SURGICAL INSTRUMENTATION PROGRAM

TRAINING SURGICAL PLANNING

IQX-FT-003-BUC
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STUDENT NAME: NATALIA MENDOZA CODE: 01190021001 PRACTICE

LEVEL: lll

TEACHER'S NAME: PRACTICE STAGE: FOSUNAB NOTE:

SPECIALTY: SURGEON: DATE: 17-08-2022

NAME OF PATIENT: MEDICAL HISTORY NUMBER: PATIENT AGE:

SURGICAL PROCEDURE TO PERFORM:

REVASCULARIZATION OF THE MYOCARDIUM (RMV)

SURGICAL INSTRUMENTATION PROCESS

1. PLANNING STAGE:

1.1. Surgical Objective: (Make description)

• Bridge using autologous grafts to adopt blood flow to ischemic heart tissue.
• is to supply blood to the areas of the heart that suffer most from lack of irrigation such as consequence of the
appearance and growth of lesions coronary.

1.2. Anatomy and physiology: (Make graph and description).

CORONARY CIRCULATION.
 SURGICAL INSTRUMENTATION PROGRAM

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The saphenous vein has the typical three-layer wall structure.

tunica adventitia, tunica media, and tunica interna (intimate).

The myocardium is the main functional component of the heart and the thickest of the three layers that make it up. It is
the muscular layer that allows the execution of cardiac contractions.

Histologically, the myocardium is composed of cardiac muscle cells (cardiomyocytes).

 SURGICAL INSTRUMENTATION PROGRAM

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1.3. Check list:

MEDICAL EQUIPMENT/ DRUGS AND

SUTURES AND
INSTRUMENTAL DEVICES SOLUTIONS
NEEDLES

Extracorporeal disposable clothing precut silk

basket. package bone wax Saline solution
of cardio. Polyglactin 910 and
Reciprocating saw. Scalpel blades #11-15 0½ Lidocaine 2% without
electrosurgery pencil epinephrine
Polyester 2/0
chest tube
alligators. Plato
2/0 polyester with
aseptosyringe ptfe
Vascular clip (yellow Pleurovack Silk 0 .1 . 4/0 ½
– blue) Plastic containers Polypropylene 4/0
Radiopaque gauzes Polypropylene 6/0
perfusion clamp (10 un Polypropylene 7/0
vent cannula package ) surgical wire
20cc syringe 2/0 pacemaker cord
Vascular basket. suction rubber 100 and 200 clips
Yankawer cannula MONOCRYL 3/0
Jelco (14 orange)
Gloves
coronary team. Compresses (20)
Handlebars
Sternal separator. Micropore
(finochietto) loban
Nelaton 14 probe
Breast separator. pathology flask
Had valve
premium connectors
aortic punch medtronic
4.0
crescent knife 15°
elastic bandage
Octopus evolution ace
arteriotomy cannula
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2. ORGANIZATION STAGE:

a. Arrangement of May tables and reservation (make scheme).

1.MB# 11 AND 15. 10. T. metzembaum large

8 14
2.T. metzembaum 11. P. baby mosquito.
11
3.T May 12.Castro old needle
7 13
4.p. kelly curve holder.
6 1
2 5.P. Kelly Adson 13. turnstiles.
5 3 14. Gauze.
6.p rochester
9
4 2 1
7.p. tube
0
1 8.needle tray
9. vascular
dissections.

7
1 8 6
1 2
3
9
3 5
12 4
11

1. eq. extracorporeal, 5. gloves. 12. Coca with

compresses, gauze. saline solution.
6. eq. coronary.
2. cardiovascular disposable 13. cannulas.
clothing package. 7. usable.

3. compress, MB, vascular 8. pathology flask.

dissections. 9. coke with lidocaine.
4. reciprocating saw. 11. asept syringe, syringes,
electrocautery.
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2.2. Patient position (Name and graphic):

Supine position.

