1. Types of needles

2. Curved needles
1/2 of circle
3/8 of circle
5/8 of circle

3. Types of needles according to the threading
Eyed
Eyeless

4. Types of needles according to cut section
Cutting needle
Rounded needle

5. Control of 1ry hemorrhage

6. 1ry hemorrhage
Place pack for 4 min

7. Hold the injured vessels by 2 artery forceps

8. 3 ligations
2 ligations
Artery :high pressure
Vein :low pressure

9. Adhesive tapes

10. Types of sutures

11. Simple stitches

12. Tension suture
It takes muscles &peritoneum
On tension of the suture

13. Continuance stitches

14. Lambert's suture

15. Mattress stitches

16. Chest drain

17. Position of the patient in the chest drain

18. Sit of the incision
Mid axillary line
Ant. Axillary line

19. Med. axillary line
Ant. axillary line
Points of drain

20. Spread the muscle fibers by artery forceps to expose pleura
Lung
Spread the muscle fibers by artery forceps to expose pleura

21. Pierce pleura and introduce finger to confirm entry to pleura

22. Guiding of the drain by your finger

23. Make sure that the incision is large enough to accommodate the drain + your finger

24. Suture the drain with loss sutures to the skin

25. Rib
Drain
Rib

26. Spleen

27. Normal spleen anatomy

28. Stomach
Gastrosplenic lig.
Ant.lienorenal lig
Spleen
Pancreas
Kidney
Post.lienorenal lig.

29. Anterior lienorenal ligament
Gastro pherenic ligament
Spleen
Anterior lienorenal ligament
Pancreas
posterior lienorenal ligament

30. Gastropherenic ligament Post. Layer of lienorenal ligament
Ant. layer of lienorenal ligament
Post. Layer of lienorenal ligament

31. splenectomy

32. Down displacement of the stomach

33. Insertion of hot packs behind spleen

34. Hot packs around spleen

35. Divide the posterior layer of lienorenal ligament
Stomach (medially)
Spleen (medially)
Hot packs
Divide the posterior layer of lienorenal ligament

36. Divide the posterior layer of lienorenal ligament
Traction of the spleen medially

37. Divide the gastrosplenic ligament

38. Divide the gastrosplenic ligament

39. Divide the anterior layer of the lienorenal ligament

40. Ant. Lienorenal lig.
Pancreas
Splenic artery
Spleen
Pos. lienorenal lig.

41. Squeeze the spleen
Divide splenic vein

42. Problems

43. Multiple splenic adhesions

44. Rectum and anal canal

45. Overall view of the rectum and anal canal

46. Anatomy of rectum and anal canal
Dentate line
External sph.
Internal sph.

47. Internal plexus of veins
Superior rectal vein
Internal plexus of veins
External anal sphincter
Anal canal
Internal anal sphincter
Anatomical anal canal structure

48. Anal Fistula

49. Internal opening of the fistula
External opening of the fistula
The track of the fistula

50. Insertion of probe
Probe

51. Insertion of rode of glass in the fistula

52. Opining of the fistula by cut the skin on the glass rode along the all track

53. The external opining of the fistula Anus
The triangular track of the incision

54. The healing by Granulation tissue

55. Anal fissure

56. Anal fissure (lower part of anal canal)

57. Anal fissure
Traction of the fissure from sentinel pile
Sentinel pile

58. Removal of the fissure+ the skin around it
Internal sphincter

59. Fissuerectom and posterior internal sphincterectomy

60. Hemorrhoidectomy

61. Superior rectal vein
Plexus of veins (site of internal piles
External sphincter
Internal sphincter

62. Superior rectal vein
Internal piles

63. Hold the piles by 2 Allis forceps

64. Sit of the V- incision in the anal skin

65. Ligation of the root of the piles
Part of anal skin

66. V- shape incision in the skin

67. V shape incision
The pile

68. Sits of primary piles 11 3 7

69. Granulation tissue
Healthy skin

70. Circumcision

71. Uncircumcised penis

72. Retract the propuce backwards Clean the coronal sulcus by alcohol

73. Ring anesthesia at the base of the penis

74. Traction of the propuce by artery forceps

75. Squeeze pines glandes

76. Bone cutting method circumcision
Bone cutting forceps
Bone cutting method circumcision

77. Artery forceps
Cut the prepuce till sulcus of glans penis

78. Cut the propuce all around the coronal sulcus

79. Interrupted sutures
Mucous membrane of the penis

80. Circumcised penis

81. Renal operations

82. Incision for renal operations Anterior superior iliac spine
Ribs
Incision
Anterior superior iliac spine

83. External obliq.
Per renal fat
Internal obiq.
Peritoneum
Tranversus abd.
Serretus post.
Kidney
Fascia trans.
Ltissmus dorsi
Site of incision

84. External oblique
Latissmus dorsi
Incision

85. External obliq.
Internal obliq.
Latissmus dorsi
Serretus posterior

86. External obliq.
Internal obliq.
Fascia Transversalis
Latissmus dorsi
Serretus posterior

87. Transverses abdominus
Lumber fascia

88. Move the pre renal fat by finger
Peritoneum
Pre renal fat
kidney
Move the pre renal fat by finger

89. Separation of the peri renal fat to separate kidney from supra renal gland

90. If we don't separate the ft we remove the supra renal gland with kidney

91. Identify the ureter Renal vein (anterior) Renal artery (middle )
Ureter (posterior)

92. Ligate and divide the ureter as low as possible

93. Brodel's bloodless line
Nephrolithetomy
Brodel's bloodless line
incision

94. Renal stone

95. Nephrolithetomy
Radial incision

96. Pyelolithotomy

97. Ligation above &below the stone in the ureter

98. Removal of the stone

99. Stone in the urinary bladder

100. Site of incision

101. Removal of the stone