Ch.12 Surgical Techniques

Question 1

Pressure to be used with suction pump/vacuum

Answer 1

80-120mmHg

Question 2

Epinephrine to control bleeding - dose

Answer 2

1:100,000/1:200,000 solution soaked on gauze - mucosal/sunmucosal bleeding

Question 3

10% buffered formalin dose for bleeding

Answer 3

0.02 - 0.06ml/kg bw diluted 1:9 with saline

Question 4

Vessels up to what size can be coagulated with monopolar cautery

Answer 4

2mm diameter

Question 5

Describe obliterative coagulation

Answer 5

• Direct contact btw hand-held electrode and the vessel
• Vessel wall shrinks
• Ocludes lumen by thrombosis and coagulum

Question 6

Coaptive coagulation

Answer 6

Hemostat on vessel
Elctrode on hemostat

Question 7

Scalpel grips

Answer 7

Pencil - very precise, steep angle

Fingertip - 3/4/5th fingers under handle, movement originates from shoulder

Palm grip - Strongest grasp, standing flank

Question 8

Needle driver grips

Answer 8

Tripod - Precise, delicate

Palm/Modified thenar eminence grip - fast but not precise, robust tissue

Thenar - Ring finger in ring below, thenar eminence top

Pencil - Very delicate, Castroviejo need holder, opthalmic sx

Question 9

Tissue forceps

Answer 9

Tripod grip

Question 10

Speed of cutting with electrocautery

Answer 10

7mm/s

Question 11

Cons of electrocautery

Answer 11

Delayed wound healing
Decreased resistance to infection

Question 12

Pressure to be applied through Esmarch turniquet

Answer 12

600mgHg

Question 13

How often does the turniquet need to left off in surgery

Answer 13

After 60-90 mins deflate for 5 mins every 30