SPECIALTY O.R. EQUIPMENT

Specialty Equipment Today’s Operating rooms are increasingly specialized. As new technology is developed, the need for specialized equipment increases.

Endoscopes Used for diagnosis, biopsy, visualization, and/or repair of a structure within a body cavity. Endoscopes are introduced thru existing body openings or small skin excisions. Shortens hospital stay and recovery times.

Endoscopes Some scopes are inserted thru existing body orifices for the purpose of viewing, repairing, or biopsy of tissue. Examples: – Bronchoscope -Hysteroscope – Laryngoscope-Otoscope – Colonoscope-Cystoscope

Endoscopes Other scopes are inserted thru trocar/ cannula assemblies into body cavities or joint spaces. Examples: – Arthroscope – Laparoscope – Thoracoscope New scope technology is being discovered every day.

Endoscopes Flexible scopes have maneuverable tips and channels to introduce, instruments or suction/irrigation. Rigid scopes are used for most Laparoscopes, Cytoscopes, and Arthroscopes.

Endoscopes Often attached to a camera and light source to produce an image on a monitor. Able to use electrosurgical devices for cautery and dissection. Some endoscopes have the ability to use lasers.

Video equipment A mobile tower with video monitors, light source, and video camera allow the image from the endoscope to be seen on a monitor. Some towers have the ability to record or document surgical findings. (Pictures, Video) Connecting cords must be sterile that connect the tower to the endoscope.

Insufflators Machine that infuses CO2 gas thru a verres needle or cannula to expand the abdominal cavity during laparoscopy. Creates a space within the cavity to allow viewing. Intraopertive pressure is 12-15mm Hg.

Power Tools Any instrumentation that uses nitrogen, batteries, or electricity are called power tools. Many uses, such as drilling, reaming, sawing, reshaping bone, or cutting skin for grafting.

Power Tools Tools powered by compressed nitrogen are operated by hose connections to tank or wall nitrogen. Tools operated at manufacturer recommendations. (usually between psi)

Power Tools Dermatomes and dermabraders Power Saws come with various blades. (oscillating, reciprocating) Power Drills (High speed, Low torque) Power Reamers(Low speed, High torque) Cranial perforators

Lasers Acronym meaning: – Light Amplification by the Stimulated Emission of Radiation. Used in surgery since Uses light energy to create heat to cauterize tissue.

Lasers Monochromatic – Photons of the laser are all the same color. – Color of light reacts with the colors of the tissues. Light is collimated so it does not spread out as it travels away from the source.

Lasers Factors that decide the penetration depth of the laser beam include: – Power – Color – Wavelength – Duration of exposure

Lasers Parts of the laser system: – Excitation source – Head – Ancillary components – Control panel – Delivery system

Lasers Excitation source – Provides energy that allows the laser head to produce light. Active media – Gas lasers are stimulated by electrical source. – Solid/liquid lasers stimulated by flash lamps.

Lasers Ancillary components – Console – Cooling system Air or water cooled – Vacuum pump (CO2 laser)

Lasers Control panel – Regulates the modes, duration times and wattage required to control the laser. – Safety features

Lasers Delivery system – Delivers laser energy from the laser head to the tissues. – May use mirror or fibers to deliver light energy.

Lasers Carbon Dioxide – Most frequently used system. – Color of tissue does not affect absorption of light. May be used on light and dark tissues – Light energy will heat cells to bursting point. – Produces laser “plume”.

Lasers Argon – Produces a blue or green light. – Absorbed by dark or red tissue – Ideal for retinal surgery as it does not heat clear tissues.

Lasers Nd:YAG – Readily absorbed by tissue protein – Poorly absorbed by water and hemoglobin. – Powerful and precise coagulating properties. – May be used thru a microscope or endoscope.

Lasers KTP – Green light that works well on red or darker tissues. – Hemoglobin or melanin

Lasers Excimer – Produces a pinpoint ultraviolet beam. – Minimal thermal spread to healthy tissues. – Used in cornea reshaping surgeries.

Lasers GI endoscopy - Nd:YAG Angiodysplasias - Argon Bronchoscopy - CO2, Nd: YAG Arthroscopy - CO2, Nd: YAG, Ho: YAG Cystoscopy - Nd: YAG Hysteroscopy - Nd: YAG Lap Chole - Nd: YAG, Ho: YAG, KTP, or Argon Colonoscopy - Argon or Nd: YAG

Microscopes Binocular apparatus that magnifies tissues during microsurgery. May be ceiling mounted or on mobile frame. Most are equipped with a foot or hand control for magnification and illumination. STSR will drape with sterile cover.

Fiber-optic Headlamps Worn on the head by surgeons for additional lighting at the operative site. Frequently used by cardiovascular, neuro, and oral surgeons. Headlamp is attached to a light source generator by a fiber-optic cord.

Irrigation/Aspiration Units Pulsed saline solution pulverizes clots and necrotic tissue, aiding in healing. Splash shields protect surgical team from fluids. Also known as a pulse lavage. Powered by nitrogen.

Phaco Emulsifier Uses ultrasonic energy (cavitation), to fragment diseased eye lenses. Suction/irrigators are used to remove the fragments. Used in cataract surgery.

Cryotherapy Delivers liquid nitrogen thru an insulated probe to diseased tissue to facilitate removal. Extreme cold will create necrotic tissue without damaging neighboring tissue. Use for brain tumors and retinal surgery.

Nerve stimulators Produces small electric currents, used to identify essential nerves. Needles with an attached wire is inserted into adjacent tissue. Probes deliver an electric current to the tissue in question, and any movement is observed. Useful for identifying 7 th cranial nerve during ENT procedures May be used by anesthesia to assess neuromuscular blockers.

Suction Systems Vacuum system to remove fluids from the surgical site and patients airway. Every room must have a minimum of TWO suction units. May be central or portable source. Suction tubing, Collection unit, and Suction tips are needed for use.

Surgical Lights Two or more, ceiling mounted operating lights provide focused lighting during the procedure. Freely adjustable to any angle and light pattern. Equipped for attachment of autoclaved handles or sterile covers. Wall mounted fixture, adjusts intensity and power switch.

Pneumatic Tourniquets Necessary device for procedures on extremities. – Reduce the amount of blood loss – Increase visualization of the surgical site Consists of: – Cuff (BP cuff) – Tubing – Pressure device

Pneumatic Tourniquets Battery back-up in case of power outage. Cuff may be sterile or unsterile. Placed proximal to the surgical site. Pressure of tourniquet decided by surgeon and anesthesia. ½ greater than systolic BP. Must be deflated periodically for cases longer than an hour.

Sequential Compression Devices (SCD’s) Chambered sleeves are placed on the patients extremities. Air is pumped in the sleeves by chamber moving any fluid (blood, lymph, etc) Used to prevent venous statis, leading to deep vein thrombosis, or pulmonary embolism.