Basic Surgical Skills: Anastomosis

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Dr.

Shahzad Alam Shah


Assistant Prof. Laparoscopic Surgery
Basic Surgical Skills

Anastomosis
Basic Surgical Skills
Incisions and use of appropriate
instruments
Materials and methods used for
surgical wound closure
Technique of skin closure
Sutures, knots and needles
INCISION OF SKIN
Made by scalpels with disposable
blades attached
Blades
Different sizes and shapes

Incision
Knife should be pressed down firmly
at right angle
Different sites have different incisions

Closure of wound
Closed with minimum of tension
Edges should be everted
Knots
To one side
Secure enough

Needles and Sutures
Needles
Various shape and sizes
Curved
Straight
Commonly half circle and 3/8 circle
Traumatic and atruamatic
With and eye at the end or attached to
the suture at swage


Needles
taper (needle body is round and tapers
smoothly to a point)
cutting (needle body is triangular and
has a sharpened cutting edge on the
inside)
reverse cutting (cutting edge on the
outside)
trocar point or tapercut (needle body is
round and tapered, but ends in a small
triangular cutting point)
blunt points for sewing friable tissues
side cutting

NEEDLES
SUTURE
Surgical suture is a medical device
used to hold body tissues together
after an injury or surgery. It generally
consists of a needle with an attached
length of thread. A number of different
shapes, sizes, and thread materials
have been developed
Types of sutures
Absorbable or non absorbable
Inert or non inert
Braided or non braided
Natural or synthetic
Silk
Polyester
Polypropylene
Catgut

Placement of suture
Start with placement of needle over
needle holder
Use of Forcep
Placement
SUTURE
CONTINOUS
INTERRUPTED
Simple
Mattress
Secure Wound Closure
Correct suture material
Appropriate bites of tissues and
sutures spacing
Secure Knots
Knot Tying
Types of Knots
Square Knot
Surgeon`s Knot
Reef Knot
Other Methods of Closures

Serosa Is Closed
Patency is Checked

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