SURGICAL INSTRUMENTATION PROGRAM

SURGICAL PLANNING PRACTICE TRAINING

Version: 1
IQX-FT-003-PCS

STUDENT NAME: CODE: PRACTICE LEVEL: 2

Paula Alejandra Gutierrez Martinez 01190022029

NAME OF THE TEACHER: PRACTICE SCENARIO: NOTE:

GLENDA INSTITUTE OF THE HEART

SPECIALITY: SURGEON: DATE: NOV 18, 2022

CARDIOLOGY

PATIENT NAME: MEDICAL HISTORY NUMBER: PX AGE:

HENRY JAIMES 1983923943 58
SURGICAL PROCEDURE TO PERFORM:
REVASCULARIZACION MYOCARDIAL

SURGICAL INSTRUMENTATION PROCESS

1. PLANNING STAGE:

1.1. Surgical Objective: (Make description)

Myocardial revascularization surgery (MRS), also called coronary bypass surgery, is a medical procedure to improve the irrigation of
the heart. It may be needed when arteries that supply blood to heart tissue, called coronary arteries, have narrowed or blocked
arteries.

1.2. Anatomy and physiology: (Make graph and description). The myocardium is the thick muscular layer in the middle, which
allows the chambers of the heart to contract and relax to pump blood to the body. The pericardium is the sac that surrounds the
heart. It is made up of thin layers of tissue and holds the heart in place and protects it.
 SURGICAL INSTRUMENTATION PROGRAM

SURGICAL PLANNING PRACTICE TRAINING

Version: 1
IQX-FT-003-PCS

1.3. Checklist:

MEDICAL PHARMACEUTICALS AND

INSTRUMENTAL EQUIPMENT/DEVICES SUTURES AND NEEDLES SOLUTIONS
 SURGICAL INSTRUMENTATION PROGRAM

SURGICAL PLANNING PRACTICE TRAINING

Version: 1
IQX-FT-003-PCS

Adult extracorporeal Clothing package Bone wax Warm saline solution

container Gloves Silk 0 sh cutting
Compresses Etibond 2/0 round
Sierra reciprocante Gauze Polypropylene 4/0
Handles Polypropylene 6/0
Instrumental of dr, Giraldo Cardioplegia cannula Polypropylene 7/0
Y-adapter Pre-cut silk 1 and 4/0
Coronary team Sternal separator Monocryl 3/0 ps2 cutting
Pathology bottle Suture cables for
Accessory equipment Aortic Clamp pacemaker 2/0 sh
Castroviejo needle holder
Punch
Arterial cannula
Canula venosa unica
Jelco seriva
20 cc syringe
10 cc syringe
Aseptojeringa
Suction rubber
Electrobisturi
Sharps, gauze
fanny pack
Ioban
Clip clip clip
Clip of 100 and 200
Wire cutter
Pacemaker wires
Vacuum cleaner
Elastic bandage
CO2 Line

1. ORGANIZATIONAL STAGE:

a. May table arrangements and reservation (make scheme).

 SURGICAL INSTRUMENTATION PROGRAM

SURGICAL PLANNING PRACTICE TRAINING

Version: 1
IQX-FT-003-PCS

• Mb 11 and 3 field clips

• Sharps scissors.
• Scissors metzembaum finepincers protected
• Sep. Farabeufdifine sections
• P. mosquito and baby mosquito vascular dissections
• p. Kelly curvadissection with claw and without claw

• p. Kelly adson
• p. Rochester
• Tube Clamp

• Basket • Dilators
• Arterial and venous cannulas • Hook
• Canula cardioplegia • Pott's scissors
• Adept • Detrich's scissors
• Pathology bottle
• Weitlander
• Cokes, fanny packs
separator
• Thread passing
• Wire cutter
• Fraszier and yankawer cannula
• Deniis dissection
• Scissors
• Fine scissors • Arteriotomia
• Castroviejo needle holder cannula
• Clamp bulldog • A punch
• Connectors
• Sternal
protectors

2.2. Patient position (Name and graphic):

 SURGICAL INSTRUMENTATION PROGRAM

SURGICAL PLANNING PRACTICE TRAINING

Version: 1
IQX-FT-003-PCS

2.3. Location of the Surgical Team (make graphic):

 SURGICAL INSTRUMENTATION PROGRAM

SURGICAL PLANNING PRACTICE TRAINING

Version: 1
IQX-FT-003-PCS

2. EXECUTION STAGE:
a) Anesthesia (write the type of anesthesia):general
b) Incisión (escribir el tipo de abordaje y el nombre de la incisión):Incision for sternotomy, minimal internal or medial
incisions in left leg for saphenous vein extraction.
c) Surgical Process (Describe the main steps of the medical-surgical technique with the instruments to be used).

