SURGICAL INSTRUMENTATION PROGRAM

TRAINING SURGICAL PLANNING

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IQX-FT-003-BUC

STUDENT NAME: ANGIE NATALIA BAUTISTA BAUTISTA CODE: 01200022008 PRACTICE LEVEL: III

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

SPECIALTY: CX SURGEON: DATE: 17/11/2023

CARDIOVASCULAR Dr. Giraldo

NAME OF PATIENT MEDICAL HISTORY NUMBER: PATIENT AGE:

SOFIA LOPEZ 17645454 3 years
SURGICAL PROCEDURE TO PERFORM: CLOSURE OF INTERVENTRICULAR COMMUNICATION

SURGICAL INSTRUMENTATION PROCESS

1. PLANNING STAGE:

1.1 Surgical Objective: (Make description)

Close the defect that causes communication between the two ventricles using a Goretex patch.
 SURGICAL INSTRUMENTATION PROGRAM

TRAINING SURGICAL PLANNING

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1.2 Anatomy and physiology: (Make graph and description)

Interventricular septum
The muscular structure that separates the right
and left lower cardiac chambers (CARDIAC
VENTRICLES). The interventricular septum has a
very small membranous portion, just below the
AORTIC VALVE, and a large thick muscular
portion consisting of three sections including the
inlet septum, the trabecular septum, and the
outlet septum.
 SURGICAL INSTRUMENTATION PROGRAM

TRAINING SURGICAL PLANNING

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1.3. Check list

MEDICAL EQUIPMENT / DEVICES SUTURES AND NEEDLES DRUGS AND
INSTRUMENTAL SOLUTIONS
• Compresses • Bone wax
• Pediatric extracorporeal • Gauze • Saline
equipment • Electroscalpel Solution
• 20ml syringe • Silk 3/0 with 26mm ½round circle • Bupivaca
• Pear needle (retract the heart) ine
• Reciprocating saw • Suction rubber • Polypropylene 5/0 needle ½ circle
• Antegrade cardioplegia cannula (arterial loop and cardioplegia)
• Arterial cannula • Polypropylene 5/0 (venous loop
• Accessory equipment • Selective venous cannula and vent)
• Connectors • Polypropylene 6/0 (valve closure
• Vent Aspirator and atrium).
• Pediatric sternal separator • Semi-rigid pericardial aspirator • Silk 0 ( arterial cannula fixation)
• Loban • Pre-cut silk 1 (cannula fixation).
• Sharps container • Silk 4/0 (atrial repairs).
• 5/0 and 6/0 accessory needle • PDS 1 (sternum closure).
• Gauze container
holder
• Pathology bottle • Poliglactin 910 3/0 (tcs)
• Syringe of 23 (blue) • Poliglecaprone 25 4/0 (skin
• Alligators closure)
• Total occlusion clamp • Pacemaker thread
• Nelaton 8 probe
• Blake drain
• Cocas • Fixomul
• Goretex patch
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2. ETAPA DE ORGANIZACIÓN:

a. May table arrangements and reservation

 SURGICAL INSTRUMENTATION PROGRAM

TRAINING SURGICAL PLANNING

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2.2 Patient Position (Name and Graphic):

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

 SURGICAL INSTRUMENTATION PROGRAM

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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):

Sternotomy and thoracic incisión

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

1. Make incision 1. mb #7 hb #15.

2. Deep tissue incision.
3. Sternotomy.
4. Manual separation of the sternum.
5. Sternum hemostasis
6. Fixed separation of the sternum.
7. Opening of the pericardium.
8. Repair of the pericardium.
9. Tobacco bags in:
-Ascending Aorta (purse of tobacco for arterial
cannulation).
-Aorta root (tobacco pouch for cardioplegia
cannulation)
10. Tobacco bags in:
-Superior and inferior vena cava (purse of
tobacco for selective venous cannulation)
- Left atrium (tobacco bag for vent aspirator
cannulation)
11. Tourniquet or threads to refer the tobacco
bags.
12. Cannulation.
13. Fixation of the cannulas.
2. Electrocoagulation and dissection.
3. Reciprocating saw with downward saw.
4. Senn Miller type separators.
5. Electrocoagulation device.
6. Autostatic separator.
7. Elastic apprehension, vascular device and
electrocoagulation.
8. Elastic apprehension vascular device and
needle holder with 2/0 silk suture.
9. Vascular type elastic apprehension, synthesis
and 5/0 TF-1 polypropylene suture material.
10. Vascular type elastic apprehension,
synthesis and 5/0 2C-1 polypropylene suture
material.
11. Mosquito-type hemostatics.
12. Umlaut type mb#7 hb#11.
13. 1 pre-cut silk.
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14. Purging of the arterial cannula. 14. Tube clamp and gauze.

15. Incision in the inferior and superior vena 15. Umlaut type mb#7 hb#11
cava and perform cannulation.

16. Proper connection of the cannula to the 16. Connectors.

extracorporeal circuit.
17. Cannulation. 17. Indirect antegrade cardioplegia cannula.
18. Purged of cardioplegia. 18. Protected mosquito clamp.
19. Connection. 19. Extracorporeal circulation tubing.
20. Incision in the left atrium and cannulate the vent 20. Umlaut type mb#7 hb#11.
aspirator.

21. Aortic clamping. 21. Total occlusion vascular clamp.

22. Right atrium. 22. Umlaut (scalpel blade 15), and vascular
dissection.
23. Repair of the walls of the atrium. 23. Silk 4/0.
24. Shape it according to the size of the defect. 24. Synthetic or biological patch.
25. Patch placement. 25. Polypropylene 5/0.
26. Closure of the atrium. 26. Polypropylene 6/0.

27. Accelerate patient warming. 27. Warm saline solution.

28. The patient's extracorporeal circulation exit. 28. Aortic unclamping.

29. Removal of cardiovascular cannulas, resolve
possible bleeding.
30. Position as you see fit in atrium and
ventricle respectively.
29. Umlaut, vascular elastic dissection, providing
for partial occlusion clamp and reinforcing
sutures with and without support of
polytetrafluoroethylene pads.
30. Synthesis, elastic dissection, pacemaker
thread.
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31. Position as you see fit in the pleura and 31. Umlaut, elastic apprehension, suture and
mediastinum respectively. synthesis and Blake's drain.
32. Face fabrics. 32. Synthesis, elastic apprehension and sutures
(PDS 1, absorbable suture, etc.)

WEEKLY REPORT FORMAT OF TRAINING PRAC SURGERY ASSISTANCE RECORD FORM - TRAINING PRACTICE
IQX-FT-024-UDES

STUDENT SIGNATURE:
TEACHING SIGNATURE: __________________________