Podstawowe instrumentarium chirurgiczne
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Podstawowe instrumentarium chirurgiczne

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Narzędzia chirurgiczne w zależności od zastosowania dzielą się na tnące, chwytające, przemieszczające, szyjące oraz iniekcyjne. Te specjalistyczne narzędzia stosowane przez chirurga podczas operacji wykonane są zazwyczaj ze stali nierdzewnej, a ich nazwy bardzo często pochodzą od nazwisk projektantów, wybitnych chirurgów 2 poł. XIX w.

Narzędzia tnące

Wśród narzędzi tnących wyróżnia się nóż (skalpel) z wymiennymi ostrzami, nożyczki, nóż elektryczny wykorzystujący zmienny prąd o wysokiej częstotliwości i niskim napięciu, jak również aparaty zaawansowane technologicznie, takie jak elektroniczny dwubiegunowy zgrzewacz naczyń czy nóż ultradźwiękowy.

Narzędzia chwytające

W chirurgii stosuje się również narzędzia do chwytania tkanek, które dzielą się na pincety, kleszczyki z zamkiem, kleszczyki Chaputa oraz klemy.

Dostępne są dwa rodzaje pincet: pincety anatomiczne, które zakończone są nacięciami, które zapobiegają miażdżeniu tkanek i służą do przytrzymywania delikatnych struktur oraz pincety chirurgiczne, zakończone ząbkami. Te natomiast wykorzystuje się do przytrzymywania skóry, powięzi oraz mięśni.

Kleszczyki z zamkiem wyróżnia się proste i odgięte. Wśród nich są Kleszczyki Kochera, które zakończone są ząbkiem i wykorzystywane są do przytrzymywania powięzi i mięśni; Kleszczyki Mikulicza, wykorzystywane do przytrzymywania otrzewnej i powięzi, są lekko zagięte; jak również Kleszczyki Peana, które stosuje się do chwytania i zaciskania delikatnych struktur, m.in. naczyń, te nie mają ząbków.

Do przytrzymywania żołądka i jelit wykorzystuje się Kleszczyki Chaputa.

Ponadto, wyróżnia się trzy rodzaje klem: miękkie – niemiażdżące, które wykorzystywane są do zaciskania naczyń i jelit, twarde – miażdżące, te służą do zaciskania wycinanych odcinków jelit oraz naczyniowe – które są w stanie zacisnąć pełne światło lub niektóre duże naczynia krwionośne.

Narzędzia przemieszczające

W skład instrumentarium do odciągania i rozwierania tkanek wchodzą haki chirurgiczne. Dzielą się one na skórne, podskórne, do powłok brzucha, w celu odciągania lub ochrony narządów wewnętrznych, a także automatyczne w celu rozwierania tkanek.

Narzędzia szyjące

W chirurgii do szycia tkanek wykorzystuje się imadła, których zadaniem jest trzymanie igły podczas szycia tkanek; igły chirurgiczne z ostrzem okrągłym (stosowane w zszywaniu tkanek miękkich, np. wątroby, żołądka czy mięśni) lub trójkątnym (do szycia skóry i ścięgien), jak również szwy chirurgiczne i szycie ręczne tkanek.

Narzędzia iniekcyjne

Instrumentarium iniekcyjne to narzędzia, które wykorzystuje się do wprowadzenia w tkanki, narządy lub naczynia krwionośne różnego rodzaju substancji i leków. Dzięki nim możliwe jest również oczyszczanie pola operacyjnego. Jednym z podstawowym narzędzi iniekcyjnych będą różnego rodzaju strzykawki oraz igły.

Źródło: Noszczyk W., Chirurgia Repetytorium, Wydanie II uaktualnione Warszawa 2019, s. 82-85

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