PROGRAMA DE INSTRUMENTACION QUIRURGICA

Fecha: 25/11/2015
PLANEAMIENTO QUIRURGICO FORMATIVA
IQX-FT-003-BUC Versión: 0
STUDENT NAME: CODE: 01220022028 PRACTICE LEVEL: III
Lorena Aguilera

TEACHER'S NAME: Glenda PRACTICE STAGE: ICB NOTE:

SPECIALTY: CARDIOVASCULAR CIRUJANO: Dr Giraldo FECHA: 13/10/2023

NAME OF PATIENT: MEDICAL HISTORY NUMBER: PATIENT AGE: 60

Roberto Silva Rodriguez 91068610

SURGICAL PROCEDURE TO PERFORM:

Myocardial revascularization + change of aortic valve

SURGICAL INSTRUMENTATION PROCESS

1. PLANNING STAGE:

1.1. Surgical Objective: (Make description)

Myocardial revascularization is performed to restore blood supply to blocked coronary arteries, while aortic valve change
is performed to correct a damaged or narrowed aortic valve.

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

• Coronary arteries are the blood vessels that supply blood to the heart muscle. These arteries provide oxygen
and nutrients needed for the heart.

• The aortic valve is one of the four heart valves and is located between the left ventricle and aorta. This valve
allows blood to flow from the left ventricle to the aorta.

ELABORO REVISO APROBO

Lizzeth Güiza Páez Sandra Milena Vásquez Borja Norly Eidy Molina Miranda
Coordinadora de Practica Coordinadora de Calidad Directora Programa
 PROGRAMA DE INSTRUMENTACION QUIRURGICA

Fecha: 25/11/2015
PLANEAMIENTO QUIRURGICO FORMATIVA
IQX-FT-003-BUC Versión: 0

1.3. Check list:

MEDICAL SUTURES AND DRUGS AND

INSTRUMENTAL EQUIPMENT/DEVICES NEEDLES SOLUTIONS

Coronary equipment Clothing package Skin: Monocryl 3/0

Accesory equipment Chest tuve TCS: Vicryl 0 Cold and warm saline
Extracorporeal HB 11 and 15 Pericardium repair: Silk 0 solution
equipment Electrobisturi Fix tubes: Silk 1 Heparin
Acc disection Suction rubber Polyester with pleget 2/0:
Reciprocating saw Yankawer cannula aortorrhy reinforcement
Morse sternal spreader Resort aspirator Tube to thorax: Polyester
Extracorporeal circulation Pericardical aspirator 2/0
machine Vent aspirator Bone wax: Esternon
Wire clip Suction rubber Surgical wire 6
Pacemaker Lines Polypropylene 4/0: Aortic
Breast separator Tourniquets repair
Vent Pacemaker thread
Y-connector Ticron 2/0: aortic and
Ioban venous cannulation
Anterograse cardioplegia
canula
Compresses
Radiopaque gauze
Venous cannula
Plastic containers
Nelaton probe #8 and #14
Micropore
Asepto siringe
20CC siringe
Valve meter
Pathology bottle
Pleuroback
Alligators
League clips 100 and 200
Gloves
CO2 rubber
Cayman
Tube to thorax 34

ELABORO REVISO APROBO

Lizzeth Güiza Páez Sandra Milena Vásquez Borja Norly Eidy Molina Miranda
Coordinadora de Practica Coordinadora de Calidad Directora Programa
 PROGRAMA DE INSTRUMENTACION QUIRURGICA

Fecha: 25/11/2015
PLANEAMIENTO QUIRURGICO FORMATIVA
IQX-FT-003-BUC Versión: 0

2. ORGANIZATION STAGE:

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

2.2. Patient position (Name and graphic):

Supine decubitus

ELABORO REVISO APROBO

Lizzeth Güiza Páez Sandra Milena Vásquez Borja Norly Eidy Molina Miranda
Coordinadora de Practica Coordinadora de Calidad Directora Programa
 PROGRAMA DE INSTRUMENTACION QUIRURGICA

