I

>
-
Terminal parts are unned
& Fenestrated
>
-

Ridge in one blade

a grove in other-
>
-
Eeeth
No
, non-traumatic forceps

>
-
Used during the small & large intestive resection
to hold the margin of the
get before applying intestinal clamp
>
-

during gastrectory , gastrojejuns to my

occlusion
to hold margin of stomach while
applying an

clamp:
used to hold
out marine of bladder
during
-
>
-

transvesical prostated y

BABCOCK

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 Paragas and Scissors -

① Ailey forceps ( Haemostat →

→
finger rings

Ratchet
/ - Shaef .

Blades T
- Senators

to
→ Used
veins
control
bleeding femur artery ,

and capillaries .

Mosquito forceps Repair of haeelufo

-
→
,

cleft palate .
② Tissue
Allis
Holding forceps -

teeth
Apposing
✓ → Ratchet

Uses -

- Hold
fascia ,
aponeurosis .

.
sleek flaps .

③ Kochel 's
'

tfoeceps .
-

Ratchet Senators

( ng
>→ opposing
tooth

be evened
-
can or
sturaighto
the ends
- The sheep tooth on
persuade a

better
grip .

Uses -

→ Hold
tough structures alike fascia .

aponeurosis .

During thyeoidectoiuy ,
it can be used to
hold the strap muscles
for dividing them .
⑨ Sinus forceps
*
-

No hatchet

f Senators
q only at

① the
tip .

1
To hold the
wall
Used as of air

abscess
earthy .

Hilton 's method abscess

drainage to
→

of
bleak the locule
.

- to
facilitate free opening Inside the
has
it ratchet
cavity
.

,
no

⑧ Swab
f sponge holding forceps -

Ratchet Blades
→
fr
Round ends
f. with sanction

Uses -

→ Hold the swab (game pieces) to

prepare the

parts with antiseptic agents at the time

of surgery .
 ⑥
Babcock 's
forceps
&
&
-

notetraumatic
⑦ Effed
ends

Ratchet
{ triangular
fenestration
&
Allows

soft tissue
to
bulge
out .

Uses -

- Hold

resection
Intestines
during anastomosis or

- Hold
fallopian tubes ,
appendix .
ueetee ,

coed , etc .

⑨ Tissue
Dissecting / Mayo 's 1 Scissors →

Fine
seiste
-
-

Uses -

Dissect tissue planes during surgical

→

operations .

Cut
→ or divide
important estuoetuees .
⑧ Straight scissors -

Uses -

→ To cut sutures fkaots .

----

⑨ Needle Holder -

→ Criss -
cease

ceeooee for placing

needle
secretions

\ Ratchet Small distal blades

alay be straight evened

-
or

Is
- A
good control and
grip achieved

by placing the needle at the function

of proximal 93 Ws
and distal .

-
Should be held between thumb and

Hug finger .
⑥ ( Toothed)
Dissecting forceps
-
-

] Toothed

] No tooth

Uses -

-
Hold sleek and
tough structures .

-
peek Individual layers such as seeoea ,

seeoniuseehae
layers , mucosa ,
etc .

during
anastomosis .
 Retractors -

① Deaver's eeteaetoe -

→
Bread, gentle eave .

-
Also called Deaver 's live eeteaetoe .

Blood enured blade

gentle
-
, .

Uses -

Tleteact liner
dining negatory
cholecystectomy
-

gastrectomy
Retract
ee

and
.

abdominal
spleen other
-

viscera .

-
Astronautic
Provides the
-

adequate exposure of surgical

field .

Retract lumbar
kidney upwards deicing
-

sywyootheetoeuy .
② Doyen 's Retractor →

in
-
used
pelvic organs .

③ alanis Retractor →

→ Broad operating
end

uses -

→ Retract the abdominal wall

,
once the

peritoneum Is
opened .

-⑨ Langenbach Retractor →

Shallow end
p

Uses →

Weenie
surgery
→ .

→
Superficial surgery
to retract skin ,
fasciae
and aponeurosis .
⑧
⑭
CZERNY 's letueetoe -

→ Double hooked end .

Blade ←

→ Double -
hooked eetraetoe on one side and
a
single blade on the other side .

