Category: Basic Surgical Skills

Minimal access therapy : principles

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MINIMAL ACCESS THERAPY 1.AIMS AND OBJECTIVES 1.1.Aims The aims of the course is that : Participants should be able to perform, with confidence, basic procedures such as laparoscopic cholecystectomy or lapraroscopic appendicectomy under the initial supervision of an experienced laparoscopic surgeon. They should also be able to act as proficient first assistant at laparoscopic procedures. […]

VASCULAR ANASTOMOSIS Basic Principles in Vascular Surgery Adequate exposure Proximal and Distal control Heparinisation – Systemic or Local Arteriotomy Selection of suture materials Type of closure Vascular anastomosis A successful vascular anastomosis involves a meticulous technique which includes gentleness in handling absolute asepsis and extreme care in placement of sutures.   Arteriotomy and ClosureIndications: Embolectomy, Thrombectomy, […]

HAND SUTURED BOWEL ANASTOMOSIS BY SEROSUBMUCOSAL TECHNIQUE   1.Types INTERRUPTED SEROSUBMUCOSAL SUTURE ( the “gold standard” for intestinal anastomosis). CONTINUOUS SEROSUBMUCOSAL SUTURE. 2.The Basis Faster and sounder healing when compared to the traditional two layer anastomosis. CLOSEUP VIEW OF SINGLE SUTURE  3.Advantages Accurate tissue apposition. Incorporates submucosa – the strongest layer. Minimises damage to submucosal vascular plexus. Lesser […]

ISOLATION & LIGATION OF BLOOD VESSEL IN MESENTERY  TECHNIQUE Isolate the loop of bowel to be resected. Transilluminate the mesentery to study the pattern of blood supply to the bowel segment. Select the line of vascular section. Choose a shallow wedge of mesentery for benign leisions and deeper wedge for malignancies. Incise the the peritoneum […]

Tendon suture

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TENDON SUTURING Instruments  Hypodermic needles  Small curved hemostat  Fine non-toothed forceps  Needle holder 3-0 and 5-0 prolene sutures  Suture cutting scissors   Preparation Match correct tendon ends using the position of the tendons & the corresponding shapes of the cut ends. Fix tendon with a needle and steady one end with a needle. Do not grasp […]

Tissue debridement

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TISSUE DEBRIDEMENT          This is the most essential step in the management of the contaminated or dirty wound. Thoroughly wash the wound with copious amounts of normal saline under pressure using either a large syringe , rubber bulb or a pulsatile lavage system. Remove large particles of dirt with a toothed forceps. Sharply excise [ using […]

Skin suture

Skin suture

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Suturing Techniques   2 skin hooks   Fine non-toothed forceps   Needle holder   Suture cutting scissors Select appropriate suture material [ the finest suture compatible with holding the skin edges together]. Suture deeper layers with absorbable sutures. 1] Simple interrupted Insert needle thro’ skin at right angles including enough subcutaneous tissue to aid in ever ting the skin […]

Handling of instruments, knots by hand and instruments

INSTRUMENTS AND KNOTS  HANDLING BASIC INSTRUMENTS   1. Knife   2. Dissecting forceps   3. Scissors   4. Needle holder   5. Needles & Sutures   6. Knots   1. Knife               METHODS OF HOLDING THE KNIFE                 Blades come in various sizes to suit the task at hand and are detachable from their handles. The […]