A large inventory of common surgical instruments in obstetrics and gynecology
Surgical instruments are essential tools for surgery, and obstetricians and gynecologists need to be familiar with the characteristics and uses of various surgical instruments.
Basic operating equipment for obstetrics and gynecology
scalpel
Different handles and blades of different shapes and sizes can be selected according to the needs of the operation. The blade is used to cut the skin and muscles, the tip is used to clean blood vessels and nerves, and the handle can be used for blunt separation. Large blades are used for large-scale cutting of superficial tissues, sizes below 10 are used for fine cutting and dissection, and pointed blades are used for poking holes and cutting small pipes.
The blade should be clamped and installed with a vascular forceps (or needle holder) to avoid cutting fingers. For example, a No. 24 blade is generally used for cesarean section, which is used to cut the skin and subcutaneous tissue, and enter the abdominal cavity to cut the lower part of the uterus. Use a No. 11 blade.
Scissors
Scissors have round and pointed ends, and you should choose to use them according to your needs. The round head is generally used to cut the tissue, and sometimes it can also be used to open or separate the tissue. The correct method of use is to extend the thumb and ring finger of the right hand into a ring of the scissors, place the middle finger in front of the ring, and press the index finger against the axis of motion of the scissors to stabilize it.
In obstetrics and gynecology surgery, the round tip is often a tissue scissors, which is used to cut and divide tissues. Pointed scissors can also be used to separate tissues that require delicate operations.
stitch
Needles are divided into size, thickness, and straight. Bent round needles are often used in obstetrics and gynecology operations (triangular needles are rarely used). Gynecological pelvic surgery often uses short, short, 1/2-radian small round needles to adapt to deep and narrow gap operations. Pay special attention to needle removal. The curved needle should be pulled out of the tissue along the curved needle arc. There are also suture needles with thread, you can choose different thickness of needle thread according to your needs.
pliers
Vascular forceps are used for holding, hemostasis, and suture aids. Different models of different sizes can be selected according to the surgical site. Ellis is used to clamp tissues, such as clamping the uterine incision during cesarean section, clamping the vaginal stump during hysterectomy, and clamping the margin during fibroids removal.
tweezers
is divided into toothed forceps and non-toothed forceps, toothless forceps are used for clamping and separation, and toothed forceps are only used for clamping the skin or very tough tissues. Generally, large toothless forceps are used to clamp gauze to stop bleeding after surgery, or to clamp gauze to wipe the uterine cavity during cesarean section. You can also use oval forceps instead.
It is divided into two types: toothed and non-toothed. The toothed sponge forceps are mainly used to hold and transfer sterilized instruments, sutures, dressings, drainage tubes, etc., and are also used to clamp gauze dipped in disinfectant. To disinfect the skin of the surgical field, or to swab blood deep in the surgical field, the sponge forceps without tooth lines are used to hold the dirty organs, and the damage is small.
Pull hook
Retractor is an important surgical auxiliary instrument, which is indispensable for exposing the surgical field. The thyroid retractor can be used to expose the surgical field when cutting the skin and opening the anterior sheath. After entering the abdominal cavity, the square head retractor is often used, and the S retractor can be used for the deeper pelvic cavity. Choose different sizes according to specific needs.
Vaginal retractor: It is mainly used in vaginal operations, such as transvaginal surgery, or when the uterine cup needs to be exposed during hysterectomy. Of course, it can also be used for transabdominal surgery to expose the surgical field. The effect is the same as that of a square head retractor.
speculum
is mainly used for gynecological examination to open the vagina and expose the cervix. Before putting it in the vagina, apply a small amount of liquid paraffin to the front end for lubrication. Divided into stainless steel speculum and disposable speculum. There is also a special type used for cervical LEEP surgery. A suction tube is connected to the speculum, which can absorb the smoke generated by cutting while being exposed.
palace bar
is mainly used when the uterine cavity is required to expand the cervix. The size of the uterine expansion rod is 5-10 mm, and the size of the uterine expansion is from small to large to the size you need. The spatula and straw also have different sizes, which can be selected according to the size of the uterine cavity and neck tube. There is a scale on the probe, which is used to detect the anterior or posterior position of the uterus and the depth of the uterine cavity. It is necessary to find out the position of the uterus and the depth of the uterine cavity before taking the ring or upper ring.
cervical biopsy forceps
is used to clamp specimens when cervical biopsy is required.
Forceps
Forceps assisted delivery is a commonly used method of obstetrics to solve dystocia, and it is used for the second stage of labor. The specific operation method is to place the forceps on both sides of the fetal head, and the two leaves of the forceps are buckled together with the uterine contraction forceps to assist in the delivery of the fetal head.
The specific application time is that the cervix of pregnant women has been opened, but the position of the fetal head is low, the head of the fetus cannot be delivered smoothly, or the pregnant woman or the fetus has comorbidities and needs to be delivered as soon as possible, it is necessary to use forceps to complete this process. The use of forceps at this time is to shorten the delivery time to avoid serious consequences.
rupture membrane forceps
When the uterine orifice is dilated ≥ 3 cm, there is no disproportion of the head and pelvis, the fetal head is connected, there is no umbilical cord prolapse and placenta previa, between two contractions, use the left hand and index finger to penetrate the vagina to guide, and the right hand holds Use dental forceps to tear open the fetal membrane, and expand the breach with your fingers. After rupture, the operator's fingers should stay in the vagina. After 1 to 2 contractions, the operator will take out the fetal head into the pelvis. Pay attention to whether you can see the lanugo, the amount of amniotic fluid flowing out and the color of the amniotic fluid.
Listen to the fetal heart rate after rupture of the membrane. When the amniotic fluid is low, gently push up the fetal head to facilitate the outflow of amniotic fluid for easy judgment. When there is too much amniotic fluid, use a long needle to rupture the membrane at a high position, and block the uterine mouth with your fingers to allow the amniotic fluid to flow out slowly, so as to avoid a sudden drop in intrauterine pressure leading to placental abruption. The fetal head should be used with caution.
pelvic measurement
The size of the pelvis is expressed in terms of the distance between the bones, that is, the size of the pelvic diameter. The size and shape of the pelvis vary with each person's physical development, nutritional status, genetic factors, and ethnic differences. Therefore, within the normal range, the length of each diameter of the pelvis also has certain differences. The value of the diameter of the pelvis described in various materials is the average value of many normal pelvises. The measuring instrument has a fixed scale, and the data can be read during measurement.