SURGICAL INSTRUMENTATION PROGRAM

TRAINING SURGICAL PLANNING

IQX-FT-003-BUC
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STUDENT NAME: CODE: PRACTICE LEVEL: lll

KAREN DANIELA ORTIZ MANTILLA 01190021054

TEACHER'S NAME: PRACTICE STAGE: NOTE:

GLENDA PABON INSTITUTO

CARDIOVASCULAR

SPECIALTY: SURGEON: DATE:

CX DR. OCAMPO 14/10/2022

CARDIOVASCULAR

NAME OF PATIENT: MEDICAL HISTORY PATIENT AGE:

NUMBER: 2099263
JOSE RAUL ARENAS PINILLA 80

SURGICAL PROCEDURE TO PERFORM:

MYOCARDIAL REVASCULARIZATION

SURGICAL INSTRUMENTATION PROCESS

1. PLANNING STAGE:

1.1. Surgical Objective: (Make description)

Perform bridging using anthologous grafts a adopt blood Flow to ischemic cardiac tissue.

1.2. Anatomy and physiology: (Make graph and description).

The coronary arteries supply blood to the heart muscle. As with all other tissues in the body, heart muscle needs
oxygen-rich blood to function, and oxygen-depleted blood must be expelled. The coronary arteries run along the
outside of the heart and have small branches that penetrate the heart muscle to carry blood.

Since the coronary arteries carry blood to the heart muscle, any disorder or disease of the coronary arteries can
lead to serious complications by reducing the flow of oxygen and nutrients to the heart muscle. This can cause a
heart attack or death. Atherosclerosis (a buildup of plaque on the inner lining of an artery that causes it to narrow
and become blocked) is the most common cause of heart disease.
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1.3. Check list:

MEDICAL EQUIPMENT/ DRUGS AND

DEVICES SUTURES AND SOLUTIONS
INSTRUMENTAL
NEEDLES

- Clothes pack - Precut silk 4/0 -Saline solution

- Adult - HB #11 #15 - Vicryl 2/0 ½ CR ct1 - Heparin

extracorporeal
basket - Microscalpel - Silk 0 ½ CR 26 mm - Nitropusiate
- Coronary basket
- Electrocautery - Precut silk 1 - Bupivacaine 0.5% with
epinephrine
- Reciprocating saw - Ethibond or polyester
2/0 CR 26 mm or sh
- compresses
- Prolene or
- gauzes polypropylene 4/0 ½ CR
- 10cc syringe 17 mm or cv-23

- 20cc syringe - Prolene or

polypropylene 6/0 3/8
- insulin syringe CR 9.3 mm or BV17
- #18 hypodermic needle - Prolene or
polypropylene 8/0 3/8
- arteriotomy cannula
CR 9.3 mm BV-17
-ioban
- Pacemaker wire 0
- suction rubber
- Vicryl or polyglactin 910
- yankawer cannula 0 1/2 CR 36mm or ct1

- coronary team - Aciflex or surgical steel

5
- accessory coronary
equipment - Monocryl or
poliglecaprone 3/0 3/8
- Nelaton probe #8 circle 19mm or ps-2
- blue fanny pack

- pathology flask

- dressing

- Nelaton probe #14

- accessory gowns

-Starfish

- Cannulas for
extracorporeal circuit

- EOPA cannula

- Anterograde
cardioplegia venous
cannula

- Lines for extracorporeal

- CO2 rubber

Rigid pericardial suction

- Leads for pacemaker

-punch
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- Handlebars

- Chest tube 32 and

pleuroback

- Ligaclip forceps

- Pericardium separator

- bone wax

2. ORGANIZATION STAGE:

a. Arrangement of May tables and reservation (make scheme).

1. MB # 3 HB #15

2. MB # 7 HB # 15

3. MB #7 HB# 11

4. Tijera de metzembaum

5. Tijera de mayo

6. Separadores de farabeuf

7. Pinzas Kelly rectas

8. Pinzas Kelly curvas

9. Pinzas Kelly adson

10. Pinzas mosquito protegidas

11. Pinzas Kocher

12. Pinzas Rochester

13. Clamp de tubo

14. Instrumental microvascular

15. Pinzas de disección

16. Coca para material cortopunzante

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1. Canasta extracorpora y compresas

2. Sierra, caucho de succión, electrobisturí

3. Paquete de ropa

4. Suturas e hilos de marcapaso

5. Pinzas Ligaclips

6. Porta agujas

7. Canulas para circulación extracorpórea

8. Tapa de con geringas

9. Cocas accesorias con aseptojeringa

14. Clamp de oclusión Satinsky 10. Instrumental para safeno

15. Clamp de oclusión parcial 11. Tijera castriviejo microcoronaria

16. Punch 12. Disecciones microvascular finas

17. Porta alambre 13. Sonda acanalada

18. Corta alambre

19. Disección adson con garra

20. Porta agujas pequeño

21. Disecciones con garra

22. Tijera de Lister

23. Riñoneral azul

24. Recipiente para gasas

25. Frasco de patologia

26. Separador mamario

27. Separador esternal y guantes

28. equipo coronario

2.2. Patient position (Name and graphic):

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2.3. Location of the Surgical Team (make a graph):

3. EXECUTION STAGE:

a) Anesthesia (write the type of anesthesia):

- General Anesthesia

b) Incision (write the type of approach and the name of the incision):

- Incision for sternotomy, minimal internal or medial incisions in left leg for saphenous vein extraction.

c) Surgical Process (Describe the main steps of the surgical medical technique with the instruments to be used).