1. The steps of the preparation time are performed The steps of the opening time are performed (skin incision, tcs,
extraction of the saphenous vein as free graft, extraction of the internal mammary artery as pedunculated graft,
permeabilization of grafts, sternotomy, incision and repair of pericardium): MB 3 sheet 15 (left piema)
electrobisturi, Weitlander separator, Farbeuf separators, compresses, Dissection forceps, Metzembaum scissors, ligaclip
forceps and clip ligas 200 and 100, silk 4/0, 10cc syringe, arterioromia cannula, heparinized solution, 1cc syringe,
nitropusiate solution, Vicryl 2/0, monocryl 3/0 MB 7 sheet 15 (thorax), electrobisturi, Breast separator, Sternal separator,
Vascular dissection forceps, Silk 0, reciprocating saw.
2. The vascular time steps (tobacco bags) are performed. Polyester 2/0, thread passes, aortic cannulation scissors, clamping
right auriculilla, cannulating single venous in right auricula, initiating pump and clamping aorta): metzembaum, MB 7 sheet
11, cannula EOPA 40, tube clamp, silk1. Partial occlusion clamp, Metzembaum's scissors, vascular dissection, single venous
cannula 32/40, Anterograde cardioplegia root cannula, curved Kellys, extracorporeal circulation lines, connectors, rigid
pericardium suction.
3. Incision is made in the right coronary artery to perform the respective anastomosis to the saphenous vein as a free graft:
MB 7 sheet 15, fine microcoronary scissors, vascular dissection forceps, dennis dissection
4. Proximal anastomosis of the free graft of the saphenous vein to the right coronary artery is performed: Prolene 8/0,
vascular needle holder, dissection, mayo scissors, dennis dissection.
5. Elevation of the apex of the heart is performed to perform the second Starfished anastomosis sequentially to the
circumflex artery continuing: starfished
6. Incision is made in the circumflex and in the graft to perform the respective anastomosis to the saphenous vein as a free
graft in a sequential way: MB 7 sheet 15, fine microcoronary scissors, vascular dissection forceps, dennis dissection
7. Sequential anastomosis of the free graft of the saphenous vein to the circumflex artery is performed and the starfished is
removed: Prolene 8/0, vascular needle holder, dissection, scissors of May, dissection dennis
8. Epicardium separation is performed and incision is made in the anterior descending Se to perform the respective
anastomosis to the 15 internal mammary artery as a pedunculated graft, preparing the breast graft: Epicardium separator,
MB 7 sheet 15, fine microcoronary scissors, vascular dissection forceps, dennis dissection, 1cc syringe with nitropusiate
9. Distal anastomosis of the pedunculated graft, from the internal mammary artery to the anterior descending artery is
performed: Prolene 7/0, vascular needle holder, dissection, mayo scissors, dennis dissection
10. It is declampeated (removing satinsky) and the Cla aorta is clamped again and a small hole is made for the third and final
anastomosis of the sequential free graft of the saphenous vein:Clamp of partial occlusion, Punch
11. Proximal anastomosis to the aorta of the last portion of the sequential free graft is performed:Prolene 6/0, vascular
needle holder, dissection, scissors, denis dissection
12. The steps of the closing time are performed (It comes out of pump. Hild desclampea (partial occlusion clamp). It is
decanulated and tomiquetes sutures, pacemaker thread position, tube to thorax position along with pluroback, compress
count, ace sternum suture. TCS and skin suture: Pacemaker thread 0, Polyester 20. Tube to thorax 32. pleuroback.
Compresses, vascular dissection, steel 5. vicryl 0, monocryl 3/0
 SURGICAL INSTRUMENTATION PROGRAM

SURGICAL PLANNING PRACTICE TRAINING

Version: 1
IQX-FT-003-PCS

FORMAT OF WEEKLY REPORT OF THE TRAINING PRACTICE

RECORD FORMAT OF ASSISTANCE TO SURGERY - TRAINING PRACTICE IQX-FT-024-UDES

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