Surgery instruments like a safety scalpel must be kept in proper shape as they are vital towards carrying out an operation properly in USA. Surgical instruments are designed to ensure that the surgeons can complete surgeries in an effective and safe manner using safety scalpels and other tools. Surgeries are mainly held to modify or remove any kind of body tissues. Surgical instruments also come in a variety of types designed to do separate things. They are categorized based on their usage. Also they are sometimes categorized according to the materials they are made of.
Disposable and non disposable surgical scalpels:
The scalpel is one of the most common surgical instruments, and recently safety scalpels in USA are the most used of them. These are used for incisions or thin cuts on the flesh to reach the inner organs. The retractors are used used to keep the cuts open so that the surgeons can reach in and go through with the operation. Forceps are another popular surgical instrument which is used for picking and holding tissues. When it comes to cutting tissues scissors are also used but these scissors are not the same as the household ones. These are much more precise and effective. All these instruments are made from hardened and tampered steel. After considering their composition they are labelled as reusable or not. There are also other surgical instruments which are made for just one time usage. These are destroyed after usage like the disposable surgical needles. Disposable surgical scalpels are always sterilized the moment they are purchased in home and hospital departmental stores in USA. These disposable tools are generally made from runner or plastic materials. Protective surgical gloves, twin bone nasal catheter, nasal oxygen catheter, oxygen mask, suction catheter, and trachea’s tony tubes are few examples of these types of instruments.
Electrosurgery instead of a Scalpel CutWhere can I locate the history of the surgical scalpel?
Ancient Egyptians used sharpened obsidian for surgery and embalming. I've never heard of using a piece of papyrus. One probably couldn't cut through flesh with papyrus, which is a grass.
Incidentally, I've also heard that plate glass blades are used on occasion in modern times, due to the incredible edge they can be given.There seem to be glass knives made for cutting specimens for microscopy, tough diamond knives have replaced them for the more precise cuts.
Wikisurgery contains an unrivalled amount of operative information in the shape of unique operative scripts and images.
A scalpel may appear alarming at first.
This is a useful safety reaction and should mean that you will learn carefully and steadily.
A small minority of trainees develop an aggressive gung-ho tendency when holding a scalpel.
For fine work with a No 15 blade, hold the scalpel like a pen.
This is the correct way of holding a pen, using a tripod grip.
The three parts of the tripod are the side of the middle finger and the tips of the index and thumb.
Other ways of holding a pen, such as placing it between the sides of the thumb, index and ring finger, are unacceptable.
This grip enables the surgeon to:Flex and extend the digits, so that the scalpel moves in and out during delicate dissections. Rotate the handle of the scalpel with the thumb, so the scalpel can cut small diameter curves.
The most usual grip with a No 10 or 22 blade is as if you are holding a table knife.
The handle rests in the palm of the hand.
The digits and hand are largely on top of the scalpel unlike with the pen grip.
This means that the scalpel can be held close to the surface of the tissues when cutting, without the digits and hand getting in the
way as in the pencil grip.
The grip is quite gentle.
For tougher tissues, such as the skin on the back, grip more firmly and place your index finger on the top of the handle rather than
on the side.
This will let you increase the downward pressure of the blade on the tissue.
For more delicate tissue, hold the handle between the thumb on one side and the four fingertips on the other.
The handle does not touch the hand.
Holding the scalpel in the fist or like a dagger is far too clumsy.
DO NOT dissect with the handle of the scalpel.
You will be concentrating on the site of dissection and may accidentally cut your assistant.
DO NOT hold the scalpel in your hand while using another instrument.
You may accidentally cut the patient as you concentrate on the dissection area.
ALWAYS pass the scalpel to someone else handle first.
Preferrably, place the scalpel in a dish for the scrub nurse to pick out.
DO NOT throw the scalpel down onto the bench (or onto the patient.)
The part of the blade that does the cutting is the curve and not the tip.
This means that you need to drag the curve of the blade across the tissue.
Scratching with the tip of the blade is a beginner's error.
A scalpel with a straight blade should be reserved for stab incisions such as for a drain tube.
You will feel the curved blade cutting into the tissue.
Go slowly and gently at first with repeated strokes in the same place, until you see how much the blade is cutting the tissue.
Brace your hands and fingers so that you make controlled movements without the blade suddenly slipping.
Press harder at the beginnings and ends of incisions to allow for the less efficient cutting action at the tip and the back of the blade.
Laser Surgery as a Scalpel
Laser surgery is surgery that uses a laser (instead of a scalpel) to cut tissue. Examples include the use of a laser scalpel in otherwise conventional surgery, and soft-tissue laser surgery, in which the laser beam vaporizes soft tissue with high water content. Laser resurfacing is a technique in which covalent bonds of a material are dissolved by a laser, a technique invented by aesthetic plastic surgeon Thomas L Roberts, III using CO2 lasers in the 1990s. The CO2 (carbon dioxide) laser remains the gold standard for the soft tissue surgery because of the ease of simultaneous photo-thermal ablation and coagulation (and small blood capillary hemostasis).
Laser surgery is commonly used on the eye. Techniques used include LASIK, which is used to correct near and far-sightedness in vision, and photorefractive keratectomy, a procedure which permanently reshapes the cornea using an excimer laser to remove a small amount of tissue. Types of surgical lasers include carbon dioxide, argon, Nd:YAG laser, and Potassium titanyl phosphate.