PROCESO QUIRURGICO PROCESO DE INSTRUMENTACION

 SURGICAL INSTRUMENTATION PROGRAM
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IQX-FT-003-BUC
1. The steps of the opening time (skin incision,
Ics.
Extraction of the vena salena as free nient.
extraction of the internal mammary artery as a
pedunculated graft, permeabilization of
grafts, sternotomy, pencardial incision and
repair)
2. Vascular time steps are performed (tobacco bags.
aortic cannulation, right atrium bypass, cannulation
of single venous shape in right atrium, starting
pump camping aorta)
3.Correction time steps are performed
4.An incision is made in the right coronary artery to
perform the respective anastomosis to the vena
salena as a free graft
5. Proximal anastomosis of the free saphenous vein
graft is performed the right coronary artery
6. Elevation of the apex of the heart is performed to
perform the second
sequential anastomosis to the circumflex artery
continuing with the graft of the vena salena
7. An incision is made in the circumflex and in the
graft to perform the respective anastomosis to the
satena vein as a free graft in the form sequential
8. Sequential anastomosis of the free saphenous
vein graft is performed
to the circumflex artery and the starfished is
removed.
9. Epicardium separation is performed and an
incision is made in the descending anterior to
perform the respective anastomosis to the
internal mammary artery as a pedunculated graft,
preparing the graft of the mammary
10. Distal anastomosis of the pedunculated graft is
performed, from the artery internal mammary
artery to anterior descending artery
11. The aorta is unclamped (removing satinsky) and
the aorta is clamped. again and make a small hole
for the anastomosis third and final sequential free
graft of the salena vein
12. An anastomosis is made proximal to the aorta of
the last portion of the
sequential free graft
13. The closing time steps are carried out (pump
exits,
unclamp (partial occlusion clamp), decannulate and
tie tourniquet sutures, pacemaker wire position,
position of chest tube along with pluroback,
compress count. suture of sternum, cough and skin
suture). The steps of the completion time (Cleansing
and curing) are performed
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1.MB#3 ( pierna izquierda) electrobisturí,
separador de weitlander, separadores de
Farabeuf, compresas, Pinzas de disección,
Tijera de Metzembaum, pinzas ligaclip y ligaclips
200 y 100, seda 4/0, Jeringa de 10cc, canula de
arterioromia, solución heparinizada, Jeringa
de 1cC. Solución con nitropusiato,Vicryl2/0,
monocryl 3/0 MB 7 hoja 15 (torax), electrobisturi,
Separador mamario,
2. Polyester2/0, pass threads, scissors
metzembaum, MB 7 blade 11, cannula
EOPA 40, tube clamp, silk 1, partial occlusion
clamp, scissors metzembaum, vascular
dissection, single venous cannula 32/40, Cannula
of antegrade cardioplegia by root, Curved Kellys,
circulation lines extracorporeal, connectors,
suction rigid pericardium.
3.
4. MB7 blade 15, microcoronal scissors
fine, vascular dissection forceps, dennis
dissection
5. Prolene 8/0, vascular needle holder,
dissection, mayo scissors, dissection
6.Starfished
7. MB7 blade 15, microcoronary scissors
fine, vascular dissection forceps,
dennis dissection
8. Prolene 8/0, vascular needle holder,
dissection, mayo scissors, dissection
dennis
9. Epicardial retractor, MB 7 blade
15, fine microcoronal scissors, tweezers
vascular dissection, dissection
dennis, Syringe 1cc with nitropusiate
10. Prolene7/0, vascular needle holder,
dissection, mayo scissors, dissection
dennis
11.clamp de oclusión parcial, punch
 SURGICAL INSTRUMENTATION PROGRAM

TRAINING SURGICAL PLANNING

IQX-FT-003-BUC
Versión: 1

WEEKLY REPORT FORMAT OF TRAINING PRACTICE

SURGERY ASSISTANCE RECORD FORM - TRAINING PRACTICE IQX-FT-024-UDES

STUDENT SIGNATURE: DANIELA ORTIZ M TEACHING SIGNATURE: __________________________

CONTROL DE CAMBIOS

FECHA DE
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APROBACIÓN 

 
Lizeth Guiza
Coordinadora de Prácticas 
00  Versión de Prueba    25/11/2015
 
 
 
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