Uses -

Retract
layers of abdominal wall
-

muscles ,
etc .

in
Used
appendicectomy herniorrhaphy
-
.

or
thy eoidectoeuy .
Dealers →

A dealer is a cheated channel which allows

any fluid collected ,

to come out
after
main wound
closure
of the .

classification of Dealer
Systems -

⑧ Open dealer -

dealer
[Link] eoeuegated .

eater is
-

lufectiow high .

- contraindicated
is
in mesh
repairs Infection
as

in mesh
already a serious
complication .
 ② closed
siphon dealer -

Dealer is connected to sterile with

-
a
bag
without one -
valve
ee
way
.

late
- Reduced
infection .

③ closed suction drain -

is
-

Negative pressure of 100 - soo men

ng
used
to eeeate vacuum to drain the secretions .

powered

Can be attached to one or two dealers .

⑧ Sump suction drain -

suction with
parallel ale is
acegatine a rent
-
-

used to
prevent the adjacent soft tissue
dealer
being sucked Into the brewer
of the .

⑤ Under water seal drain -

To deaden
pleural space
-
.
complications of dealers-

Infection
-

Displacement
interfere with healing process
-
.
 Tubes and catheters →

① foley 's self Retaining urinary

-
catheter -

--

patients
-
tu prostate
3 way

→
Size in Fiend
scale written
here ( → Balloon
.

equine)

veins
>
- - drainage → Bladder
-
opening
poet
-
-
-

Balloon part
-
-

indications cattveteusatioer
foe uieuaey
-

⑨ Retention of nuke
→ Acute betatron
bladder
Neurogenic
→

② Choate obstruction .

③ Estimation of mine
output
-

⑨ Comatose
patient
⑤ of nuke
collection
samples .
 infection catheter
Procedure
of of Foley 's
→

Peep ace sterile field

&

Apply sterile
gloves
I
Got the distal
portion of
catheter with lubricant
&
if female , separate labia with
non - oloeeieeraht hand .

hold
if male ,
the
penis with
how dominant hand .

I
identify
and
the
winery meatus
Insect until
I-2
gently
dudes where
beyond
we starts to
flow
I
the balloon with
Inflate
saline
&
until
Gently pull catheter
balloon is
sang against
bladder neck .

I
eoaeect catheter to

drainage system
d
Place drainage bog below
level
of bladder
② ahahecot 's catheter -

has wide diameter

flower
shaped end
-
-
.

Uscg →

- Dealer ahioebee [Link] abscess .

Dealer bladder teaeeseeueeeal

uiihaey after
-

prostatectomy .

feeding gastrostomy tube

-
.

Deader thoiacis
empyema
-
.

③
X Nasogastric / Ryle 's tube -

shots)
- Tip ( lead

- →
Base

Rubber tube 1
-
→

Body
-

sterilisation - V-
rays
→
 Blind bulbous
-

tip contains a head shot inside

Into
the tube to
facilitate passage of tube

oesophagus I
due to
the .

weight) .

There aee
fore
is
edueulee
makings →

The distance ieueasueed

from the
tip
⑨ first week - AO een -

upper central incisor

[Link]
and
orifice
stomach
of
.

② Second made a 50 een -

Body of stomach
③ Third week - 60 car -
Pylons .

⑨ tfoeuth made -
65 cur - first
part of duodenum .

Used →

b-

t
-

t
-

-
 Indications
for Ryle
's like
feeding as

① Unconscious critically
or ill
patient -
.

② Inability to swallow egg after maxillofacial surgery

bulbar
or
palsy .

③ patients with lower .

⑧ nleueogeecie dysphagia .

interdiction Ryle 's tube

of
→

Explain the
procedure to
patient
to
Ask the patient to lie flat in bed
with extended week .

I
nostril is selected
A- more
potent
and
peopeily cleaned
it
Nostell lubricated with
24 .
eigaoeaiue jelly
of
&
lubricate tube with
the
lip of
liquid paraffin glycerine or

&
lntueduee
the
the
tip gently through
nostril .

I
Patient when
tip
coughs the
leeches the oropharynx .

