SURGICAL INSTRUMENTATION PROGRAM

TRAINING SURGICAL PLANNING

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STUDENT NAME: ANDRES OSPINA CODE: 01220022027 PRACTICE LEVEL: III

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

SPECIALTY: CX SURGEON: DATE: 08/09/2023

CARDIOVASCULAR

NAME OF PATIENT: MEDICAL HISTORY NUMBER: PATIENT AGE: 12 AÑOS

BARTOLITO 1092948209

SURGICAL PROCEDURE TO PERFORM:

REINTERVENTION CHANGE OF THE RIGHT VENTRICULAR DUCT TO THE PULMONARY ARTERY

SURGICAL INSTRUMENTATION PROCESS

1. PLANNING STAGE:
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1.1. Surgical Objective: (Make description)

Reintervention to change a right ventricular duct to a pulmonary artery is a medical procedure to correct or improve blood circulation in the heart and lungs,
especially in cases of congenital heart malformations. The main objective of this surgery is to improve pulmonary blood flow and ensure proper oxygenation of the
blood.
1.2. Anatomy and physiology: (Make graph and description).
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1.3. Check list:

MEDICAL EQUIPMENT/ DEVICES DRUGS AND SOLUTIONS

INSTRUMENTAL SUTURES AND NEEDLES
● Extracorporeal basket ● Clothing package ● PROLENE 4/0 needle 2 RB 1 ● Saline
● Old castro needle holder ● Radiopaque gauze ● PROLENE 5/0 needle 2 C-1 ● oxygenated water
● Clamps ● Asept syringe ● PROLENE 6/0 needle 2 C-1
● Hegar dilators ● Compresses ● Silk 0 with SH
● Oscillating saw ● Cokes ● SUTURE PACEMAKER
● Pipe scissors ● Electro THREAD 2/0 SKS-3
● Wire cutter ● Suction rubber ● Ti-con 2-/0 needle CV-305
● Pipe clamp ● Canula yankawer 1/2 round
● Syringe 20cx
● Tegader ● Hemostatic
● Micropore ● Bony wax
● Semi-rigid vacuum ● Surgicel
cleaner
● Connectors in Y, 3/8 x 1/2
● 3/8 x 1/2 pipe
● Turnstiles
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2. ORGANIZATION STAGE:

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

● - SCALPEL #7 BLADE 15
● - SCALPEL #7 BLADE 11
● - RADIOPAQUE GAUZE
● - METZENBAUM SCISSORS
● - COKE PROTECTED MOSQUITO CLIPS
● - ROCHESTER CLAMP
● - MAY SCISSORS
● - VASCULAR DISSECTIONS
● - FARABEUF SEPARATORS
● - KELLY CLAMP
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RESERVATION TABLE

● - ASEPTOSYRINGE
● - CLAMPS
● - OLD CASTRO NEEDLE HOLDER
● - SUTURES
● - WIRE CUTTER
● - PIPES 3/8 X 1/2
● - PERICARDIUM CANNULA
● - EXTRACORPOREAL BASKETCOKES
● - NEEDLE CARRIER
● - HEGAR DILATORS
● - FINOCHETO SEPARATOR
● - 20CC SYRINGE
● - PIPE SCISSORS

2.2. Patient position (Name and graphic):

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

1. surgical instrumentalist
2. surgeon
3. anesthesiologist
4. perfusionist
5. auxiliary
6. helper
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a) Anesthesia (write the type of anesthesia):

● General anesthesia

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

● Sternotomy and thoracic incisión

● saphenous as graft

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

Step 1: Patient Preparation

Placing the patient on the operating table in a supine position.

Administration of general anesthesia to induce unconsciousness and ensure analgesia.
Connecting the patient to a heart, blood pressure and oxygen saturation monitor for continuous monitoring.
Step 2: Surgical Access
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Performing a longitudinal incision along the breastbone to access the heart, known as the median sternotomy.
Use of sternal separators to keep the chest cavity open.

Step 3: Establishing Extracorporeal Circulation (ECC)

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Connecting the patient to a heart-lung machine (CEC pump).

Insertion of cannulas into the aortic artery and right atrium to divert blood out of the body to the CEC pump and then return it oxygenated to the patient.
Step 4: Hypothermia and Induction of Cardiac Arrest

Gradual cooling of the heart and body to reduce metabolism and stop cardiac function (hypothermia).
Administration of cardioplegia (cardioprotective solution) in the coronary artery to induce cardiac arrest.
Step 5: Approach of Truncus Arterioso
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Identification of truncus arteriosus anomaly.

Separation of the arterial trunk in its components, the aorta and the pulmonary artery.
Closure of anomalous communications between the right and left ventricles.
Step 6: Aorta and Pulmonary Artery Reconstruction
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Using patches of biocompatible material (such as pericardium or artificial tissue) to reconstruct and divide the main artery into an aorta and pulmonary artery.
Step 7: Valvular Function Assessment

Blood flow tests and evaluation of the valves for stenosis or regurgitation.
Correction of any valve dysfunction if necessary.
Step 8: Reperfusion and Reheating

Gradual restoration of normal blood flow to the heart.

Allow the heart to overheat at body temperature.

Step 9: Closing the Chest

Closing the sternum with stainless steel wires.

Suture the skin to close the surgical incision.
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Step 10: Completion of the CEC

Disconnect the patient from the CEC machine.

Removal of cannulas from arteries and veins.
Step 11: Postoperative Monitoring

Transfer of patient to intensive care unit (ICU) for continuous monitoring of vital signs and cardiac function.
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WEEKLY REPORT FORMAT OF TRAINING PRACTICE

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

STUDENT SIGNATURE: TEACHING SIGNATURE: __________________________