Theory Unit 3 Objectives 2-4 2019 1050 PDF

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SURG1050 Surgical Technology Theory – Fall 2019 Unit 3. Introduction to Surgical Procedures Objectives Chapters 12, and parts of Chapters 11, 14, 15, 17, 20, and 21 Chapter 14 General Surgery 1. Identify common surgical incisions. (read Table 14-3 and Figure 14-5, no written class prep necessary) ALL TESTIBLE a. Right upper paramedian; left lower paramedian b. Right subcostal (done when removing gallbladder); right medline transverse; Pfannenstiel c. Upper longitudinal medline; lower longitudinal medline d. McBurney’s (can be used when they perform inguinal hernia repair); right inguinal oblique e. Right Thoracoabdominal (open lung biopsy) f. Vertical incision; Median i. Upper (epigastric or supraumbilical) g. Vertical incivion; Paramedian i. Just off midline to right or left; superior or inferior h. Oblique i. Inguinal ii. McBurney i. Transverse i. Upper: bilateral subcostal ii. Lower: Pfannenteil iii. Midline: right or left j. Thoracoabdominal 2. List tissue layers of the abdominal wall. (Procedure 14-1, anatomy page 408) a. Subcutaneus fat b. Scarpa’s facia c. External Oblique muscle d. Internal Oblique muscle e. Transverse abdominus muscle f. Transversalis fascia g. Peritoneum When suturing close the wound they might group the tissue 3 ways (fascia, muscle, and skin) Chapter 11 Hemostasis 3. List (3) patient factors that may affect surgical hemostasis. a. Congenital bleeding disorders such as hemophilia can affect bleeding during a surgery. b. Acquired disorder including i. Liver disease ii. Anticoagulant therapy with heparin or warfarin sodium iii. Aplastic anemia is a condition where the body stops producing enough red blood cells. As a result patient are ask to take anticoagulant drug like aspirin before the procedure. 4. List (4) methods of hemostasis. a. Mechanical hemostasis

b. c.

d.

e.

f.

i. Hemostatic instruments such hemostat are used to grasp and compress blood vessel. ii. Ligatures or ties can also be used to tie off blood vessels (such as silk) 1. Can natural or synthetic iii. When many blood vessels needed to be ligated for a short period time, ligating clips are used iv. Sponges can be used to apply pressure on bleeding areas and absorb the blood. 1. Raytecs, Laps, Tonsil Sponges, Kitners, or Patties v. Hemoclips/ligaclips vi. Pledgets vii. Bone wax viii. Tourniquets Biological hemostasis (pharmacological) i. Fibrin glue Thermal Hemostasis i. Electrosurgery uses electrical current to cut and coagulates tissue ii. Lasers are an intense and concentrated beam of light that cuts and coagulate tissues iii. Ultrasonic (Harmonic) Scalpel is a device that converts electricity into mechanical energy, allowing the blade to move in an ultrasonic motion to cut and coagulate tissue iv. Argon plasma coagulator Chemical Hemostasis (pharmacological) i. Silver nitrate (any bleeding in the mucous area, rectum or vaginal area) ii. Monsel’s solution iii. Epinephrine 1:1000 middle ear hemostasis Pharmacologic i. Topical hemostatics ii. Gelatin; various forms (Gelfoam, Gelfilm) iii. Collagen Blood Replacement including: i. Use of donor blood (homologous donation) 1. It is the most common method of blood replacement. 2. All donated blood are tested for any signs of syphilis, hepatitis, or human immunodeficiency virus (HIV) before it is given to the patient. 3. There is still the possibility that the donors blood can transmit any blood borne pathogens despite being carefully tested. ii. Have the patient donate his or her own blood before the surgery (autologous donation) 1. This can be done 4 days before the surgery, however, it is preferred that it is done 1 month before the procedure. iii. Have the patient’s own blood collected and use it during the surgery (auto-transfusion)

NOTE: to prep for class for objectives 5-9, complete the assigned procedure worksheets from relevant chapters per assigned surgical procedures: 5. Define terms and abbreviations related to surgical procedures. 6. Identify surgical anatomy and physiology for specified surgical procedures. 7. State a pathophysiologic condition or indication for specified surgical procedures.

8. List special equipment, instruments/sets, supplies, and medications/category/purpose needed for specified surgical procedures. Chapter 12 Surgical Case Management (refer to table 12-14 pages 3711-372 and relevant Chapters) 9. Summarize procedure step sequence for specified surgical procedures. Objectives 5 – 9 apply to the following assigned procedures: Breast biopsy (14-20) – will do in class in group workshop McVay Inguinal Herniorrhaphy (14-16) Cholecystectomy, open with cholangiogram (14-10) Dilatation and Curettage (D&C) (15-11) Diagnostic laparoscopy for gynecology (15-6, titled “basic laparoscopy”) Myringotomy (with tubes; 17-1) Tonsillectomy and adenoidectomy (17-12) Knee Arthroscopy (21-12) Bunionectomy (21-19) Cystoscopy (20-7) TURP (20-10) NOTE: The numbers in parentheses refer to the textbook’s list of procedures on the inside front cover....