I
Reassure and ask to swallow

the tube .

I
The tube to the stomach
passes
with
gentle pushes .

I
 Base the tube is adhered to the
of forehead
by a
leucoplast
&
Open end is plugged

tube in stomach
confirmation of lip of the -

① ale into the tube

Infect by pushing piston
the
auscultate the
and
simultaneously
sound
epigastrium .

A
gurgling
In the
confirms
the
position of tube

stomach .

③ Aspirate the
gastric contents
-
litmus
paper test -

- Positive .

③ Straight X -

day . .

⑨ Kehr's T tube
- -

-
whenever ttne CBD is Incised ,
it is sutured

after Inserting the T tube

limb Is
-
.

-
The short
placed neetically weather the
in it
Cbp
after making a -3 holes
splitting
-

ee

it
entirelylimb .

is exteuoused and connected

The
long
-

to a sterile container .

Presence of T tube
peeueut peritonitis due to
-
-

biliary leakage in eases

of residual stones

blocking the lower end

of ebb .
and
Anvil

be 1Huh
 Surgical handles and blades -

① BARD
⑭ PARKER 'S HANDLES →

A flat stainless steel instrument with end

-
one

with either side

uauowee a slot on
for
blade
attaching the
scalpel .

The numbers the handle 3.5 . 9 9

of
- eee
may
.

BP handles sterilised
are
by autoclave
-
.

② Surgical blades -
-
Blade numbers 10 , 11 , 12,23 and 15
fit in BP handle

numbers 3.5 and T .

Blade 18 2A in
- numbers . 19 20 , 21.22.23
.
and
fit
BP handle number A .

-
Blonde numbers 20 ,
21 .
22 , 23 and 24 have

wide and iueiseous

shaft ace used
for lager
and dissections .

number and Is
- Blade e5 has a crown
shaft
smaller Incisions while
used
free ,
excising
a sebaceous cyst .

Blade number is also known stab

11 as
knife
-

and is used
foe deainage of an abscess .
 NEEDLE
HOLDER
↑

smalle as compared to shaft

needle holder
are

>
- Blades of the

>
-
Blade t
recotec hold fire nees

sufore on carface
needle holder
>
-
> small size
abdomen
,
at the depth inside
-

used for inturing

>
-
long needle holdle-
Pelvis/chest

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din
-
e
E

-
>
-

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scissor
Watery forup

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Artery forceps

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used
during almost all
operations
to we'd tough structures like

Skin Fascia & aponeurosis

-
,

&

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 To hold
delicate
satires
peritoneum
vessell , never &

Muscles dining dissection

sutonni -

=> Plain dissecting

Fore -

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----

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 >
-

eapeotomy
During skin main can be

retracted
All fres >
-

used to hold skin main during incisional hemia

-

4 there is gap blu the

Blades are long
blades to accomodate some amount of
Tissues :
⑯X

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 In general, corrugated drain sheet is
considered as an open type of drain.
The open drainage system is a tube
which is inserted into the body and
drains out onto a dressing. They drain
fluid on to a gauze pad or into a stoma
bag. They are inserted directly into the
wound bed and they drain into a
dressing.

Corrugated drains are intended for open passive

drainage, used in situations where wounds must
be kept open. They are placed directly into the
wounds left to heal by secondary intent.
The product is intended for single use only.
Corrugated drainage sheet with safety pin
REF*
1508518x
1508618x
Contains
latex? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
No Contains
DEHP? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Ye
s Corrugated
drains . . . . . . . . . . . . . . . . . . . .Polyvinyl chloride
Safety pin . . . . . . . . . . . . . . . . .Hard steel with
Nickel coating
Drain length, mm
250
400
Drain width, mm
25
25

-
47
-

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Abdominal drainage kits are used in the post-
operative stage to enable drainage of
excessive fluids from the peritoneal cavity.
They are used, for example, in paracentesis
procedures for draining abdominal ascites.
The product is intended for use by medical
practitioners. T

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Orange 14
I 6
Grey
=

= I 8
Green
Pink 20

22
Blue
=

2K
Yellow =

26
purple =
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 An endotracheal tube is a
flexible tube that is placed in
the trachea (windpipe) through
-

the mouth- or nose. It can be

used to assist with breathing
during surgery or to support
breathing in people with lung
disease, chest trauma, or
airway obstruction.

