Systematic Approach to Describe Instruments & Operative Procedures in Surgery, Orthopedics and Anesthesia Vinod Pusdekar
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1SYSTEMATIC APPROACH TO DESCRIBE INSTRUMENTS & OPERATIVE PROCEDURES IN SURGERY, ORTHOPEDICS AND ANESTHESIA2
3SYSTEMATIC APPROACH TO DESCRIBE INSTRUMENTS & OPERATIVE PROCEDURES IN SURGERY, ORTHOPEDICS AND ANESTHESIA
Vinod Pusdekar MBBS MS (General Surgery) FMAS Consulting General Surgeon Swami Vivekananda Medical Mission Hospital Nagpur, Madhya Pradesh, India Foreword Varsha Sagdeo
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Systematic Approach to Describe Instruments & Operative Procedures in Surgery, Orthopedics and Anesthesia
First Edition: 2013
9789350903810
Printed at
5Dedicated to
My grandfather
Late Shri Jaideorao Pusdekar
6
7Foreword
This book is a project that has spanned over a decade. This book is extended to serve as a ready source of necessary information about all surgical instruments which are routinely used in surgical practice in most of the teaching institutes. It also includes practical knowledge about instruments used in surgery, orthopedics and brief description about anesthesia needed for undergraduate level. This book emphasizes on a quick recall of all features of surgical instruments and brief description of surgical procedures. Students will find this book extremely useful for introduction to surgery as it is taught and practiced at major teaching institutes. This book will also help junior residents for their everyday procedures for on-the-spot duty.
The organization of this book is very interesting. It starts with preparation for surgery like sterilization of the surgical instruments and step by step introduces the instruments as they are used in surgery. For easy understanding of the students, topics are divided in sections which are again divided into chapters. Section one provides brief information regarding sterilization, types and parts of surgical instruments. Chapters are divided depending on the use of various instruments, like second chapter deals with sponge holder, its uses, various ways of holding and using it. It proceeds in the same manner likewise in description of instruments, types of instruments, various parts of instruments, its uses and the way it has to be held. Same is true about all instruments. Full section is devoted to tubes, catheters, and drains used in surgical practice. A full section is devoted to anesthesia, which describes all anesthetic equipments which are routinely used while giving anesthesia. This section also deals with commonly used anesthetic drugs and preanesthetic medications in brief. Similarly, a full section is devoted to orthopedic instruments and implants.
After a brief introduction to preoperative preparation of patient on the operation table and draping, section dealing with surgical procedures are divided into two parts, major and minor operative procedures. It includes almost all major surgeries which an undergraduate student is expected to know. The description is stepwise, so it is easy to understand and recall. At the same time, alternative laparoscopic procedures are also mentioned wherever done. It also deals with postoperative care of the various surgical procedures. All minor and bedside procedures are well described. It also deals with fluid and electrolyte management.
8OUTSTANDING FEATURES OF THIS BOOK
This book is extensively updated for latest equipments and procedures.
The illustrations which has been chosen perfectly and photographs of actual instruments help for quick recall while preparing for examination. Thorough coverage is provided for the equipments used in operation theater.
An undergraduate student can rely on this book as a single source of information on surgical instruments, various bedside procedures, major and minor surgeries, brief necessary information on anesthesia, orthopedics instruments and implants, and fluid and electrolyte management.
Dr Varsha Sagdeo
mbbs ms (Gen. Surgery) dnb (Pediatric Surgery) fics
Director Medical Education
Incharge of Breast Care Centre
Cancer counsellor, Shri Radhakrishna Hospital &
Research Institute, Nagpur
Ex-Dean, Government Medical College &
Indira Gandhi Medical College, Nagpur
Maharashtra, India
9Preface
It is observed that students, especially undergraduates, often find it difficult to prepare themselves for practical examination after theory papers. They need to know instruments in general surgery, anesthesia and orthopedics, basic operative and bedside procedures in general surgery, sterilization procedures, etc. while preparing for table viva in practical examination. This book covers all these aspects in a comprehensive manner.
Keeping this in mind, this book is written to help the undergraduate students prior to practical viva examination. This book is also helpful to the postgraduate students of general surgery, orthopedics and anesthesia.
Every attempt has been made to provide a condense information by framing it pointwise.
With five years of extensive hardwork, I am able to present this book to the students of surgery.
In general surgery section relevant points for identification of the instrument and their uses are mentioned. While discussing the use of instruments, emphasis has been given to mention the particular operation where the instrument is commonly used.
