1. Powered Surgical Instruments
CHESAPEAKE BAY PERIOPERATIVE CONSORTIUM
Property of Chesapeake Bay Perioperative Consortium, © 2017

2. Objectives The learner will be able to:
Identify current applications of powered surgical instruments
Describe basic components of powered surgical instruments
Identify the mechanisms of action of powered surgical instruments
Discuss care and handling of powered surgical instruments

3. Power Equipment
Power equipment ranges in type from electrosurgical units to high-technology laser units. Which includes :
Power drills
Saws
Specialized light sources

4. Uses of Powered Instruments
Precision Drilling
- Insert screws, wires, pins
Precision Cutting
-side to side, front to back
-obtaining bone graft
-Amputation
Sculpting
-Reamers
-Burrs

5. Uses of Powered Instruments
Shaving
-smoothing joint surfaces
-skin grafts
Ultrasonic Cell Disruption
-Cataract- (Phacoemulsification)
-Brain Tissue (CUSA-cavitron ultrasonic surgical aspiration
-Lithotripsy (Kidney stone)

6. Specialty Uses Orthopedics -Reciprocating Saws - Oscillating Saws
- Saggital Saw
- Rotary attachments
-Reamers, Drills
- Screwdriver
- Wire Drivers
- Rasps
- Osteotomes
- Power rongeurs

7. Specialty Uses cont. Thoracic •Neurosurgery - Sternal Saw - Craniotome
•Plastic Reconstructive Perforator
- Dermabraders Drill
- Dermatomes Midas Rex
•Oral/Dental High speed drill/burrs
- Drills Saw

8. Power Source Compressed air/Nitrogen - centrally supplied
- tank with gauge
Electrical
Battery
Sonic Energy
(generator)

9. Advantages Enables surgeon to work with greater efficiency.
Causes less trauma to tissues and surrounding structures.
Reduces blood loss from bone.
Decreases surgical time.
Reduces fatigue for the surgeon.
Patient under anesthesia for a shorter period of time.

10. Disadvantages/Dangers
Heat Generated from drill can damage bone cells
High speed disperses fine mist of bone and blood
Normal tissue and operators fingers may be caught in drill or saw.
Air Hoses may whip out of control if defective or not attached properly.

11. Handling and Safety
All powered equipment must be checked by Bio-medical engineering.
Examine air hoses for integrity. DO NOT use if s/s of wear and tear.
Inspect batteries for corrosion or other damage/defects.
Inspect accessories for intactness & sharpness of cutting edges.

12. Handling and Safety Cont..
All power equipment should be inspected by the user before and after each use.
Power cords should never be crimped or bent; any tears or breaks in the cord should negate the use of the cord until it is repaired cords should lie flat on the floor
Extension cords should be avoided and power

13. Handling and Safety Inspect accessories after use for intactness
Inspect straightness of accessories
Wear PPE during use
Use tissue protectors/burr guards
Never leave the trigger out of the safety mode when not in use

14. Handling and safety Cont..
Inspect accessories after use for intactness.
Inspect straightness of accessories.
Wear PPE during use.
Use tissue protectors/burr guards.
Never leave the trigger out of the safety mode when not in us.

15. Handling and Safety cont.
Place powered equipment on a separate table when not in use.
Operate equipment only at manufacturer’s recommended setting.
“Bleed” attachments before detaching from compressed air source.

16. ALWAYS TEST THE
INSTRUMENTS
WITH THE
ACCESSORIES
ATTACHED TO IT
BEFORE HANDING
IT TO THE
SURGEON

17. Troubleshooting Power source Hose, cord, or battery Hand piece
Check components in the following order:
Power source
Hose, cord, or battery
Hand piece
Accessory attachment
Controls and/or safety switch

18. Care and Cleaning Concurrent cleaning during case.
DO NOT IMMERSE HAND PIECES IN WATER
Concurrent cleaning during case.
Use water, not saline for wiping.
After case, clean immediately.
Dried-on organic material will hamper action of disinfectants and sterilization processes.

19. Care and Cleaning
Leave air hoses attached during cleaning to prevent entry of moisture into motor
Remove accessories prior to cleaning
Wipe surfaces of hand pieces, cords, hoses with mild detergent/disinfectant recommended by manufacturer

20. Care and Cleaning Pay special attention to cannulated areas.
Rinse carefully w/ water to avoid moisture to motor, holding instrument nose-down
Dry with soft cloth
If using ethylene oxide sterilant, dry thoroughly to prevent ethylene glycol formation

21. Lubrication Follow manufacturers recommendations.
Use recommended products.
Some instruments need to be run during or after lubrication.

22. IMPORTANT!
All instruments and devices used in surgery should be cleared by the US Food and Drug Administration (FDA) for use in surgery and have written, manufacturer-validated cleaning and decontamination instructions for use (IFU).

23. References
Rothrock, J, C. Alexander’s Care of the Patient in Surgery.14th ed. St. Louis,MO: Mosby;2011.
Guideline for Cleaning and Care of Surgical Instruments.In: Aorn Guidelines for Perioperative Practice. AORN, Inc, 2017.