exploratory
laparotomy
A exploratory laparotomy is a surgical procedure involving an incision through
the abdominal wall to gain access into the abdominal cavity. It is also known as coeliotomy.
Nursing responsibility:
Preop: Patients should be NPO for 8 hours before surgery. If they are going to operate on their
bowels, they will undergo a bowel prep the previous day. They'll need an IV to keep them well
hydrated while NPO. It's also nice if they can take a bath with an antiseptic cleanser the night
before.
Postop: Right after surgery you need to keep a close eye on their vitals, ins/outs, and mental
status to catch problems early. You also want to check out the dressing over the surgical site to
make sure it's not pouring out blood or some other fluid. Early ambulation and pulmonary toilet is
very important in order to avoid complications such as pneumonia and deep vein thrombosis.
Pain control is key here, since pain will limit their ability to walk, cough, and deep breathe.
Nursing Diagnosis:
Acute pain related to skin integrity secondary to surgical operation
Instrument set:
104 BASIC LAPAROTOMY INSTRUMENTS
1 T/C (TUNGSTEN CARBIDE INSERTS) MAYO SCISSORS 6.75" STRIGHT
1 T/C (TUNGSTEN CARBIDE INSERTS) MAYO SCISSORS 6.75" CURVED
1 T/C (TUNGSTEN CARBIDE INSERTS) METZENBAUM SCISSORS 7.00" CURVED
1 T/C (TUNGSTEN CARBIDE INSERTS) METZENBAUM SCISSORS 9.00" CURVED
1 T/C (TUNGSTEN CARBIDE INSERTS) METZENBAUM SCISSORS 9.00" STRAIGHT
1 T/C (TUNGSTERN CARBIDED INSERTS) MAYO HEGAR NEEDLE HOLDER 6.00"
1 T/C (TUNGSTEN CARBIDE INSERTS) MAYO HEGAR NEEDLE HOLDER 7.00"
1 T/C (TUNGSTEN CARBIDE INSERTS) MAYO HEGAR NEEDLE HOLDER 8.00"
1 T/C (TUNGSTEN CARBIDE INSERTS) MAYO HEGAR NEEDLE HOLDER 10.50"
1 YANKAUER SUCTION TUBE
2 SCALPEL (KNIFE) HANDLE # 3
2 SCALPEL (KNIFE) HANDLE # 4
1 SCALPEL (KNIFE) HANDLE # 7
1 OPERATING SCISSORS 5.50" STR SHARP/BLUNT
1 THUMB DRESSING FORCEPS 5.50"
1 TISSUE FORCEPS 5.50" 1X2 TEETH
1 ADSON DRESSING FORCEPS 4.75" SERRATED
1 ADSON TISSUE FORCEPS 4.75" 1X2 TEETH
1 RUSSIAN TISSUE FORCEPS 8.00"
1 DRESSING FORCEPS 7.00"
1 TISSUE FORCEPS 7.00" 1X2 TEETH
6 HALSTED MOSQUITO FORCEPS 5.00" STRAIGHT
6 HALSTED MOSQUITO FORCEPS 5.00" CURVED
6 KELLY FORCEPS 5.50" STRIAGHT
12 KELLY FORCEPS 5.50" CURVED
6 ROCHESTER-PEAN FORCEPS 6.25" CURVED
2 ROCHESTER PEAN FORCEPS 8.00" CURVED
4 ROCHESTER OCHSNER FORCEPS 6.25" STR 1X2 TEETH
1 MIXTER FORCEPS 7.25" FULLY CURVED
1 MIXTER FORCEPS 9.00"
1 BABY MIXTER FORCEPS 5.25" FULLY CURVED
8 BACKHAUS TOWEL CLAMP 5.25"
1 FOERSTER SPONG FORCEPS 9.50" STR SERRATED
1 POOL SUCTION TUBE
1 U.S ARMY RETRACTOR SET OF 2 PCS.
1 RIBBON RETRACTOR 3/4" X 13"
1 RIBBON RETRACTOR 1 1/4" X 13"
1 RIBBON RETRACTOR 2" X 13"
1 DEAVER RETRACTOR 1" X 12"
1 DEAVER RETRACTOR 2" X 12"
1 RICHARDSON RETRACTOR SMALL
1 RICHARDSON RETRACTOR LARGE
1 KELLY RETRACTOR
1 BALFOUR RETRACTOR
2 LAHEY GALL DUCT FORCEPS 7.50"
2 ALLIS TISSUE FORCEPS 6.00" 4X5 TEETH
2 ALLIS TISSUE FORCEPS 10.00"
2 BABCOCK TISSUE FORCEPS 6.25"
2 BABCOCK TISSUE FORCEPS 9.25"
4 SCHNIDT TONSIL FORCEPS 7.50"
1 DeBAKEY TISSUE FORCEPS 8.00"
2
http://en.wikipedia.org/wiki/Laparotomy
http://www.surgeryencyclopedia.com/La-Pa/Laparotomy-Exploratory.html
http://answers.yahoo.com/question/index?qid=20081112232401AAPsaEF
Extracapsullar Cataract extraction
Extracapsullar Cataract extraction is the removal of the natural lens of the eye (also called
"crystalline lens") that has developed an opacification, which is referred to as a cataract.
