Beruflich Dokumente
Kultur Dokumente
LEARNING OBJECTIVES:
1. Discuss common gynecological surgical procedures.
2. List five instruments unique to gynecology instrument sets.
3. Name three anatomic structures potentially damaged by faulty instrumentation.
Lesson Plans
range of specialties, including laparoscopic, robotic, and microscopic. This
lesson will focus on basic instruments utilized in open gynecology procedures.
Unique attributes of female anatomy has given life to Plato’s expression,
(Instrument Continuing “Necessity is the mother of invention.” (circa 375 B.C.) Instrument designers,
Education-ICE) frequently the surgeons themselves, have worked to meet the need with
an eye toward safety. Certified Instrument Specialists (CIS) continue the
tradition by maintaining and processing gynecologic instrumentation to the
highest standard.
and Heaney hand-held retractor. A dulls quickly. Needle holders and forceps damaged if there is no information
crucial consideration in processing must be matching in length to enable describing complete and functional
these retractors is assuring the edges the surgeon to repair the tissue severed use of the instruments. Maintaining a
are smooth. A burr on the blades can in removal of the uterus. Heaney needle record of preventative care provided by
cause tissue and nerve damage. The holders have curved jaws to increase a reputable instrument service company
self-retaining retractors have multiple visibility of needle placement. The jaws helps determine budgeting for repair
moving parts that must be thoroughly of the needle holders are critical in this or replacement of instrumentation.
inspected for cleanliness, burrs and all function. The needles used to repair Surgical teams appreciate knowing
removable parts. Blades, wing-nuts or this tissue are round bodied. The jaws the instrument sets are properly cared
set screws assure proper function in are flat surfaced. Undue wear of the for each time they are used. Processing
use. Any missing or broken part delays serrated jaw surface will not hold the and sterilization do take a toll on the
the procedure and causes undue stress. needle securely causing it to spin in instruments. Audits that reveal “use
Should missing or broken pieces go the tissue. Bleeding results, and can versus presence” of instruments in the
undetected until the conclusion of the be difficult to control. Inspection is key set can guide set make-up. Removing
procedure, valuable time is wasted in providing quality instruments and a instruments no longer used decreases
searching for an item that was not positive patient outcome. wear and tear on the instrument and
present as expected. Clamps designed reduces unnecessary work load of
Objective 3. Name three anatomic
to grasp and occlude large blood vessels inspection and handling. An added
structures potentially damaged by
and ligaments supporting the uterus in plus for the surgery team is they do not
faulty instrumentation.
the pelvis include the Heaney, Ballantine have to count instruments that will not
and Rodgers. These large sturdy Vital structures not directly involved be used. The audit can also point out
clamps can be straight or curved jaws in gynecological surgeries are at risk instruments that need to be placed in
with serrations running horizontally or of damage from instrumentation. the set. Are there instruments that are
longitudinally. The strength and size is Abdominal wall tissues and nerves can opened for a majority of cases? Placing
critical in controlling blood loss. The be compressed by malfunctioning or them in the set reduces the time and
CIS’s inspection of this clamp must poorly placed retractors, resulting in expense of handling, packaging and
include the ratchet strength to assure increased post-operative pain. A burr sterilizing wrapped or peel pouched
secure closing and prevent inadvertent on the blade used to retract the bladder instruments. The surgery team saves
opening of the clamp in use, cleanliness or bowel can tear the tissue requiring time and effort in opening an additional
and smooth operation of the jaws. A additional repair. Major blood vessels can item. Improving quality provides benefits
set usually includes three of each kind be damaged by clamps that are sprung for the patient, surgeon and the facility!
in exactly matching size and shape. This and do not hold properly. Damaged
Bibliography
helps optimize available space for the blood vessels means increased blood
International Association of Healthcare Central
surgeon’s hand and required clamps in loss that may require blood transfusion
Service Materiel Management. Central Service
the surgical field. Clamps of unequal for the patient, which significantly
Technical Manual. Sixth Edition. 2005.
length increase the risk of bleeding. increases the risk of the procedure.
Scissors must be of appropriate length. Scultz, R. Inspecting Surgical Instruments, An
Routine sizes are needed for opening Objective 4. Review instrument Illustrated Guide. 2006.
and closing the incision and length set audit procedure for quality International Association of Healthcare Central
of 8 to 9 inches are needed to reach improvement. Service Materiel Management. Instrumentation
structures deep in the pelvis. The Quality improvement is a vital function Resource Course: Identification Handling and
Jorgensen scissor is a curved right angle for the CIS. Along with the routine Processing of Surgical Instruments. 2006.
scissor used to seperate the cervix from care and maintenance of surgical Chen, NC; Towler, MA; Moody, FP; McGregor, W.
the vaginal mucosa. The prudent CIS instruments, education is required to Mechanical Performance of Surgical Needle Holders.
will test the cutting edge of this scissor assure a strong knowledge base of Journal of Emergency Medicine. 1991; 9:477
with each use because of the dense, the instrumentation. It is difficult to
fibrous nature of the cervix. This scissor recognize when items are missing or
CIS Self-Study Lesson Plan Quiz
(Instrument Continuing Education-ICE)
Surgical Instrumentation for Gynecological Procedures
Questions (circle correct answer):
1. “Post partum” refers to the 7. Burrs occur only on orthopedic 13. Heaney needle holders must have
time period immediately after instruments and not considered smooth jaws and inserts.
giving birth. a problem for GYN instruments. True
True True False
False False
14. Tissue damage to the bladder
2. A laparoscopic tubal ligation 8. Wing nuts are completely and bowel can occur from
can be scheduled when ever interchangeable, therefore do faulty instruments.
the patient chooses. not need to be counted. True
True True False
False False
15. Quality improvement is a hallmark
of the caring and competent CIS.
3. Surgeons are often involved in 9. Heaney clamps are always used
designing instruments that in pairs. True
meet specific needs. True
False
True False
False
10. Ballantine clamps are
4. Lasers are never used in interchangeable with Rodgers
gynecological surgery procedures. clamps if you run short.
True True
False False
Sponsored by:
5. The CIS knows to provide longer 11. Clamps of unequal length are
Babcocks for a “post partum” preferred over equal length clamps.
tubal ligation. True
True False
False
12. Jorgensen scissors are designed to
6. Self-retaining instruments hold the be slightly curved and cut only
incision open during the procedure. delicate tissues.
True
True
False
False
REQUEST FOR PAPER/PENCIL SCORING (please print or type information below)
REQUEST FOR ONLINE SCORING (payment and scoring made directly online at www.iahcsmm.org using either online check or credit card)
q Check here if you wish to have your results emailed to you City State Zip code
( )
Detach quiz, fold, and return to:
Daytime telephone IAHCSMM Membership Number
Purdue University
PEC Business Office
Stewart Center, Room 110 • 128 Memorial Mall Email Address
West Lafayette, IN 47907-2034 If your name has changed in the last 12 months, please provide your former name
(800) 830-0269 Purdue University is an equal access/equal opportunity institution