SURGICAL INSTRUMENTATION PROGRAM

TRAINING SURGICAL PLANNING

Versión: 1
IQX-FT-003-BUC

STUDENT NA CODE: 01200021038 PRACTICE LEVEL: III

ME: ANGIE PRADA

TEACHER'S NAME: Lidy Higuera PRACTICE STAGE: FOSUNAB NOTE:

SPECIALTY: CX SURGEON: DR DATE: 17/03/2023

GIRALDO

NAME OF PATIENT: WILLVER HERIBERTO MEDICAL HISTORY NUMBER: PATIENT AGE: 39

SANTAMARIA PARADA 91521590
SURGICAL PROCEDURE TO PERFORM:
MYOCARDIAL REVASCULARIZATION

SURGICAL INSTRUMENTATION PROCESS

• PLANNING STAGE:

1.1. Surgical Objective: (Make description)

is a medical procedure to improve the blood supply to the heart. It may be necessary when the arteries that supply blood to
the heart tissue, called coronary arteries, have a narrowing or blockage.
 SURGICAL INSTRUMENTATION PROGRAM

TRAINING SURGICAL PLANNING

Versión: 1
IQX-FT-003-BUC

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

The coronary arteries run all around the outer surface of the heart - forming a sort of crown (hence their name) - and
branches branch off from it to carry blood to the entire heart muscle.

The two main coronary arteries are the left and right coronary artery.

• The left coronary artery (ICA). The left main coronary artery supplies blood to the left side of the heart muscle (the
left ventricle and left atrium). The left main coronary artery divides into two branches:

- The left anterior descending artery which is a branch of the left coronary artery and supplies blood to the
anterior portion of the left side of the heart.
 SURGICAL INSTRUMENTATION PROGRAM

TRAINING SURGICAL PLANNING

Versión: 1
IQX-FT-003-BUC

- The circumflex artery which arises from the left coronary artery and surrounds the heart muscle. This artery
supplies blood to the outer and posterior areas of the heart.

• The right coronary artery (RCA). The right coronary artery carries blood to the right ventricle, right atrium, sinoatrial
node (SA node) and atrioventricular node (AV node), which regulate heart rhythm. The right coronary artery divides
into smaller branches, including the right posterior descending artery and the acute marginal artery.

The other smaller branches of the coronary arteries include: the obtuse marginal (OM), the perforating septal (PS)
and the diagonals.

Cross section of a
right internal partially obstructed
mammary artery artery

atheroma
blockage of
the coronary
segment of the arteries
saphenous vein

1.3. Check list:

 SURGICAL INSTRUMENTATION PROGRAM

TRAINING SURGICAL PLANNING

Versión: 1
IQX-FT-003-BUC

MEDICAL EQUIPMENT/ DRUGS AND

SUTURES AND
INSTRUMENTAL DEVICES SOLUTIONS
NEEDLES

• EXTRACORPOR • CLOTHING • SILK 0 1/2 HEPARIN

EAL EQUIPMENT PACKAGE ROUND INFILTRATION
• RECIPROCATIN • ELECTROBISTURI CIRCLE OF WARM SALINE
G SAW • RUBBER SUCCION 26MM SOLUTION
• CAIMANS • BISTURI BLADE • PROLENE OR
• CORONARY N11 POLYPROPYL
EQUIPMENT N3 • BISTURI BLADE ENE 7/0
• SEPARATOR N15 3/8CIRCLE
MAMMARY • COOPER TUBE ROUND 9.
• FINE • MICRO SCALPEL 3MM
INSTRUMENTAL • ASEPTOSYRINGE • PROLENE OR
DR GIRALDO • RADIOPAQUE POLYPROPYL
• STERNAL GAZE ENE 6/0
SEPARATOR • ARTERIOTOMY 3/8CIRCLE
CANNULA ROUND 13MM
OR2C-1
• TUBE TO THORAX
34 • PROLENE OR
POLYPROPYL
• ANTEROGRADE
ENE 4/0
CARDIOPLEGIA
1/2CIRCLE
CANNULA
ROUND 17MM
• SET OF
ORCV-23
TOURNIQUETS
• MONOCRYL
AND THREAD
OR
PASSER
POLYGLECAP
• NELATON 8
RONE 3/0
PROBE
3/8CIRCLE
19MM OR PS-2
 SURGICAL INSTRUMENTATION PROGRAM

TRAINING SURGICAL PLANNING

Versión: 1
IQX-FT-003-BUC

• NELATON RPOBE • PRECUT SILK

14 FR 1
• IOBAN • PRECUT SILK
• INTRA-AORTIC 4/0
PUNCH • VICRYL OR
• CO2 GUIDE POLYGALCTI
• TORUNDAS N910 2/0 ½
• PATHOLOGY CIRCLE
BOTTLE ROUND36,4M
• COMPRESSES M OR CT1
• 20 SYRINGE • VICRYL OR
• 10 SYRINGE POLYGALCTI
• JELCO SERIVA N910 0 ½
CATHETER CIRCLE
• CLIPS ROUND36.4M
M OR CT1
• ARTERIAL
CANNULA • ETHIBOND OR
POLYESTER2/
• VENOUS
0 ½ CIRCLE 25
CANNULA
MMROUND OR
• GLOVES
SH
• BONE WAX
• ACIFLEX OR
• PACING WAIRES ( SURGICALST
RED AND BLACK) EEL 5
• PACEMAKER
WIRE 0
 SURGICAL INSTRUMENTATION PROGRAM

