalscissors組織剪剪線剪CommClassificationbytypeofpointsAlltypesofscissorscanhavebluntorsharpblades(A:Sharp:Sharp,B:Blunt:Blunt).整理課件ClassificationbytypeofpoinAlltypescanhaveeitherstraightorcurvedblades整理課件AlltypescanhaveeitherstraMayoandMetzenbaum整理課件MayoandMetzenbaum整理課件Mayoscissors(B)areusedforcuttingheavyfasciaandsutures.

Metzenbaumscissors(A)aremoredelicatethanMayoscissors.

Metzenbaumscissorsareusedtocutdelicatetissuesandscissorshavealongerhandletobladeratio.整理課件Mayoscissors(B)areusedfor執(zhí)剪的方法剪線的方法視頻027

整理課件執(zhí)剪的方法剪線的方法視頻027整理課件三、

tissueforcepsA.DifferenttissueforcepsB.PencilgripforthumbforcepinuseC.Palmedpositionforthumbforcepbeingcarried整理課件三、tissueforcepsA.DifferenttThumbforcepsareheldlikeapencil

整理課件ThumbforcepsareheldlikeaThumbForcepsarenotheldlikeaknife

整理課件ThumbForcepsarenotheldlik鑷子在手術中的使用視頻028

整理課件鑷子在手術中的使用視頻028整理課件四、止血鉗五、持針鉗HemostaticforcepsNeedleholder整理課件四、止血鉗五、持針鉗HemostaticforcepsNe持針鉗在手術中的應用整理課件持針鉗在手術中的應用整理課件ClassificationbysizeandshapeandsizeoftipsHemostaticforcepsandhemostatsmaybecurvedorstraight.整理課件ClassificationbysizeandshaKellyHemostaticForcepsandMosquitoHemostatsBotharetransverselyserratedMosquitohemostats(A)aremoredelicatethanKellyhemostaticforceps(B).整理課件KellyHemostaticForcepsandMMosquitohemostats(A)haveasmaller,finertipComparisonofKellyandMosquitotips整理課件Mosquitohemostats(A)haveaCarmalt視頻029

整理課件Carmalt視頻029整理課件Mayo-HegarHeavy,withmildlytaperedjaws.Nocuttingblades.整理課件Mayo-HegarHeavy,withmildlyOlsen-HegarIncludesbothneedleholdingjawandscissorsblades.Thedisadvantagetohavingbladeswithintheneedleholderisthesuturematerialmaybeaccidentallycut.整理課件Olsen-HegarIncludesbothneed六、surgicalneedles1.needlepoint2.needlebody3.needlelength4.needlediameter5.needlechordlength6.needleridusABCB.conventionalcuttingC.reversecuttingA.Theshapeofthepointandbodyofnocutting整理課件六、surgicalneedles1.needlepoi七、retractorRibretractorAbdominal~Perineal~整理課件七、retractorRibretractorAbdomiSennBladesateachend.Bladescanbeblunt(delicate)orsharp(moretraumatic,usedforfascia).整理課件SennBladesateachend.BladeHohmanLeverstissueawayfromboneduringorthopedicprocedures.整理課件HohmanLeverstissueawayfromWeitlanerEndscanbebluntorsharp.Hasraketips.Ratchettoholdtissueapart.整理課件WeitlanerEndscanbebluntorGelpiHassinglepointtips.Ratchettoholdtissueapart.整理課件GelpiHassinglepointtips.Ra創(chuàng)鉤在手術中的應用視頻030

整理課件創(chuàng)鉤在手術中的應用視頻030整理課件創(chuàng)鉤的使用整理課件創(chuàng)鉤的使用整理課件創(chuàng)鉤的使用整理課件創(chuàng)鉤的使用整理課件創(chuàng)鉤的使用整理課件創(chuàng)鉤的使用整理課件八、towelforcep視頻031

整理課件八、towelforcep視頻031整理課件九、tissueforceps整理課件九、tissueforceps整理課件Forceps:consistoftwotinesheldtogetheratoneendwithaspringdevicethatholdsthetinesopen.Forcepscanbeeithertissueordressingforceps.Dressingforcepshavesmoothorsmoothlyserratedtips.Tissueforcepshaveteethtogriptissue.Manyforcepsbearthenameoftheoriginatorofthedesign,suchasAdsontissueforceps.整理課件Forceps:consistoftwotinesRatTooth:ATissueForcepsInterdigitatingteethholdtissuewithoutslipping.Usedtoholdskin/densetissue整理課件RatTooth:ATissueForcepsIntAdsonTissueForcepsSmallserratedteethonedgeoftips.TheAdsonstissueforcepshasdelicateserratedtipsdesignedforlight,carefulhandlingoftissue整理課件AdsonTissueForcepsSmallserrAllis:AnIntestinalTissueForcepsInterdigitatingshortteethtograspandholdbowelortissue.Slightlytraumatic,usetoholdintestine,fasciaandskin整理課件Allis:AnIntestinalTissueFoBabcock:AnIntestinalTissueForcepsMoredelicatethanAllis,lessdirectlytraumatic.Broad,flaredendswithsmoothtips.

Usedtoatraumaticallyholdviscera(bowelandbladder).

整理課件Babcock:AnIntestinalTissueSpongeForcepsSpongeforcepscanbestraightorcurved,canhavesmoothorserratedjaws.Usedtoatraumaticallyholdviscera(bowelandbladder).整理課