Myocardical

SURGICAL INSTRUMENTATION PROGRAM
TRAINING SURGICAL PLANNING

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STUDENT NA CODE: 01200021024 PRACTICE

LEVEL: III
ME: DAVID JONES PARDO
TEACHER'S NAME: Lidy Higuera PRACTICE STAGE: FOSUNAB ICB NOTE:
SPECIALTY: CX SURGEON: DATE: 24/03/2023
CARLOS OCAMPO
NAME OF PATIENT: ANGEL FIDALGO SANABRIA MEDICAL HISTORY NUMBER: PATIENT AGE: 56
91450142
SURGICAL PROCEDURE TO PERFORM:
MYOCARDICAL REVASCULARIZATION DA
SURGICAL INSTRUMENTATION PROCESS
1. PLANNING STAGE:
1.1. Surgical Objective: (Make description)
THE PURPOSE OF THE SURGERY IS TO PERFORM A REVASCULARIZATION OF THE CORONARY ARTERIES

WHICH ARE BLOCKED OR OBSTRUCTED WHICH IS GENERATING AN ISCHEMIA AND A LOW EFFICIENCY IN
THE HEART, THIS MAY BE GENERATED BY ATHEROSCLEROSIS OR ANOTHER RISK FACTOR, BECAUSE WHAT

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IS OF VITAL IMPORTANCE TO RECOVER SAID CARDIAC FUNCTION
1.2. Anatomy and physiology: (Make graph and description).
TAKEN FROM:

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https://i0.wp.com/post.medicalnewstoday.com/wp-content/uploads/sites/3/2022/04/1797975-branches-of-the-
right-coronary-artery_1296x900-body-1024x711.png?w=1155&h=1890
THE IRRIGATION OF THE HEART IS MAINLY IRRIGATED BY TWO BRANCHES OF THE ASCENDING
AORTA, THEY ARE CALLED THE RIGHT AND LEFT CORONARY ARTERIES, THESE TWO BRANCHES
IRRIGATE THE MYOCARDIUM AND THE EPICARDIUM
RIGHT CORONARY ARTERY, ARISES FROM THE CORONARY SINUS AND DIRECTED THROUGH THE
ATRIOVENTRICULAR GROUCH, IS DIVIDED INTO THE RIGHT POSTERIOR DESCENDING ARTERY AND
MARGINAL ARTERY
LEFT CORONARY ARTERY, THIS BRANCH ARISES FROM THE CORONARY SINUS AND EMERGES
BETWEEN THE AORTA ARTERY AND THE PULMONARY TRUNK, THE BRANCHES OF THIS ARTERY ARE
THE LEFT ANTERIOR DESCENDING ARTERY AND THE LEFT CIRCUMFLEX ARTERY
TAKEN FROM: https://fmed.uba.ar/sites/default/files/2019-04/Irrigaci%C3%B3n%20Arterial%20y%20Drenaje

%20Venoso%20del%20Coraz%C3%B3n.pdf
ANATOMY OF THE GRAFTS USED
MAMMARY ARTERY

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The internal thoracic artery (ITA), also called the internal mammary artery (IMA), is a descending collateral
branch of the prescalenic portion of the subclavian artery (AS).

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1.3. Check list:
MEDICAL EQUIPMENT/ DRUGS AND

DEVICES SUTURES AND SOLUTIONS
INSTRUMENTAL
NEEDLES
-CORONARY -CLOTHING PACKAGE -PROLENE 7/0 OF 3/8 HEPARIN

EQUIPMENT CIRCLE VASCULAR
(VASCULAR BASKET) -ELECTROBISTURI
-SILK 0 OF ½ OF
-SEPARATOR -RUBBER SUCCIN CIRCLE 26 MM SOLUTION SALINE
MAMMARY -BISTURI BLADE 15 (3) -PROLENE 4/0 OF ½
-FINE INSTRUMENTAL -BBISTURI BLADE 11 CIRCLE ROUND RB-1 INFILTRATION
DR GIRALDO (1) 17 MM BUPIVACAINE 0,5%
(RECONDITIONING)
-STERNAL -COOPER TUBE
SEPARATOR -POLYESTER 2/0 OF ½
(FINOCHETO) -ASEPTOJERINGE CIRCLE VASCULAR 25
MM
-EXTRACORPOREAL - VENIPUNCTURE

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EQUIPMENT (MCE) -TUBE OF THORAX 32 - PRE-CUT SILK 1
-RECIPROCATIN SAW -SET OF TORNIQUETS -MONOCRYL 3/0 OF 3/8

AND THREAD PASER 19MM TAPPER
-OCTOPUS CUTTING
-NELATON PROBE 8
FR and 12 FR -POLIGLACTIN 910 0
OF ½ CIRCLE 36MM (2)
-IOBAN
-ACIFLEX 5
-CO2 GUIDA AND
TUBE -PACEMAKER WIRE 0
-TORUNDAS
-COMPRESSES
-CLIPS LT 100 AND 200
-GLOVES
BONE WAX
- CAIMAN CABLES
PACEMAKER
- COKES AND WAIST

BAGS
-MICROSCALPEL
-20 CC SYRINGE +
PINK NEEDLE

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2. ORGANIZATION STAGE:
a. Arrangement of May tables and reservation (make scheme).