Metabolic changes of the crystalline lens fibers over the time lead to the development of the
cataract and loss of transparency, causing impairment or loss of vision. During cataract surgery, a
patient's cloudy natural lens is removed and replaced with a synthetic lens to restore the lens's
transparency.
Procedure:
The surgical procedure in phacoemulsification for removal of cataract involves a number of steps.
Each step must be carefully and skillfully performed in order to achieve the desired result. The
steps may be described as follows:
1. Anaesthesia,
2. Exposure of the eyeball using a lid speculum,
3. Entry into the eye through a minimal incision (corneal or scleral)
4. Viscoelastic injection to stabilize the anterior chamber and to help maintain the eye
pressurization
5. Capsulorhexis
6. Hydrodissection pie
7. Hydro-delineation
8. Ultrasonic destruction or emulsification of the cataract after nuclear cracking or chopping
(if needed), cortical aspiration of the remanescent lens, capsular polishing (if needed)
9. Implantation of the artificial IOL
10. Entration of IOL (usually foldable)
11. Viscoelastic removal
12. Wound sealing / hydration (if needed).
Nursing diagnosis:
Disturbed sensory perception: Visual related to altered sensory perception
Nursing Responsibility:
Postoperatively, monitor the patient until he recovers from the effects of the anesthetic. Keep
the side rails of the bed up, monitor vital signs, and assist him with early ambulation.
Apply an eye shield or eye patch postoperatively as ordered
Communication enhancement: Visual deficit; Activity therapy; Cognitive stimulation;
Environmental management; Fall prevention; Surveillance: Safety
Instrument set:
Wheeler Double - ended Spatula, Curved; Stainless Steel
Kansas Lens Loop, Serrated, 3mm wide; Stainless Steel
Castroviejo Caliper 20mm Scale, Straight; Stainless Steel
Hartman Mosquito Forceps, Curved; Stainless Steel
Superior Rectus Forceps; Stainless Steel
Vannas Capsulotomy Scissors, Sharp tips, Curved; Stainless Steel
Westcott Tenotomy Scissors; Stainless Steel
Castroviejo Corneal Scissors, (Curved), Blunt tip, Small; Stainless Steel
Copper Cautery and Spirit Lamp; Stainless Steel
Phaco Eye Speculum; Titanium
McPherson Suture Tying Forceps, Straight; Titanium
McPherson Suture Tying Forceps, Angled; Titanium
Castroviejo Suturing Forceps with tying platform 0.12 teeth; Titanium
Jaffe Capsulorhexis Forceps; Titanium
Micro Needle Holder; Titanium
Sinskey 11 Iris & IOL Hook, Angled; Titanium
Bard Parker Blade No. 11 (1 pkg. of 100); Stainless Steel
Bard Parker Blade No. 15 (1 pkg. of 100); Stainless Steel
Bard Parker Blade HandleNo. 9; Stainless Steel
http://en.wikipedia.org/wiki/Cataract_surgery
http://www.surgeryencyclopedia.com/Ce-Fi/Extracapsular-Cataract-Extraction.html
http://www.iefusa.org/Catalog/SRS_FRONT/ProdDetailSets.php?
s_category_id=27&s_sub_category_id=121&product_id=1078
Cholecystectomy
Cholecystectomy is the surgical removal of the gallbladder, a pear-shaped organ below the liver
in which bile, produced by the liver and used to help digest fats, is stored. When the gallbladder
becomes inflamed or blocked with hardened cholesterol and calcium salts (gallstones or biliary
calculi), removal may be required to provide pain relief and prevent or treat potentially serious
complications such as infection or liver disease.
Nursing Diagnosis:
Impaired physical mobility related to pain
http://www.mdguidelines.com/cholecystectomy/definition
Laminectomy
A laminectomy is a surgical procedure in which the surgeon removes a portion of the
bony arch, or lamina, on the dorsal surface of a vertebra, which is one of the bones that
make up the human spinal column. It is done to relieve back pain that has not been
helped by more conservative treatments. In most cases a laminectomy is an elective
procedure rather than emergency surgery . A laminectomy for relief of pain in the
lower back is called a lumbar laminectomy or an open decompression.
Laminectomy Instruments Set
Contents
Distraction Forceps Straight
Compression Forceps Straight
Square Pedicle Awl 5 mm
Square Pedicle Awl 6 mm
Square Pedicle Awl 7 mm
Monoaxial Pedicle screw driver
Polyaxial Pedicle Screwdriver
Inner Nut Driver
Outer Nut Driver
Connecting Rod Bender
Flat Pedicle Probe
Pedicle Arm breaker
Rod Holding Forceps 3 mm
Rod Holding Forceps 5 mm
Rod Rotation Forceps
Derotation Wrench (pair)
Pedide Testing Probe
Graphic Container, 540 x 200 x 65 mm (Double Tray)
http://www.surgeryencyclopedia.com/Fi-La/Laminectomy.html
http://shaktiorthopaedic.tradeindia.com/Exporters_Suppliers/Exporter19633.324010/Laminect
omy-Instruments-Set.html
OREF
Open reduction External fixation is a method of immobilizing bones to allow a fracture to heal.
External fixation is accomplished by placing pins or screws into the bone on both sides of the
fracture. The pins are then secured together outside the skin with clamps and rods. The clamps
and rods are known as the "external frame."
http://medical-dictionary.thefreedictionary.com/external+fixation
