7 Basic surgical skills

Abdominal wall closure and laparoscopic port closure Abdominal wound closure technique The surgic...

Abdominal wall closure and laparoscopic port closure Abdominal wound closure technique The surgic...

Advanced vessel-sealing devices Advanced laparoscopic procedures have driven a parallel explosion...

Alternatives to sutures Skin adhesive strips Self-adhesive tapes may be used where there is no te...

DRAINS IN SURGERY In 1887 Lawson Tait suggested ‘when in doubt drain!’. This edict has been criti...

Draping Draping is the process of forming a sterile perimeter around the operating site using dis...

ELECTROSURGERY Electrosurgery employs high-frequency electrical current to assist in making surgi...

Emergency gastrointestinal surgery and drains While there seems to be some anecdotal evidence adv...

FURTHER READING Kirk RM. Basic surgical techniques , 6th edn. Edinburgh: Churchill Liv - ingstone...

Hair removal from the surgical site Hair is removed from the surgical site when it is deemed to...

Hazards of diathermy Burns These are the most common type of diathermy accidents and occur when ...

INTRODUCTION Successful outcomes in surgery depend on knowledge, skills and judgement. While this...

Knotting techniques Knot tying is one of the most fundamental techniques in surgery and a poorly...

Laparoscopic access and port placement There are two fundamental ways to access the abdomen lapar...

Lateral position Left or right lateral positioning ( Figure 7.5 ) are useful alterna tives to pro...

Learning objectives To understand: The importance of safe patient positioning • The steps involve...

Lithotomy and Lloyd-Davies position This is commonly employed for gynaecological, perineal and ur...

Monopolar and bipolar diathermy In monopolar surgery ( Figure 7.18a ), the electrical current cre...

Needles Most needles in present practice are eyeless, or ‘atraumatic’, with the suture material e...

POSITIONING ON THE OPERATING TABLE Summary box 7.1 Objectives of correct surgical positioning /un...

PREPARATION OF THE SURGICAL SITE Correct skin preparation can reduce surgical site infection - (S...

Patient safety and transfer to the operating table Patient safety is of paramount importance. Th...

Prone position In the prone position ( Figure 7.4 ) , the patient is intubated and - then log-rol...

Removal of drains A drain should be removed as soon as it has served its purpose. It is important...

Removal of metals and other foreign bodies Removal of piercings and rings from the surgical site...

Removal of skin staples or sutures The timing of removal of non-absorbable sutures depends on t...

SURGICAL EXPOSURE AND WOUND APPROXIMATION SURGICAL EXPOSURE AND WOUND APPROXIMATION SURGICAL ...

Skin antisepsis Skin antisepsis removes transient organisms and dirt, thereby preventing SSI. The...

Skin incisions Skin incisions ( Figure 7.6 ) are made using a scalpel with the blade pressed firm...

Specialist use of drains Nasogastric drainage The role of nasogastric tube placement in the surg...

Supine position This is the most common position for general surgical proce - dures. The patient’...

Surgical access to the abdomen in general surgery Access to the abdominal cavity can be achieved ...

Suture characteristics There are five characteristics of any suture material that need to be consi...

Suture techniques There are four frequently used suture techniques. 1 Interrupted sutures . Inter...

T-tube drains A T-tube ( Figure 7.21 ) may be inserted after exploration of the common bile duct...

TECHNIQUE The suturing of an incision or wound needs to take into consid - eration the site and t...

TOPICAL HAEMOSTATIC AGENTS Physical or biological topical haemostatic agents are considered adj...

The effects of diathermy Diathermy ( Figure 7.19 ) can be used for two basic purposes ( Table 7.4...

The principles of electrosurgery Electric current is defined as the flow of charged particles thro...

The role of drains in modern surgery The routine use of surgical drains has generated much contr...

principles of electrosurgery Bleeding encountered during an operation can be arterial, venous or ...