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Instrumentarul

chirurgical

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Generalitati

Totalitatea instrumentelor si

dispozitivelor ce servesc la bunul

mers al unei interventii chirurgicale

Permit accesul in zone profunde,inaccesibile mainii chirurgului

Au contribuit la scaderea

traumatismului tisular si la

miniinvazivitate: jackoscopie,

laparoscopie

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Clasificare

Instrumente taietoare

Instrumente de apucat si fixat

Instrumente de sutura Departatoare

Instrumente pentru chirurgia

osoasa Instrumentar laparoscopic

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Instrumentele taietoare

Bisturiul rece

Bisturiul electric

Foarfecele

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Bisturiul

Simbol al actului chirurgical si al

chirurgului, insa paradoxal, cel mai

putin utilizat

Priza Tipuri

1. Monobloc

2. Lama interschimbabila3. Dispozabil

Tipul adaptat nevoilor

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Foarfecele

Principalul instrument taietor

in chirurgie

Clasificare

1. De pansament Liston

2. De ata

3. De disectie: dreapta sau curba Priza: degete 1 si 4

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Foarfeca Liston de

pansament

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Foarfeci de disectie

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Foarfeca dura, de ata

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Foarfeca de microchirurgie

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Bisturiul electric

Mod de functionare:

taiere/coagulare

Pe cale clasica sau

laparoscopica

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Pensa anatomica

Prehensiune fina, in

profunzime, lungimi

diferite, fara dinti

Mana stanga apuca,mana dreapta

sectioneaza

Particular in

microchirurgie

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Pensa chirurgicala

Dura, cu dinti, lungimi

diferite

Piele, aponevroza,

musculatura, bontvaginal

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Pense hemostatice

Pean

Kocher

Mosquito Halstedt

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Pensa Pean

Cea mai folosita inchirurgie

Cremaliera

autostatica Zimti transversali petoata lungimea,FARA DINTI LA

CAPAT- caracteratraumatic

Drept sau curb

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Pensa Mosquito

Pensa Pean mica-

10cm, fina

Chirurgia vasculara

si tiroidiana

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Pensa Kocher

Pensa hemostatica dura, grosiera

Zimti pe toata lungimea+2 dinti la capat-

traumatica

Hemostaza pe structuri ferme: uter, muschi

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Pensa Halstedt

Kocher mic

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Pensa porttampon

Toaleta plagilor

Asepsia

campului

operator

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Pensa Museux, de uter

Puternica, lunga,

prevazuta cu dinti la

capat+ cremaliera

Pensa Chaput-identica dar mai

mica, la excizia tu.

Mici

Pensa de plaman-

atraumatica

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Pense pentru fixarea

campurilor

Carabus-delimiteaza campul

operator

Bachaus-izolarea tegumentului

Doyen-izolare tegumentara la

gusa

Mikulicz-izolare peritoneu-

diferentierea de Kocher

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Bachaus

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Mikulicz

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Pense speciale atraumatice

En coeur-de limba sau de

colecist

Klammer intestinala

Duodenala

in L-de rect

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En coeur

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Klammer nu pe mezou!

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Alte pense

Dejardin-de calculi

De cistic-ca un pean fin

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Instrumente se sutura

Portac Mathieu

Portac Hegar

Ac Reverdin Ac Deschamp

Ac Hagedorn

Ac Bassini Stapler

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Portac Mathieu

Grosier, sutura

superficiala: piele

musculatura, aponevroza

Priza

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Portac Hegar

Suplu, sutura

fina, in

profunzime

Priza

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Ac Reverdin

Grosier, 2

treceri prin

tesut

Chirurgialaparoscopica

peretelui

abdominal

Buton si clapeta

ce culiseaza

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Ac Deschamp-urechea la

varf

Grosier, 2

traversari

De dreapta si de

stanga In combinatie cu

sonda Payr

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Staplere

Linear/circular

Dimensiuni variabile

Clasic/laparoscopic Agrafe diferite

Scurteaza durata, creste

acuratetea Scoate factorul eroare umana

din rata de fistule

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Departatoare

Farabeuff-2 lame

Kocher-1 lama + maner

Volkmann cu dinti Valve abdominale

Autostatice vasculare

Autostatic Gosset Autostatic Finochetto

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Farabeuff

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Kocher

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Volkmann

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Valva abdominala

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Autostatic vascular

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Gosset

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Finochetto

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Chirurgia laparoscopica

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Pense atraumatice pentru

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Pense atraumatice pentruchirurgia vasculara-

clampuri Dieffenbach-buldog, vase

mici

Satinski-clamputernic, vase

mari

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Chirurgia osoasa 1 Luer

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Chirurgia osoasa 2

Gigli

Volkmann

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Sonde

Nelaton

Pezzer

Thiemann

Foley

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Dren Kehr

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Ati inceput chirurgia cu dreptul !!!