TRAINING SURGICAL PLANNING

Versión: 1
IQX-FT-003-BUC
 SURGICAL INSTRUMENTATION PROGRAM

TRAINING SURGICAL PLANNING

Versión: 1
IQX-FT-003-BUC

2. ORGANIZATION STAGE:

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

1. No. 7 scalpel handle with No. 15 and No. 12 scalpel blade

2. Scalpel handle #3 with scalpel blade #15

3. Mayo scissors (2)

4. metzembaum scissors (2)

5. Adson dissecting forceps without claw and with claw

6. Vascular dissection forceps

7. Curved mosquito forceps

8. Protected mosquito forceps

9. Curved kelly forceps

10. tube forceps

11. Kocher forceps

12. Rochester clamp

13. Farabeuf separators (2 pairs)

14. Coke for sharp material

15. Field forceps

 SURGICAL INSTRUMENTATION PROGRAM

TRAINING SURGICAL PLANNING

Versión: 1
IQX-FT-003-BUC

1.Coca with Aseptojeringa 6.Closing wire 11.Adson's dissection with claw

2.Spencer cannula for cardioplegia 7.Sternal and mammary retractor 12. Extracorporeal basket

3.Vascular dissections 8. Tourniquets 13.Reciprocating sawing equipment

4. Electric scalpel 9.Wire holder 14.Dressing pack

5.Coronary equipment 10. Wire cutter 15. Compresses, gauze

 SURGICAL INSTRUMENTATION PROGRAM

TRAINING SURGICAL PLANNING

Versión: 1
IQX-FT-003-BUC

16. Sutures 21.Connector and tourniquet equipment.

17.Needle holder 22. Kidney bag

18.Cannulas for extracorporeal circulation, suction 23. Pacemaker cable

cannulas, ioban, 20cc syringe, suction rubber,
Ligaclip clamp + Ligaclips (100 and 200) 25.
electrosurgical scalpel.
25. Punch
19. Handles, gloves
26. Micro scalpel
20.Pathology flask and container to wash the valve.

2.2. Patient position (Name and graphic):

DECUBITUS SUPINE
 SURGICAL INSTRUMENTATION PROGRAM

TRAINING SURGICAL PLANNING

Versión: 1
IQX-FT-003-BUC

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

Anesthesiologist P

A
Surgeon
C
Assistant
I Extracorporeal
IQ machine
E
Perfusionist N

May table

Reserve table
 SURGICAL INSTRUMENTATION PROGRAM

TRAINING SURGICAL PLANNING

Versión: 1
IQX-FT-003-BUC

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):

• Sternotomy and thoracic incisión

• saphenous as graft

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

- STARTING WITH THE EXTRACTION OF THE SAFENA VENOUS INJECTION (mb#3 hb#15 electro, 200 clips, ligaclip, vascular
dissection).
- BLOOD LEAKAGE AND PATENCY CLOSURE IS PERFORMED.
The arteriotomy cannula and silk 1 are given to fix it.
A syringe 10 with heparin is passed to vasodilate the vein.
- SKIN IS INCISED - MB 7 HB15, HEMOSTASIS - ELECTRO AT 40
- FINOCHETO AND FARABEUF RETRACTORS ARE PASSED TO THE ASSISTANT
- RECIPROCATING CLAMP IS PASSED
- PASS ELECTRO AT 80 FOR HEMOSTASIS OF THE STERNUM
 SURGICAL INSTRUMENTATION PROGRAM

TRAINING SURGICAL PLANNING

Versión: 1
IQX-FT-003-BUC

- THE MAMMARY SEPARATOR IS PASSED AND THE ELECTRO IS LOWERED TO 30 TO DESIGN THE VASCULAR BED.
- ONCE THE MAMMARY ARTERY IS FOUND, FINE VASCULAR DISSECTION IS PERFORMED, 100 CLIPS FOR LIGATION.
- THE MAMMARY SEPARATOR IS REMOVED AND THE STERNAL SEPARATOR IS PASSED.
- VASCULAR DISSECTION AND ELECTRO IN 40 TO INCISE THE PERICARDIUM AND EXPOSE THE HEART.
- THE STITCHES OF THE TOBACCO POUCH OF THE AORTA IN THE VENA CAVA ARE MADE AND THE TOURNIQUETS ARE
PLACED THROUGH THREADS AND LEFT REPAIRED AND AFTER THIS, AN ARTERIOTOMY AND VENOTOMY ARE PERFORMED
TO FIX THE CORRESPONDING CANNULAS AND FIX THEM.
- WHEN THE HEART ENTERS THE PUMP, THE SAPHENOUS GRAFT IS PLACED. IN THIS CASE, THE REPAIR OF THE RIGHT
CORONARY ARTERY, THE ANTERIOR DESCENDING ARTERY AND THE ANASTOMOSIS OF THE RIGHT CORONARY ARTERY WITH
THE MAMMARY ARTERY IS PERFORMED.
- PATENCY AND ANASTOMOSIS ARE VERIFIED AND THE HEART IS REMOVED FROM THE PUMP AND THE CARDIOPULMONARY
BYPASS CANNULAE ARE REMOVED AND THE PACEMAKER LEAD AND CHEST TUBE ARE PLACED.

WEEKLY REPORT FORMAT OF TRAINING PRACTICE

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

STUDENT SIGNATURE: ANGIE PRADA TEACHING SIGNATURE: __________________________

CONTROL DE CAMBIOS
 SURGICAL INSTRUMENTATION PROGRAM

TRAINING SURGICAL PLANNING

Versión: 1
IQX-FT-003-BUC

FECHA DE
VERSIÓN DESCRIPCIÓN DEL CAMBIO RESPONSABLE
APROBACIÓN

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
superior.
Coordinadora de prácticas

01 Eliminación pie de página por 03/08/2022

modificación en procedimiento control
de documentos y registro.