#Sense Anastie
-
e

Endotracheal => Freisn

- >

object destruction
tube
=>
Airmay protection :
-

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Chronic catgut

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Iv infusion
set

? Types of fluid
uses & indication
.

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 MY-2474
roll-500x

consists of several essential parts,

each serving a specific purpose to
facilitate the administration of
medications, infusion of fluids, and
withdrawal of blood.

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 189
---

man
%
taking fork

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e Welfare Circular stapler is used in general surgery, thoracic surgery, surgical The linear cutting stapler is
eatment of obesity and in colo-rectal surgery, to perform end-to-end, side-toend, and
de-to-side anastomoses. C used in abdominal surgery,
thoracic surgery, gynecology
and pediatric surgery.
Generally, the stapler is used
for resection and transection
of organs or tissues.

scopy) is a procedure to examine the insides of the rectum and the anus.

µat④
>
-
Hemorrhoids :

# Pale
Abnorma
geoxith :
uses w
-

B
Your
60 w
g
b

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MIPH stands for minimally
invasive procedure for
haemorrhoids. Also referred to
as stapler hemorrhoidectomy,
the procedure is involved to
treat patients suffering from
piles. It is a painful condition,
marked by the development of
haemorrhoids in the anal canal.

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The main purpose of the water
seal is to allow air to exit from the
pleural space on exhalation and
prevent air from entering the
pleural cavity or mediastinum on
inhalation. When the water seal
chamber is filled with sterile fluid
up to the 2 cm line, a 2 cm water
seal is established.

ndications for Insertion of

a Chest Drain
Chylothorax
Pleural effusions
Pneumothorax
Post cardiac surgery
Haemothorax

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X-ray
Coffee bean appearance
Achalasia cardia
Apple core
Bladder stone
Cannon ball
Diaphragmatic
hernia
Gas under diaphragm
hydropneumothorax
invertogram
ivu
pneumothorax
T-tube cholangiogram
Ureteric stone
Intestinal
obstruction
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 tissue
° Breast
fibuefatty
-
-

simple mastectomy = No IND

Surgery performed mastectomy f

° =
M RM

°
Incision = Steward ⑧ Halsted Radical Mastectomy ⑧ Ramdiasffeton
ORR
Patey -
- t

NO Gmbh node removed MR① peat minor ±

Auchincloss
simple mastectomy µ Ae
=
→

DC's →
pectoral fascia
phylloid tumor → whole ALN

Axillary Art
f-cephalic
=

Ste
preserved
=
-

Bells nerve
Nyein

complication
•
Hemorrhage Nerve
to Nerve
-
- Inter cos to brachial
•

Injury
•

winging of scapula
• Senoma
formation
Lymphedema
•
.

• Local Recurrence

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 absorbed cholesterol
Caius §defective transport of
accumulates in
which
Mucosa .

cholesterol
•
) Bed absorption of

in cholesterosis
Murphy sign

some
Name
Choleecystosis
: -

a) Strawberry gb is PwTalignaut)
( stem
b) polyposis glandular
.is proliferous
c) cholecystitis
d) diverticula of gb

)
Tx =
cholecystectomy ( always)
-

( chalestenosis
 with dilated distalpart C fundus)
Pear shaped organ yo gallbladder
Fat female forty flatulence
Etiology ⑨ Rft for
stones =

fertile

Sx =
Cholecystectomy
Indication
-
.
-

Gallbladder
with stone
 Semitransparent
C- chino coccus ovoid
granulosa
Lange structure
cystic
3
•
layers : -

