Thoracotomy

umar tariq aga

1. THORACOTOMY Lecturer: umar tariq Msc anaesthesia / ott

2. Thoracotomy tray contains General set. Rib raspatory (both right & left) Bone holding forceps ( fergusson`s ). Bone nibbler. Rib spreader ( Finochietto retractor) Rib shear. Rib approximator Lung hemostat

3. Lung retractor Bickford`s bronchial clamp. Hemostat curved forceps 20-30 Hemostat straight forceps. Bulldog clamps Debakey vascular tissue forceps Debakey satinsky vascular forceps Lung holding forceps.

4. BONE NIBBLER or RONGEURS It is used to nibble bone. Used in variety of procedures like debridement in chronic osteomyelitis , spine surgeries, tumor excisions and biopsy. Used to remove tough soft tissue like fibrous tissue.

5. RIB Shear It is an instrument with large handles which are made rough to give a good grip. This instrument has one cutting blade, the other blade has serrations and deep groove instead of cutting edge. It is used to rib resection as in cases of empyema thoracis , chondromas of rib

6. RIB APPROXIMATOR It is an instrument that brings together two ribs to permit surgical closure of the intercostal space (or) A strongly built device for pulling ribs together following retraction for surgical access to the thoracic cavity.

7. Allisons lung retractor It is a hand held non ratcheted retractor. Used to holding lung tissue. It has a solid handle with a finger rest at the bottom and a flattened wire spatula shaped working surface. The wires are flexible. Straight with a 65mm retracting surface. Commonly used in cardiothoracic surgery

8. BRONCHUS CLAMP Used to grip, hold and move parts of the bronchus while suturing or stapling during procedures involving the lung and trachea. Curved right and is 9 inches long This instrument has unique tips that have long serrations on the jaws and sharp pins and holes that will line up to provide a stable hold.

9. DeBakey vascular tissue forceps Used for grasping fine issue and blood vessels or soft tissue dissection. Narrow tips and atraumatic teeth cause little to no demage to the tissues. Also called thumb forceps

10. DeBakes satinsky vascular forceps Also called atraumatic vena cava clamp. Specially designed for total or partial occlusion of either the superior vena cava or the inferior vena cava, the two large veins that takes blood to heart. Tip is blunt. medium sized clamp

11. Lung holding forceps Duval lung forceps are light weighted. Used the grasping large tissue and organs. Mainly used to grasp the stomach and lungs. Triangular fenestrated tips are horizontally serrated providing a large, secure grasping surface