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Dpgi Classes New Delhi 130/2sudarshan Road, Gautam Nagar, New Delhi

DPGI classes in New Delhi provides training in surgical instruments and suture materials for the FMGE exam. It lists various common surgical instruments like sponge holding forceps, towel clips, scalpels, and needle holders and their indications and proper use. It also discusses sutures and their absorption rates. Various gastrointestinal, genitourinary, and tubal instruments are also defined along with their purposes.

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64 views

Dpgi Classes New Delhi 130/2sudarshan Road, Gautam Nagar, New Delhi

DPGI classes in New Delhi provides training in surgical instruments and suture materials for the FMGE exam. It lists various common surgical instruments like sponge holding forceps, towel clips, scalpels, and needle holders and their indications and proper use. It also discusses sutures and their absorption rates. Various gastrointestinal, genitourinary, and tubal instruments are also defined along with their purposes.

Uploaded by

ALL SET
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Dpgi classes New Delhi

130/2Sudarshan Road, Gautam nagar , New Delhi

+91-9560935393,+91-9354297795
www.dpgi.in
www.fb.com/dpgi.delhi
[email protected]
Instruments & Suture
Materials
For Surgery(FMGE)
Sponge Holding Forceps
Indications- Sponge holding
Forceps
 With sponge-
 Preparation of the part for
operation.
 Blunt dissection.
 Hemostasis
 To dry the operative field
Indications- Sponge holding
Forceps
 Without sponge-
 To hold tongue
 To retract bowel.
 To hold bowel or stomach.
 To hold gallbladder
Towel Clip
Indication- Towel Clip
 To fix draping towels in position.
 To fix suction tube to towel.
 To hold tongue
 To hold patella
 To fix facio-maxillary fractures
 To hold flail segment
Knife Handle
Types of Blades and Handles
Blade No. Handle No. Indication I

10 3/5 Stab incisions, children

11 3/5 Stab incision, adults


12 3/5 Tonsillectomy
Cardiovascular surgery

15 3/5 Plastic & Pediatric


surgery
21 4 Skin incisions
23 4 Deeper incisions
Types of grips on Scalpel
 Pencil grip- Use of intrinsic muscles of hand.
 Finger tip grip- Less dorsiflexion & radial deviation. Maximum cutting
edge contact.
 Palm grip- When great pressure is required
Methods of cutting with a
scalpel
 Press Cutting- Stab incision.
 Slide cutting- Direction of motion is at right angles to pressure.
 Sawing- to and fro or push & pull.
 Scraping- Direction of motion is perpendicular to both the edge of blade
& pressure
Dissecting Forceps- Plain & Toothed
Indications- Dissecting Forceps
 To hold structures during dissection.

 To hold bleeding vessels

 To hold structures during insertion of sutures


Dissecting Scissors
Indications- Scissors
 Tissue dissection
 To cut sutures and ligatures during surgery.
 Suture removal
 Cutting bandages- Lister’s bandage cutting scissors.
 Venesection
Hemostat
Indications- Hemostat
 Catch bleeding vessels.
 As a pedicle clamp.
 To hold cut edges of fascia etc. during dissection & suturing.
 As a dressing forcep.
 To hold one end of continous suture
 To hold peanuts for blunt dissection
Mosquito Forceps
 Mosquito forcep-
 Is a fine curved short hemostat.
 Tip is said to be so fine so as to be able to catch the proboscis of a
mosquito.
Mixter Forcep
Indications- Mixter
 Soft tissue dissection
 To go around nerves and blood vessels.
 To pass ligatures around nerves & vessels.
Babcock’s Forceps
Indications- Babcock’s Forceps
 To hold appendix.
 To hold stomach or intestine.
 To hold urinary bladder.
 To hold ureter
 To hold vas deferns
 To hold lymph node during biopsy
Allis Forceps
Indications- Allis Forceps
 To hold fascia & aponeurosis.
 To hold fibrous capsules
 To hold subcutaneous tissue.
 To hold edges of scrotal incision in hydrocoele repair.
 To hold edges of vagina during abdominal VVF repair
Retractors
Indications- Retractors
 To retract edges of incision.
 To steady tissues during dissection.
 To hold important structures away to prevent injury.
 To achieve pressure hemostasis from cut edges of incision
Deaver’s Retractor
Doyen’s Retractor
Roux’s C- shaped Retractor
Langenbeck’s Right Angled Retractor
Czerny’s Retractor
Needle Holder
 Ratio of length of handle is to blade is 4:1
 Inner surface of the blade has criss- cross serrations for secure grip on
the needle.
 Each blade has a longitudinal groove on inner surface- prevents wobbling
of needle
Gastro-Intestinal
Instruments
Intestinal Crushing Clamp
 Used for intestinal resection anastomosis.
 On the specimen side
Intestinal Occlusion Clamp
 Used for intestinal resection anastomosis.
 Used on the part of the intestine that is anastomosed.
Proctoscope
Indications- Proctoscope
 Rectal Bleeding
 Hemorrhoids
 Internal fistula
 Anorectal Ulcers
 Strictures
 Tumors
 Pile banding
Desjardin’s Choledocho-lithotomy forceps
 Uses-
 To remove stones from gall bladder
 To remove stones from CBD
Doyen’s Mouth Gag
Skin Grafting Knife handle
Genito-Urinary System
Pyelolithotomy
Forceps
Thompson Walker Cystolithotomy Forcep
Tubes
T- Tube
 Uses-
 To permit free drainage of bile.
 To avoid leak of bile in peritoneal cavity
 To permit post-operative cholangiography.
 To permit post-operative therapeutic procedures in case of retained
stones
 T tube is first clamped. Look for
✓ Colicky abdominal pain
✓ Jaundice
✓ Fever
✓ Pale colored stools
 If any of these is present then remove clamp immediately.
 If not then do T tube cholangiogram
54
 T tube cholangiogram done at 5-9 days.