Fecha: 25/11/2015
PLANEAMIENTO QUIRURGICO FORMATIVA
IQX-FT-003-BUC Versión: 0

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

Electrobisturi
Reserve console
table Surgical
Surgeon
instrumentator

Mayo Anesthesiologist
table

Assistant
Extracorporeal
circulation machine

3. IMPLEMENTATION STAGE:

a) Anesthesia (write the type of anesthesia): General anesthesia

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

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

ELABORO REVISO APROBO

Lizzeth Güiza Páez Sandra Milena Vásquez Borja Norly Eidy Molina Miranda
Coordinadora de Practica Coordinadora de Calidad Directora Programa
 PROGRAMA DE INSTRUMENTACION QUIRURGICA

Fecha: 25/11/2015
PLANEAMIENTO QUIRURGICO FORMATIVA
IQX-FT-003-BUC Versión: 0

• Count of gauze and compresses

• Incision with m #7 hb#15.
• Apprehension and electrocoagulation instruments for deep tissue incision: electrobisturi
• Sternotomy: reciprocating saw equipment with down saws
• Manual sternum separation: Farabeuf type separators.
• Hemostasis of the sternum: electrobisturi
• Hemostasis of the sternal periosteum and for hemostasis of the bone marrow: bone wax, electro in 60.
• Fixed sternum separation: sternal protectors

• Pass microvascular dissection and electrocautery in 20 for dissection of the mammary artery.
• For ligation and hemostasis of this, use Ligaclip forceps and the clip cartridge and Metzembaum scissors.
• Pass vascular type dissection and electrocautery in 40 for the opening of the pericardium.
• Suture silk 0 for pericardial repair
• Clamp passes threads and 1 pre-cut silk, for the venas cavas, upper and lower, and tourniquet to repair these.
• Suture polyester 2/0 for tobacco bags in: Ascending aorta, superior vena cava and inferior vena cava.
• Polypropylene 4/0 suture for small bags in: Aorta root
• Prepare adequate cannulas for patient perfusion
• Mb#7 hb#11 for arteriotomies and venotomies
• Pre-cut silk 1 for fixing the placed cannulas
• Mb#7 hb#11 for atrial incision, long metzembaum scissors to enlarge atria
• Cushing separators, for viewing the atrial septum

• MB#3 HB#11 and vascular dissection to cut the aorta, then pass long tissue scissors.
• Coronary perfusion cannula, for direct antegrade cardioplegia in coronary ostium.
• Silk 4-0 to repair the walls of the aorta.
• vascular grasping forceps and scissors for dissection and removal of the aortic valve.
• It is washed with saline solution.
• The valve is measured with the gauge.
• The nursing assistant pass the valve device to be implanted.
• the valve to be implanted is biological, wash it according to the protocol.
• 2-0 vascular polyester suture in each respective repair.
• 4/0 polypropylene for aortic root, tourniquet and antegrade cardioplegia cannula

ELABORO REVISO APROBO

Lizzeth Güiza Páez Sandra Milena Vásquez Borja Norly Eidy Molina Miranda
Coordinadora de Practica Coordinadora de Calidad Directora Programa
 PROGRAMA DE INSTRUMENTACION QUIRURGICA

Fecha: 25/11/2015
PLANEAMIENTO QUIRURGICO FORMATIVA
IQX-FT-003-BUC Versión: 0

FORMATO DE INFORME SEMANAL DE LA PRACTICA FORMATIVA

FORMATO RECORD DE ASISTENCIA A CIRUGIA - PRACTICA FORMATIVA
IQX-FT-024-UDES

FIRMA ESTUDIANTE: ________________________ FIRMA DOCENTE: __________________________

ELABORO REVISO APROBO

Lizzeth Güiza Páez Sandra Milena Vásquez Borja Norly Eidy Molina Miranda
Coordinadora de Practica Coordinadora de Calidad Directora Programa