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-SCALPEL HADLE #7 AND SCALPEL HADLE #3
-MAYO SCISSORS FINE
-METZEMBAUM SCISSORS (NORMAL AND FINE)
-VASCULAR DISSECTION FORCEPS
-ADSON DISSECTION WITH AND WITHOUT CLAW
-CURVED MOSQUITO FORCEPS WITH PROTECTOR
-CURVED KELLY FORCEPS
-ROCHESTER FORCEPS
- FIELD CLAMPS
-KOCHER FORCEPS
-FARABEUF SEPARATOR (2)
- CASTROVIEJO NEEDLE HOLDER
- RETROGRADE AND ANTERORETROGRADE

SCISSORS

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-COCA WITH SOLUTION AND ASEPTOJERINGE -WIRE HOLDER
-CLIPS LT 100 AND 200 -WIRE CUTTER
-VENOPUNCTION -EXTRACORPOREAL BASKET
-JERINGE OF 20 CC -CLOTHING PACKAGE
-CORONARY EQUIPMENT - RECIPROCATING SAW
-SUTURES - MICRO SCALPEL
-COMPRESESS -STARSIHER
-VASCULAR DISSECTION - LIGACLIP LT 100 AND 200 PLIERS
-ELECTIRC SCALPEL -CAIMAN
-KIDNEY BAG
-CLOSING WIRE -HADLES , GLOVES


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2.2. Patient position (Name and graphic):


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


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1. SURGEON
2. INSTRUMENTATOR
3. ASSISTANT SURGEON
4. EXTRACORPOREAL CIRCULATION MACHINE
5.PERFUSIONIST
6. ANESTHESIOLOGIST
7. CIRCULATING NURSE
8. MAY TABLE
9. RESERVATION TABLE

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3. EXECUTION STAGE:
a) Anesthesia (write the type of anesthesia):
GENERAL
b) Incision (write the type of approach and the name of the incision):

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STERNOTOMY
c) Surgical Process (Describe the main steps of the surgical medical technique with the instruments to be used).
PROCESS INSTRUMENTAL
THE STERNOTOMY IS BEGINNING ALWAYS PRESERVING HEMOSTASIS THE STERNAL SCALPEL HANDLE #3 HB
MEDULLA IS COATED WITH BONE WAX TO PRESERVE THE HEMOSTASIS OF THE STERNAL #15
AND IN TURN THE GRAFT OF THE MAMMARY ARTERY IS PREPARED ELECTRIC SCALPER
FARABEUF SEPARATOR
RECIPROCATING SAW
BONE WAX
CLIPS LET 100
THE PERICARDIUM IS INCIDED, HEMOSTASIS AND FIXATION OF THE PERICARDIUM IS CLAWLESS DISSECTION
PERFORMED TO EXPOSE THE HEART ADEQUATELY AND THE FINOCCHETO OR THE BREAST SILK 0 WITH NEEDLE
RETRACTOR IS PLACED AND WE INCIDE THE PERICARDIUM AND PLACE TRANSFIXION NEEDLE HOLDER
POINTS VASCULAR DISSECTION
MAY SCISSORS
FINOCHETO SEPARATOR
THE HEART IS EXPOSED IN AN ADEQUATE WAY AND A WET COMPRESS IS PLACED UNDER VASCULAR PROLENE
THE HEART AND WE PREPARE THE OCTOPUS STABILIZER AND PLACE IT IN THE LEFT RECONDITIONING 4/0
ATRIUM AND PROCEED TO DO THE RECONDITIONING (BLOOD FLOW BLOCK) OCTOPUS
ANASTOMOSIS OF THE MAMMARY ARTERY IS MADE IN THE ANTERIOR DESCENDING POLESTEER 2/0

