Surgical Instruments Alvaro Enéas de Almeida Ribeiro Falcon Falcon Zélia Maria Oliveira de Almeida Index Introduction Distribution

instruments Instruments dieresis dre operative hemosta sis field auxiliary instruments Instruments Special Instruments synthesis Introduction We know what the word means surgery operation manual, it derives from the Greek smell (hand) and ergon (work). Clearly, a surgical procedure also requires tools to increase the skill of the operator and make the maneuvers were impossible to be executed only with hands. We use the terms to describe each instrument piece , in particular, and instrumental for all these parts. The number of surgical in struments is uncountable; over the years surgeons have been creating and modifyi ng new elements that will be incorporated into existing ones. Often named for it s creators, often differing only in very small details. In routine veterinary su rgical clinic used a relatively small universe, these parts, compared with diver sity in the printed catalogs of the manufacturers. These instruments will be sub ject to comments on this page, divided into different categories. Distribution There are many ways to arrange the instruments on a table, depending on the type of desk, type of surgery until the preference of the instrument. For general su rgery, many years ago the Department of Surgery, EV-UFMG adopted a standard that is followed in all undergraduate and graduate programs: Instruments dieresis Dieresis be understood by the surgical maneuvers that divide the tissues. Scalpe l scalpel classic called scalpel (lat. scalpellu) or fixed-blade knife is rarely used today, gave rise to the wires using a scalpel blade disposable. The most c ommonly used cables are: 1. 2. Cable # 3 - Use blades smaller incisions that all ow the most critical, sensitive (# 10, 11, 12, 15). Cable # 4 - Use larger blade s, are commonly used in procedures on large animals (no. 20, 21, 22, 23, 24, 25) . Scalpel, cables 3:04 Fixed scalpel blade Blade for cable 3 Scissors Scissors are tools dieresis separating tissues by cru shing the tissues are crushed between the blades that comprise it. This means th at the more critical is the contact between the two edges, the less trauma, whic h means it will be sharper. The scissors can be used to dieresis bloodless, clos ed when they are introduced into tissues and then removed open. In this case, wh o separates the tissues is the side hole of the blade, providing a too blunt dis section. Despite that they may be called by the name of its creators, the scisso rs are usually classified according to the shape of the ends of its blades, whic h can be Rombas or Fine. Of their possible combinations, derive scissors: RombaR omba (RR), Fine-Fine (FF) and blunt-Fina (RF). These instruments are found in ve rsions Reta (R) and Curve (C). In routine surgical scissors are used MAYO, versi on RRR for fascias and cutting wires. Also the Metzenbaum scissors, for the most delicate fabrics dieresis and which, being longer and thinner, are well used in cavities, reaching more deeply situated structures. Curved scissors Scissors straight Metzenbaum scissors