) Adventitia lpsuedocyst)
slotiydhhdyst
Laminated
)
④ medical
•
:
cectoupt)
-

•
) Germinal layer -
Al bend zoltw
c emdoeyst) -

Mebendazol

Sx
PAIR
(peewit .
→
Aspirate
I

( scoliocidae ) Inject
to

\
-
Reas pint)

hypertonic saline
-

Type afhemiuekctomy ? Colectomy -

anastomosis ? I t Extended
type of →
-

-
arteries tobetied ?
"
Right Extended
left
- heft
splenic
- -

Rig
terminal ileum team flexure Hepatic
fleam

I
6cm

I t I
✓
till left Recto
-

5am Middle colic

margin
c ,

Sigmoid
- -

of Yzrd of transverse
colon
[Link])
flexure
( ileocolic , Right colic ,

middle)
Types of
Anastomosis
-

-
ileo transverse
in
C Right
colectomy)
-

ideo colic
)
( extended Right
 ated notch on Anterior Border
=
Spleen
wedge shaped oblong width .

than
overlies 9 10,11 rib .
length is
larger
,
Trauma

Indication of splenectomy f-hypersflenism

Injury
p① cause of splenic abusers
I
OPS I
complication
Rly
=

Atelectasis

gastro paresis infective

endocarditis
Pancreatitis

incision = Subcostal
/ Hockey stick
 tphylo
pharmacy
Metallo

Gastritis tiemelemesis
clinical feature
-
-_

Abdominal pain
perforation
obstruction

Investigation : Usa -

CTS can

Tx
Laparotomy
-

by giving
vertices incision
( gastrostomy) psychiatric counselling
complication bleeding site of
bleeding
&
digate
.

look
for
-
 beninephsicfat
Bean shaped
organ, Gregg

kidney
Total Nephrectomy
Radical
tpomseitoneal
:
Approach µ¥my
- -

malignancy
-

in

condition
[Link] = in
Benign D suprarenal
-
Ureter
@)
t → vein
Tiesto .

of pelvis
=
Artery
tie ureter as distal
Total
-
nephrectomy
as
possible .

c) suprarenal
preserved
 shaped
Bean

organ
I
severe
kidney ① Hydronephrosis ⑤ Renal Trauma
nephrectomy
=
n

pyo nephrosis
Total ②
③ Renal carcinoma

④ Che .
pyelonephritis
C
I beam

Emery be
portion
calculus)
in pelvis

mtg lead to [Link]

's
 mummy
Gm
l

follow-up [Link]
3 5
: -
,
, ,
year

Defh€]
Hungry
Bone

syn
-

T
t
10 ml I f .

can
gluconate
hit 20 due to rapid
gun
-

entry of cart
Types of goitre?! into bone
Sx
after thyroid
which must
2 Str .

SK ?
be

Sx
saved
=
during
RLM
of
thyroid
S LN
Types
Rose position
position =

Arteries should be ligated gland possible

close to
.

as as
*

* mins
ligated before ligating artery
due to
complications ④hemorrhage
CMC) slippage of Ligature

② Respiratory distress Mt hematoma tea Chea

compressing
Tra Cheo mala cia

③ Hoarseness of Meece
⑨ hypercalcemia dft parathyroid damage
 BOTH
TEST IS

faut
'

likely to be epididymis
-7
u

fsnmguglobulaestructure
mum Cowen

Torsion
Indicate =
oqchidotectomy
Trauma
Tumor @ A)
 Breast because of
thee of fibeofally tissue .

Specimen of
Sx
performed =
Mastectomy
tumor
Indication =
-
Giantphylloid

malignancy
-

Incision used = ORR steward incision

J
2cm
Margin
22ND
Axillary
complication = sesoma post op Mx = HPE Report = CT . RT ( 9ndicatn ? )
 -

cause of Recurrence

Rfalse capsule

wet
Itis
mounted specimen
Prostate complicating
of
Bilobulah To RP : -

dlfiressiomnost likely
←

• median Tweetesral strict

Mctigue) -
water intonice

Retrogradation
-

prostate f
①Rpeennna
-

-
Fibro muscular organ
-
s×= frosted-0mF ① Bleeding

Jndicath = BPH cute intermittent

carcinoma traction
prostate
② urethral injury
[Link] treatment .

Prostatic to

urethral Fvrtthrgfn

ZggE@tEB36gggTFF3g.o
Torp Trane .cm
Prostate

[Link]
=

Resection of
neurone
"
mini: '

Frey 's supra pubic

- "

Young
-

Perineal . .
tuft leeeoz entire prostate visible