2.3. Location of the Surgical Team (make a graph):

 SURGICAL INSTRUMENTATION PROGRAM

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3. EXECUTION STAGE:

a) Anesthesia (write the type of anesthesia):

General anesthesia

b) Incision (write the type of approach and the name of the incision):

Incision: Sternotomy and area incision

femoral for vein harvesting
saphenous as a graft.

c) Surgical Process (Describe the main steps of the surgical medical technique with the instruments to be used).

Surgical process. Instrumentation process.

Perform Saphenous Vein Graft Harvest
of the left leg and closure of the
leaks and permeabilization.
An incision is made for a sternotomy.
Incise the pericardium, hemostasis and fixation of the
pericardium for complete visualization of the heart,
especially the ascending aorta, placement of the
Finochietto or sternal autostatic retractor.
Perform the extraction of the internal mammary artery
and leave repaired
Perform the stitches for the purse string in the aorta, in
superior and inferior vena cava, superior pulmonary vein
right for the placement of the grommet turnstiles
and it is repaired.
Perform arteriotomy and venotomy, to perform
subsequently cannulation with each of the
corresponding cannulas. and fix the cannulas.
The connection of the circuit tubes is made
extracorporeal, in order to start the circulation
extracorporeal
Start saphenous vein graft fixation
first anastomosis in descending artery
back and placement of straight stitches.
Mobilization of the heart from the apex to
saphenous vein graft fixation and anastomosis
with circumflex artery.
Scalpel handle #3 blade 15, electrosurgery, scissors
metzembaum, weitlaner separator, clips 200.
clammp bull dog , precut silk 4/0, polypropylene
2/0, monocrylic 3/0.
Scalel Handle #7, Blade 15. Electrocautery,
Farebeuf retractor, dissection forceps without claw.
Reciprocating saw. .Electroscalpel, dissection forceps
vascular, Silk 0 with needle, Mayo Scissors. Separator
autostatic Finochietto.
Breast separator, clips 100, electrosurgical unit, cannula
frazier with CO2 rubber.
Polyester 2/0, vascular needle holder, dissection
vascular, mayonnaise, curved Kelly clamp, tourniquets
and pass threads.
Scalpel handle 7 # 15, vascular dissectionforceps,
pre-cut silk 0, venous catheter, arterial catheter,
left line catheter, mayo scissors.
Extracorporeal circuit tubes passed to us by the
perfucian
Polyester 2/0 with ptfe
Mayo scissors, Aguaja holder, polypropylene 7/0,
fine dissection forceps, frazier cannula, rubber
of CO2.polypropylene 6/0
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Anastomosis of the internal mammary artery with the

anterior descending artery.
Check the patency of the anastomoses.
Aortic closure, remove the aortic clamp
for pump outlet
Withdrawal of cardiovascular cannulae.
Placement of the pacemaker wire and chest tube.
Hemostasis and pad count and
gauze.
Perform sternal and muscle and skin closure.
Scalpel handle 15, vascular dissection forceps
Pacing wire and pleurovac.
#5 Surgical Wire, Polyglactin 910 0,
monocryl 3/0 needle holder.
wet compress, silver dressing,
large dressing

Wound cleansing and healing

WEEKLY REPORT FORMAT OF TRAINING PRACTICE

SURGERY ASSISTANCE RECORD FORM - TRAINING PRACTICE IQX-FT-024-UDES

STUDENT SIGNATURE: ________________________ TEACHING SIGNATURE: __________________________

CONTROL DE CAMBIOS

FECHA DE
VERSIÓN DESCRIPCIÓN DEL CAMBIO RESPONSABLE
APROBACIÓN
 SURGICAL INSTRUMENTATION PROGRAM

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IQX-FT-003-BUC
Versión: 1

Lizeth Guiza
Coordinadora de Prácticas
00 Versión de Prueba 25/11/2015

Elimina del encabezado la fecha de la

implementación del formato, según Erika Grandas Ardila
disposición de la alta dirección consejo Coordinadora de prácticas
superior.
01 Eliminación pie de página por 03/08/2022
modificación en procedimiento control de
documentos y registro.