Instruments of hemostasis The temporary hemostasis can be performed in the course of surgery, with clamps instruments, equipped with locks, known hemostatic forceps. Hold its own vessel sectioned until definitive hemostasis is made, usually by ligation done with wir es. Wherever possible, they should just clamp the vessel, with a minimum of surr ounding tissue. Also bear the names of its creators, being very similar, differi ng in small details. Are differentiated, almost always, the design and the groov es inside its branches clamps. The hemostatic forceps more often used in our rou tine are: Forceps Crile They have transverse grooves across the length of your p art clamp. This also gives the utility of pedicle clamping, when the clamp is ap plied laterally, not being used to end. Being fully slotted, no slides, sets up very well to the structures that make up the pedicle. Sizes range from 14-a6 cm, straight or curved versions. Crile Forceps Forceps, Kelly Almost everything is similar to Crile, with the exception of the grooves on their part clamp, which occupy only two thirds of its length with sma ll variations to plus or minus depending on the manufacturer. Sizes range 14-16 cm, straight or curved versions. Kelly Forceps Forceps Forceps Hemostatic Halsted small€clamps delicate branches, lend themselv es very well for clamping of smaller vessels, for its accuracy. Are widely used in small animal surgery. As the forceps Crile, is totally grooved on the clamp. They are usually used forceps 12 cm, there is a variant called HARTMANNHALSTED t hat has 80-10 cm. Found in versions straight or curved. Halsted Forceps Kocher clamp Similar to the CRILE, the Kocher forceps have the inner face of the carrier clamp fully grooved in the transverse direction. They differ in having "tooth rat" on its edge, which on one hand increases the covers of his arrest to the tissues, the other makes it much more traumatic. Are presented in different sizes, straight or curved. Kocher clamp Operative field The clamps of the operative field, or simply COLLET FIELD aim to lay the cloth f ield, fenestrated or not the patient's skin, to prevent its position is changed during the work. His end is acute curve are eperfura cloth and skin of the patie nt. The most common are Backhaus forceps, and ROEDER have little of the "ball" i n the middle of each perforating branch, to limit the depth of drilling. The cla mps JONES, do not have, like its predecessors, rings seizure, and applied using only thumb and forefinger. In surgeries of small animals is desirable to use twe ezers smaller size, 80-10 cm, to reduce the trauma to tissues. Tweezers larger, 14-15 cm, are more suitable for animals with thicker skin. Forceps Backhaus Clamp Jones Forceps Roeder Auxiliaries Instrumental auxiliarsão not interfere directly in the action, just proprícias c reates conditions for the performance of other instruments. Includes dissection

tweezers, with and without teeth, whose function is to immobilize them to be cut or sutured. Also included here are those away, which as the name implies, remov es and retains the tissues or organs to facilitate and even enable surgical acce ss. The retractors are the simplest of FARABEUF and U.S. ARMY. are composed prim arily of a metal blade bent in the shape of the letter "C". Slightly more elabor ate are the retractors of VOLKMANN, which can be equipped with two to six claws, blunt or sharp, in the end that holds the tissues. They are used by the wizard, which facilitates the surgeon's maneuvers, remains so, his hands busy. To circu mvent this drawback, there are those self static retractors that when applied to the edges of the wall and keep the structures away from each other po só.São us ually employed in the thoracic and abdominal surgeries These retractors have hig her cost, due to the complexity of their construction such as Finochietto, GOSSE T AND BALFOUR. They are very useful when you do not have assistant to assist in surgery, as often happens in small animal clinics. Retractor Farabeuf U.S Army Retractor Volkman retractor Retractor Finochietto Retractor Gosset Balfour retractor Anatomic forceps tooth Anatomic forceps without teeth Synthesis tools These instruments are responsible for the maneuvering of surgical wound closure through the application of sutures. For this NEEDLES and tweezers are used to dr ive them special called HOLDERS NEEDLE. Although there are very delicate tweezer s to hold small needles, a feature of these instruments is the robustness of the carrier clamp quite differentiated from hemostatic forceps. Are fundamental to the making of sutures, since most of the needles is curved and the spaces are sm all surgical. Only straight needles and conformation "S" dispense their use. The port needles are the most used of Mayo-Hegar and MATHIEU. The Mayo-Hegar Needle Hegar-Mayo is similar to conventional hemostatic forceps, is stuck to the finge rs for the rings present in their rods and have to rack lock, progressive pressu re. But his part clamp is shorter, wider and its inside the grooves form a latti ce with a center slot in the longitudinal direction. Are devices to increase the ir efficiency in the immobilization of the needle during suturing, preventing it s rotation when the force is applied. If the branches clamps are coated hard met al (tungsten) will not show longitudinal split. Although the ease or difficulty in closing and opening may be related to the temper and quality of steel that ar e produced, theoretically its handling is softer on the instruments that have lo nger stems. In this case the application of force is further from the axis of ar ticulation of the branches,€making a move to leverage more efficient, as we know from physics. Mayohegar The Needle Mathieu Mathieu differ much from previous, in its way, has no rings o n the rods is the opening of the clamp part limited because there are a spring-s haped blade uniting their stems, which makes them automatically open, when not l ocked. They are used attached to the palm of his hand, which make them open, if