Almost all of the surgical instruments used in general surgery and superspeciality surgeries like neurosurgery, urosurgery and plastic surgery are described in details along with illustrative diagrams.
In orthopedics section, various instruments, their identification along with their uses are discussed. Orthopedic implants used in different fractures are also discussed along with their illustrative photographs.
Different sterilization procedures are discussed in details and also mentioned individually along with every instrument.
Anesthesia section includes equipments for general as well as regional anesthesia.
Commonly used drugs in anesthesia and emergency drugs are also described.
Major and minor operative and bedside procedures in general surgery are described in a step-by-step approach, and only covers the important procedures commonly asked in examinations.
Preoperative preparation of the patient prior to surgical procedures is described in detail.10
Different types of surgical suture materials, needles and the basic surgeries where they have been used are discussed thoroughly in section of suture materials.
Different types of perurethral catheters, tubes and drains used in general surgery are described.
This book also covers the basic knowledge of different intravenous fluids and intravenous cannulas used in clinical practice.
I hope this book will earn its value in its own way in the students circle.
I apologise for any inadvertent mistakes which might have been overlooked by me during editing this book.
I thank everybody including the publisher.
I am open to receive comments, any critics and suggestions for the improvement of this book in future from students and teachers. The comments and the suggestions may please be sent to me on my email address: drvinodpusdekar20@ymail.com
Vinod Pusdekar
11Acknowledgments
No one is able to do anything unless our parents make us do that. I express my sincere gratitude to my parents Mrs Shobha and Shri Prabhakarrao Pusdekar for making me and giving me the courage to write a book.
My sincere thanks and gratitude to the following persons for their constant help and encouragement during preparation of this book.
I would like to thank my teachers Dr Varsha Sagdeo madam, former Dean and HOD, Department of Surgery, Government Medical College, Nagpur, Dr Makrand Khubalkar, Associate Professor, Government Medical College, Akola, Dr Niketan Jambhulkar, Associate Professor, Government Medical College, Ambejogai and my colleague Dr Nitinkumar Borkar, Pediatric Surgeon, Assistant Professor, Jawaharlal Nehru Medical College, Sawangi, Wardha who motivated me to become a teacher and aroused my interest in academics by motivating me to take lectures of undergraduates and built my confidence in initial days of teaching.
Dr Javed Saudagar, Consulting Orthopedician at Sanjeevan Hospital, Yavatmal, Dr Abhjijeet Fuladi, Consulting Orthopedician at Swami Vivekanand Medical Mission Hospital, Nagpur, Dr Sumedh Chaudhary, Dr Pravin Agrawal, Assistant Professor, Government Medical College, Nagpur, guided me in writing the Orthopedics section, especially by providing instruments and implants for photographs.
Dr Satkar Pawar, Consulting Anesthesiologist, Nagpur, Dr Satyendra Warhade, Consulting Anesthesiologist at Meditrrinahospital, Nagpur, Dr Pradip Bhojane, Consulting Anesthesiologist at Sanjivanhospital, Yavatmal, Dr Rishikesh Awale, Assistant Professor, VN Government Medical College, Yavatmal, Dr Gajanan Maske, Assistant Professor, VN Government Medical College, Yavatmal, Dr Vishal Sawaimul, Consulting Anesthesiologist, Umred, helped me in writing the anesthesia section.
I would like to give special thanks to Dr Taneshwar Gautam, Medical Officer at Swami Vivekanand Medical Mission Hospital, Khapri and Dr Nizam Ansari, Resident Surgeon, at Sanjivan Hospital, Yavatmal, for their help by providing surgical instruments for photographs.
I would like to thank Dr Mrudula Bapat, Medical Superintendent, at Swami Vivekanand Medical Mission Hospital, Khapri and Dr Vijay Kawalkar, HOD, Department of Surgery, Sanjivan Hospital, Yavatmal, and their staff, for allowing and helping me to carry out my work in their premises.
I am indebted to my wife Dr Yamini Pusdekar who helped me during preparation of this book right from motivating me to write this book till the 12final editing of this book, also for timely communication between me and the publisher. Words are not enough to express my gratitude to her. My son Parth who inspired me for writing this book. I will never forget their sacrifice of long hours of family associations over these years while I was busy in preparing this book.
My sincere thanks to my enthusiastic students, friends, relatives and well wishers for their constant support, encouragement and help.