资源描述
Free Powerpoint TemplatesPage 1Insufflator Free Powerpoint TemplatesPage 2Insufflator The electronic CO2 insufflator is used to achieve the necessary work space by distending the abdominal wall and depressing the hollow organsBecause its automatic,the insufflating pressure can be presetThe insufflator activates&delivers gas when intrabdominal pressure falls because of gas escape or leakage from the portsCan be continuously varied from 0-30mm Hg;gas flow volumes can be set to values ranging from 0-9.9 l/mmThe important indicators of insufflators:preset pressure,actual pressure,flow rate and total gas usedQuadromanometric parameters Free Powerpoint TemplatesPage 3Electrocautery Free Powerpoint TemplatesPage 4Electrocautery this machine supports monopolar&bipolar cauteryAlso APC(argon plasma coagulator)Free Powerpoint TemplatesPage 5Light sourceFree Powerpoint TemplatesPage 6Light sourceThe light source such as 250 watt halogen lamp has a condenser systemBut,the Xenon lamp(cold light source)gives better visual clarityThe light intensity can be regulated manually or automaticallyHigh intensity Xenon lamp gives better visual and photographic clarityFree Powerpoint TemplatesPage 7Camera Free Powerpoint TemplatesPage 8Camera 2 types:single chip,3 chipHigh resolution,small&light weight,optimal sharpness,excellent color reproductionSingle chip used for routine lap surgeriesBut for video reproduction,3 chip is betterNow,digital 3 chip cameras are also availableFree Powerpoint TemplatesPage 9Harmonic scalpelFree Powerpoint TemplatesPage 10Harmonic scalpelFree Powerpoint TemplatesPage 11Harmonic probeFree Powerpoint TemplatesPage 12Harmonic scalpel The basic mechanism is by tamponading&coapting with a denatured protein coagulumMechanical energy at 55,500 vibrations/secDisrupts hydrogen bonds&forms a coagulumTemperature created is only 80-100 C,compared to electrocautery 200-300 C which also causes collateral damage&tissue necrosisNo charring or melting of tissuesThe fastest sealing instrumentFree Powerpoint TemplatesPage 13Ligasure Free Powerpoint TemplatesPage 14Ligasure Vessel sealing system Unique combination of pressure&energy to create vessel fusion by melting the collagen&elastin in the walls reforming into a permanent,plastic like sealThis seal can withstand 3 times normal systolic blood pressureLeast lateral thermal damage 1mmThe slowest sealing instrument Free Powerpoint TemplatesPage 15Enseal Free Powerpoint TemplatesPage 16Enseal Adjusts energy through each tissue bundleThis electrode consists of millions of nanometer sized conductive particles embedded in a temperature-sensitive materialEach of these particles acts like a discrete thermostatic switch to regulate the amount of currentThe vessel walls are fused through compression,protein denaturation&then renaturation Free Powerpoint TemplatesPage 17Sterrad Free Powerpoint TemplatesPage 18Sterrad Uses hydrogen peroxide vapor&low temperature gas plasma to sterilize most devices quickly with no toxic residuesTakes about 75 mins for wrapped&dry instrumentsRadio frequency energy is applied to the chamber via an RF amplifier,inducing the plasma stateReactive species are generated from the hydrogen peroxide reacting with materialsUpon completion of sterilization,instruments are dry for immaediate use or sterile storageFree Powerpoint TemplatesPage 19Cidex trayFree Powerpoint TemplatesPage 20Harmonic AceFree Powerpoint TemplatesPage 21Bowel holding Forceps manipulating bowel during diagnostic lap transmediastinal endodissection during transhiatal esophagectomy Free Powerpoint TemplatesPage 22Bowel holding curved ForcepsFree Powerpoint TemplatesPage 23Maryland dissector basic instrument for dissection Calots dissection,isolation of vascular pedicles,hernia dissectionFree Powerpoint TemplatesPage 24Blunt Grasper used during dissection with Maryland usually left hand instrument during suturingFree Powerpoint TemplatesPage 25Toothed Grasper for retracting gallbladder,extraction of gallbladderFree Powerpoint TemplatesPage 26Toothed Grasper holding thick,edematous gallbladders removal of foreign bodiesFree Powerpoint TemplatesPage 27Babcock retraction of large bowel in anterior resection,colectomies,rectopexy,stomach retraction in Hellers myotomy,fundoplication,sleeve gastrectomyFree Powerpoint TemplatesPage 28Right angle Forceps dissecting Calots,vascular pediclesFree Powerpoint TemplatesPage 29Biopsy Forceps for metastatic deposit collection,liver biopsies,stone retrievalFree Powerpoint TemplatesPage 30Clip applicator occlusion of cystic artery&duct occlusion of veins during anterior resection 2 sizes:5&10 mm 2 types:titanium&absorbableFree Powerpoint TemplatesPage 31Hook 2 shapes:J&L for peritoneal dissection of Calots removal of GB from liver bedFree Powerpoint TemplatesPage 32Suction coagulator can be used as both suction&monopolar cautery cautery can be used for drilling through distended GB,ovarian cystsFree Powerpoint TemplatesPage 33Palpation probe can be used for retracting liver lobesFree Powerpoint TemplatesPage 34Trocars pathway to the abdomen blunt&sharp tips sizes:3,5,10 mmFree Powerpoint TemplatesPage 35Reducers used to reduce size of trocars from 10 to 5 mm used to remove gauzes from abdomen types:tube&clipFree Powerpoint TemplatesPage 36Telescope invented by British physicist Hopkins in 1952 rod lens system sizes:0.8 to 14 mm diameter viewing:forward 0,angled 30&45Free Powerpoint TemplatesPage 37Ligaclip used to clip large vessels preloaded clips Free Powerpoint TemplatesPage 38Endoshears used to cut,coagulate as monopolar very useful in hernia dissectionFree Powerpoint TemplatesPage 39Optical trocar has a clear shaft&conical tip telescope can be inserted into the trocar&pushed through abdominal layers under visual guidance used when expecting adhesionsFree Powerpoint TemplatesPage 40Suture passer used for port closure suture carried through instrument&passed through the wound for closureFree Powerpoint TemplatesPage 41Punction needleFree Powerpoint TemplatesPage 42Modified Sugarbakers cardiomyotomy scissors used for cardiomyotomy for achalasia cardiaFree Powerpoint TemplatesPage 43Loop passer extracorporeal knot placed through this passer used for tying base of appendixFree Powerpoint TemplatesPage 44Abdominal specula used for dilating the port site to extract GB extract small lesions,foreign bodies,gauzeFree Powerpoint TemplatesPage 45Uterine manipulatorFree Powerpoint TemplatesPage 46Liver retractorFree Powerpoint TemplatesPage 47
展开阅读全文