it is inadvertently used excessive force during handling. Your best indication w ould be to suture structures that offer little resistance to the passage of the needle. A good indication of this is that they lack the longitudinal split which increases the support of the needle. Mathieu The Olsen-Hegar needle holder of Olsen-Hegar is characterized together in a sing le instrument, the functions of tweezers and scissors to cut the wires. Below th e portion that holds the needle for the blades that cut the wires. During fabric ation of the node instrumental, sometimes the wire can bring to the blades, bein g cut accidentally, which is why many people avoid their use. Olsenhegar The door-Gillies needle GILLIES has rings on the rods, which are asymmetric: the longest to the shortest finger and the thumb, which gives it greater ergonomics . It has no rack to hang the rods, which indicates its use be more suitable for suture needles with small, soft fabrics. Gillies The classical surgical needles needles have the forms of segments (¼, 3 / 8, ½, and 5 / 8) in circumference. The more "open", ¼ and 3 / 8 of a circle, are best employed in areas that allow more freedom of movement, as in dermal suture. The most closed, ½ and 5 / 8 of a circle, have better performance over cramped work spaces, for example, inside the cavities. For this, the surgeon prints the needl e, needle holder attached to a movement of pronation-supination more pronounced, causing it to rotate within the limit of its radius. The anterior third of the needles is usually cylindrical or triangular cross section, which allows us to c ompare it or a long cone or a long triangular based pyramid. In the first case, the needle penetrates gradually in tissues without tearing. In the second, as it progresses, cut it with its three edges. This facilitates the suture, but more traumatizing. Therefore we reserve the needles for cylindrical bodies milder and well-watered as the stomach, uterus, intestines. The more dense and resistant, as the skin is sutured with cutting needles. The straight needles and mixed (str aight with curved edge) are little used in routine. However, the needle-shaped " S", in sizes 4-5 inches, are widely used in suturing the skin of cattle. Despite being very traumatic, facilitate the work, eliminating the use of tweezers. Wer e originally designed for use in forensic medicine (autopsies), hence they are a lso called "post mortem needles." Increasingly we use needles that are already a ssembled with wires, descartaáveis, which means less trauma to the tissues. Needles Special Instruments In this category are instruments that are or have been developed specifically me ant for maneuvering in certain organs or tissues. Their diversity is enormous an d we can illustrate this by quoting the instrumentation used in orthopedic surge ries. Some, however, are present in nearly all our boxes instrumental. Forceps, Foerster A clamp is a clamp FOERSTER long rods with rings at the end of his part clamp, suitable for driving small gauze pack. Originally designed for human use in obstetrics, are widely used in veterinary medicine in the antisepsis of the operative field. This is because their long stems keep the operator's gloved han ds away from hair from areas not shaved, antisepsis during operations to avoid c ontamination. Have 20 cm or more straight or curved versions. Foerster An Allis forceps forceps widely used to hold tissues, with minimal damage, is th

e Allis forceps. Its clamp portion has stems that do not touch, except the extre mities, bent toward each other and with denticles. This explains why they are le ss traumatic. Allis The Babcock clamp forceps BABCOCK have the same uses of Allis forceps. They diff er by having the latter part clamp a little wider and also fenestrated. Babcock The clamp Doyen intestinal forceps, also called coprostáticas of Doyen are very long, with part clamp-shaped blades, flexible. The width and elasticity of its b lade delivers better compression, avoiding major trauma in the bowel. Are essent ial in intestinal resection,€in enteranastomoses. They can be straight or curved . Doyen In the special hooks ovariohysterectomy special hooks are employed, being more u sed to SNOOK or of Covault. Both have around 20 cm length. Snook Hook has a cylindrical rod, flattened at the part where the hook is formed. O Covault is cylindrical throughout its length including the hook, which features a small ball on the end. This makes the hook Covault an instrument less traumatic than the Snook. r