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ARTERY POLYPROPYLENE 7/0

MAY SCISSORS
CASTROVIEJO NEEDLE
HOLDER
FRAZIER CANNULA WITH
CO2
FINE DISSECTION OR
VASCULAR FORCEPS
PERMEABILITY AND ANASTOMOSIS ARE VERIFIED AND THE HEART OF THE PUMP IS PACEMAKER WIRE
REMOVED HE PACEMAKER WIRE AND CHEST TUBE ARE PLACED PLEUROVAC
VASCULAR DISSECTION
WET COMPRESS
THE STERNAL IS SUTURED, HEMOSTASIS IS CHECKED AND THE RESPECTIVE PLANS TCS SURGICAL WIRE 5
AND SKIN ARE SUTURED ROCHESTER
POLYGLACTIN 910 0
MONOCRYL 3/0
NEEDLE HOLDER
CLAW DISSECTION
MAY SCISSORS
WIRE CUTTER
WEEKLY REPORT FORMAT OF TRAINING PRACTICE
SURGERY ASSISTANCE RECORD FORM - TRAINING PRACTICE IQX-FT-024-UDES


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STUDENT SIGNATURE: DAVID JONES TEACHING SIGNATURE: __________________________
CONTROL DE CAMBIOS
FECHA DE
VERSIÓN DESCRIPCIÓN DEL CAMBIO RESPONSABLE
APROBACIÓN
Lizeth Guiza
Coordinadora de Prácticas
00 Versión de Prueba 25/11/2015
01 Elimina del encabezado la fecha de la 03/08/2022

implementación del formato, según
disposición de la alta dirección consejo Erika Grandas Ardila
superior.
Coordinadora de prácticas

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Eliminación pie de página por

modificación en procedimiento control
de documentos y registro.

Myocardical

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SURGICAL INSTRUMENTATION PROGRAM

TRAINING SURGICAL PLANNING

STUDENT NA CODE: 01200021024 PRACTICE

TEACHER'S NAME: Lidy Higuera PRACTICE STAGE: FOSUNAB ICB NOTE:

SPECIALTY: CX SURGEON: DATE: 24/03/2023

SURGICAL PROCEDURE TO PERFORM:

SURGICAL INSTRUMENTATION PROCESS

1.1. Surgical Objective: (Make description)

THE PURPOSE OF THE SURGERY IS TO PERFORM A REVASCULARIZATION OF THE CORONARY ARTERIES

TRAINING SURGICAL PLANNING

IS OF VITAL IMPORTANCE TO RECOVER SAID CARDIAC FUNCTION

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

TRAINING SURGICAL PLANNING

TAKEN FROM: https://fmed.uba.ar/sites/default/files/2019-04/Irrigaci%C3%B3n%20Arterial%20y%20Drenaje

ANATOMY OF THE GRAFTS USED

TRAINING SURGICAL PLANNING

TRAINING SURGICAL PLANNING

1.3. Check list:

MEDICAL EQUIPMENT/ DRUGS AND

-CORONARY -CLOTHING PACKAGE -PROLENE 7/0 OF 3/8 HEPARIN

TRAINING SURGICAL PLANNING

EQUIPMENT (MCE) -TUBE OF THORAX 32 - PRE-CUT SILK 1

-RECIPROCATIN SAW -SET OF TORNIQUETS -MONOCRYL 3/0 OF 3/8

-CLIPS LT 100 AND 200

- COKES AND WAIST

TRAINING SURGICAL PLANNING

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

TRAINING SURGICAL PLANNING

-SCALPEL HADLE #7 AND SCALPEL HADLE #3

-MAYO SCISSORS FINE

-METZEMBAUM SCISSORS (NORMAL AND FINE)

-VASCULAR DISSECTION FORCEPS

-ADSON DISSECTION WITH AND WITHOUT CLAW

-CURVED MOSQUITO FORCEPS WITH PROTECTOR

-CURVED KELLY FORCEPS

-FARABEUF SEPARATOR (2)

- CASTROVIEJO NEEDLE HOLDER

- RETROGRADE AND ANTERORETROGRADE

TRAINING SURGICAL PLANNING

-COCA WITH SOLUTION AND ASEPTOJERINGE -WIRE HOLDER

-CLIPS LT 100 AND 200 -WIRE CUTTER

-VENOPUNCTION -EXTRACORPOREAL BASKET

-JERINGE OF 20 CC -CLOTHING PACKAGE

-CORONARY EQUIPMENT - RECIPROCATING SAW

-SUTURES - MICRO SCALPEL

-VASCULAR DISSECTION - LIGACLIP LT 100 AND 200 PLIERS

-ELECTIRC SCALPEL -CAIMAN

-CLOSING WIRE -HADLES , GLOVES

TRAINING SURGICAL PLANNING

2.2. Patient position (Name and graphic):

TRAINING SURGICAL PLANNING

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

TRAINING SURGICAL PLANNING

TRAINING SURGICAL PLANNING

4. EXTRACORPOREAL CIRCULATION MACHINE

TRAINING SURGICAL PLANNING

a) Anesthesia (write the type of anesthesia):

TRAINING SURGICAL PLANNING

TRAINING SURGICAL PLANNING

ARTERY POLYPROPYLENE 7/0

WEEKLY REPORT FORMAT OF TRAINING PRACTICE

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