 T tube is removed at 12- 15 days


Nasogastric Ryle’s tube
 Tip is blunt & solid with lead shot.

 Lead shot makes tip heavy for easy passage.

 Radio opaque lead shot and line


Mark Distance Positon of tip
from
incisor
Ist 40 cm Cardiac orifice

IInd 50 cm Body of stomach

IIIrd 57 cm Pylorus

IVth 65 cm Duodenum
 Diagnostic Indications-
 To aspirate gastric contents
 To collect duodenal contents
 Chemical analysis of gastric contents in poisoning.
 Hypotonic duodenography
 Small bowel enema
 Therapeutic Indications-
 Gastric lavage.
 Saline wash in hematemesis.
 Gastric decompression in acute gastric dilatation.
 Nasogastric feeds.
 Administration of drugs to unconscious patients
Foley’s Catheter
 Urinary Indications-
 To monitor urine output
 To drain the urinary bladder in retension.
 Following repair of bladder injury
 To splint urethra after trauma
 To achieve hemostasis by pressure of balloon
 To give bladder wash
 Non urinary uses-
 As Sengstaken tube in children
 To control nasal bleeding
 To give enema to a child
 As a drain
Sengstaken Blakemore Tube
 It has 3 channels & 2 ballooons.
 One channel is for aspiration of stomach contents or gastric lavage.
 The other 2 channels are for 2 balloons.
 Capacity of distal gastric balloon is 300ml.
 Capacity of proximal esophageal balloon is 30ml.
 Gastric balloon= 300ml of air
 Esophageal balloon = 40mmHg
 Deflate after 12 hours to prevent necrosis.
 Most common complication= Aspiration pneumonia
Natural Synthetic

Catgut- Polyglyactin
plain / (Vicryl)
chromic
Polyglycaprone
(Monocryl)
Polydioxanone
Collage (PDS)
n

Polyglyconate
(Maxon)

Polyglycolic acid
Suture Type Tensile Absorption rate
strength
Silk Multifilament Loses 20% when Fibrous
wet. 80 – 100% encapsulation
lost by 6 in body by 2-
months 3weeks.
Absorbed slowly
over 1-2years

Linen Twisted 50% at 6 Non absorbable


months. 30% at
2 years.

Nylon Mono/multi- Loses 15-20% Degrades at 15-


filament per year 20% per year
Suture Type Tensile Absorption
strength rate

Polyester Mon/multifil Infinite ( Non


ament >1 year) absorbable

Polybuteste Monofilamen Infinite ( Non


r t >1 year) absorbable

Polypropyle Monofilamen Infinite ( Non


ne t >1 year) absorbable
Suture Type Tensile Absorption
strength rate

Steel Mono/multifi Infinite Non


lament (>1year). absorbable

Polyglycona Monofilamen 70% Hydrolysis.


te t remains at Complete
2 weeks. absorption
55% at 3 180 days.
weeks
Suture Type Tensile Absorption
strength rate
Catgut Plain Lost in 7-10 Phagocytosi
days s and
enzymatic
degradation
in 7-10 days
Catgut Chromic Lost within -- Do--
21- 28 days
Polyglactin Braided 60% remains Hydrolysis.
multifilame at 2 weeks. Complete
nt 30% at 3 absorption
weeks. 60 – 90
days.
Suture Type Tensile Absorption
strength rate
Polyglycolic Multifilament 40% remains Hydrolysis.
acid at 1 week. Complete
20% at 3 absorption
weeks. 60-90 days.

Polydioxonon Monofilament 70% remains Hydrolysis.


e (pds) at 2 weeks. Complete
50% at 4 absorption
weeks. 14% 180 days.
at 8 weeks
Polyglycapron Monofilament 21 days 90 – 120
e maximum days.
Thank you

• For study guidance and any info about how to appear in the exam, follow
Dr Jaswant Singh on Instagram @dr.jsswant

• For study material and group discussion please join our telegram channel
https://t.me/joinchat/QiR85xjQkYC6lF3Tc-2VZg

• For updates on upcoming classes, schedule and programs tune in to our


Facebook page @ www.fb.com/DPGInewdelhi or whatsapp @ +91-
9354297795, +91-9560935393

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