- Photochemical effect: clinically referred to as photodynamic therapy. Photosensitizer (photophrin II) is administered which is taken up by the tumor tissue and later irradiated by laser light resulting in highly toxic substances with resultant necrosis of the tumor. Photodynamic therapy is used in palliation of oesophagial and bronchial carcinoma and ablation of mucosal cancers of Gastrointestinal tract and urinary bladder.
- Photoablative effect: Used in eye surgeries like band keratoplast, and endartectomy of peripheral blood vessels.
- Photothermal effect: this property is used for endoscopic control of bleeding e.g. Bleeding peptic ulcers, oesophagial varices
- Photomechanical effect: used in intraluminal lithotripsy
A range of lasers such as erbium, dye, and CO2 are used to treat various skin conditions including scars, vascular and pigmented lesions, and for photorejuvenation.
Various types of laser surgery are used to treat refractive error:
Lasers are also used to treat non-refractive conditions, such as:
Laser endarterectomy is a technique in which an entire atheromatous plaque in the artery is excised. Laser recanalization of blocked arteries. other applications include laser assisted angioplasties and laser assisted vascular anastomosis.
Lasers are used to treat several disorders in foot and ankle surgery. They are used to remove benign and malignant tumors, treat bunions, debride ulcers and burns, excise epidermal nevi, blue rubber bleb nevi, and keloids, and the removal of hypertrophic scars and tattoos.
A carbon dioxide laser (CO2) is used in surgery to treat onychocryptosis (ingrown nails), onychauxis (club nails), onychogryposis (rams horn nail), and onychomycosis (fungus nail).
- Peritoneum-Laser is used for adhesiolysis.
- Peptic ulcer disease and oesophageal varices - Laser photoablation is done.
- Coagulation of vascular malformations of stomach, duodenum and colon.
- Lasers can be effectively used to treat early gastric cancers provided they are less than 4 cm and without lymph node involvement. Lasers are also used in treating oral submucous fibrosis.
- Palliative laser therapy is given in advanced oesophageal cancers with obstruction of lumen. Recanalisation of the lumen is done which allows the patient to resume soft diet and maintain hydration.
- Ablative laser therapy is used in advanced colorectal cancers to relieve obstruction and to control bleeding.
- Laser surgery used in hemorrhoidectomy, and is a relatively popular and non-invasive method of hemorrhoid removal.
- Laser-assisted liver resections have been done using carbon dioxide and Nd:YAG lasers.
- Ablation of liver tumors can be achieved by selective photovaporization of the tumor.
- Endoscopic laser lithotripsy is a safer modality compared to electrohydraulic lithotripsy.
The CO2 laser is used in oral and dental surgery for virtually all soft-tissue procedures, such as gingivecomies, vestibuloplasties, frenectomies and operculectomies. The CO2 10,600 nm wavelength is safe around implants as it is reflected by titanium, and thus has been gaining popularity in the field of periodontology. The laser may also be effective in treating peri-implantitis.
Laser spine surgery first began seeing clinical use in the 1980s and was primarily used within discectomy to treat lumbar disc disease under the notion that heating a bulging disc vaporized enough tissue to relieve pressure on the nerves and help alleviate pain.
Since that time, laser spine surgery has become one of the most marketed forms of minimally invasive spine surgery, despite the fact that it has never been studied in a controlled clinical trial to determine its effectiveness apart from disc decompression. Evidence-based data surrounding the use of lasers in spine surgery is limited primarily due to the presence of a number of challenging factors including patient selection, operative indications in the type of laser used in the procedure. As a result, the official Blue Cross of Idaho position on laser disc surgery concluded:
"Evidence on decompression of the intervertebral disc using laser energy consists of observational studies. Given the variable natural history of back pain and the possibility of placebo effects with this treatment, observational studies are insufficient to permit conclusions concerning the effect of this technology on health outcomes."
The CO2 laser is also used in gynecology, genitourinary, general and thoracic surgery, otorhinolaryngology, orthopedic, and neurosurgery.
- USA stainless steel blade
- Newyork scalpel handle use
- Los Angeles laryngoscope blades
- Chicago microtome blades
- Dallas surgical blade
- Houston no 11 surgical blade
- Washington microtome blades
- Philadelphia ultrasonic scalpel
- Miami dermaplaning blades
- Atlanta dissecting scissors
- Boston surgical blade
- San Francisco microtome blades
- Phoenix laryngoscope handle
- Detroit swann morton scalpel handle
- Seattle disposable blades
- San Bernardino ophthalmic surgical instruments
- San Diego microtome blades
- Denver microtome blades
- Charlotte surgical instruments
- Cleveland ultrasonic scalpel
- Salt Lake City surgical supplies
- Las Vegas stainless steel blade
- Ogden Clearfield ophthalmic surgical instruments
- Provo Orem ultrasonic scalpel
- St George surgical blade
- San Antonio surgical supplies
- Austin no 11 surgical blade
- Jacksonville scalpel handle use
- Columbus surgical blade
- Indianapolis laryngoscope blades
- Fort Worth surgical instruments
- El Paso no 11 surgical blade
- Nashville ophthalmic surgical instruments
- Memphis microtome blades
- Portland surgical supplies
- Oklahoma City dermaplaning blades
- Louisville dissecting scissors
- Baltimore microtome blades
- Milwaukee dissecting scissors
- Albuquerque microtome blades
- Tucson surgical blade
- Fresno swann morton scalpel handle
- Sacramento swann morton scalpel handle
- Mesa swann morton scalpel handle
- Kansas City ultrasonic scalpel
- Long Beach scalpel handle use
- Colorado Springs scalpel handle use
- Raleigh surgical instruments
- Virginia Beach surgical instruments