Part Ⅰ Theory
Chapter 1 Introduction ..........................................3
The history of operative surgery .........................3
Methods and expectations for learning operative surgery ...................................................5
Classifications of surgical operations..................6
Classification of incision and the degree of incision healing...................................................7
Factors that affect wound healing .......................8
The effects of an operation on the body .............8
Chapter 2 Aseptic Technique..............................10
Basic concepts of aseptic technique...................10
Source of bacteria in operative site....................10
Methods of sterilization for operative
supplies and instruments................................11
Chemical Disinfection .........................................12
Preparation of the operation...............................12
Function and position of operative staff...........19
Operative Theater ................................................19
Chapter 3 Operative Instruments....................20
Scalpel ...................................................................20
Scissors .................................................................22
Thumb Forceps.....................................................23
Haemostatic Forceps............................................24
Allis Forceps ........................................................25
Towel Clips ..........................................................25
Sponge-holding forceps .....................................25
Needle Holder .....................................................25
Retractors...............................................................26
Needle....................................................................27
Suture materials ...................................................28
Modern instruments............................................30
Chapter 4 Basic Operative Technique ...........31
Incision...................................................................31
Dissection ..............................................................32
Haemostasis..........................................................33
Tying Knots...........................................................36
Suture.....................................................................43
Cutting and removing suture.............................47
Surgical drainage .................................................48
Chapter 5 Perioperative Period ........................50
Preoperative..........................................................50
Intraoperative .......................................................51
Anesthesia .............................................................51
Postoperative ........................................................54
Treatment of postoperative complications ......55
Chapter 6 Paracentesis Technique...................56
Abdominocentesis................................................56
Thoracentesis ........................................................58
Lumbar Puncture .................................................59
Bone marrow aspiration .....................................61
Chapter 7 Wound and Debridement...............64
Classification of wound ......................................64
Basic principles of wound management...........64
Wound healing stages .........................................65
Types of Wound Healing....................................65
Debridement .........................................................66
Principles of wound treatment...........................66
General Measure ..................................................67
Pebridement procedures.....................................67
Chapter 8 Dressing Change ...............................70
Purpose of dressing change................................70
Clinical indications for a dressing change........70
Timing of the dressing changes .........................70
Dressing change necessities................................71
Preparation of dressing change supplies..........72
Dressing change procedure................................73
Dressing change when the wound is sutured.....74
Key points .............................................................74
Chapter 9 Tracheotomy ........................................75
Concept..................................................................75
Indication and contraindication.........................75
Anatomy of trachea .............................................75
Classification of a tracheotomy..........................76
Attention of preoperative, posture and
anesthesia ..........................................................77
Tracheotomy procedure......................................77
Complications of tracheotomy and
prevention .........................................................79
Tracheotomy management ................................80
Other emergency airway procedures................80
Chapter 10 Vascular Surgery.............................82
High ligation and stripping of varicose veins of the great saphenous vein .................82
Venotomy..............................................................84
Exposure of the femoral artery ..........................85
Chapter 11 Anterior Abdomina Wall and Abdominal Incision .....87
Review of anatomy ..............................................87
Abdominal incisions............................................92
Chapter 12 Splenectomy.......................................94
Introduction to the spleen...................................94
Anatomy of the spleen ........................................94
Indications for a splenectomy ............................95
Procedure for a splenectomy..............................96
Postoperative care................................................98
Chapter 13 Partial Resection and Anastomosis of Small Intestine ..............................................100
Summary of anatomy........................................100
Classification of anastomosis............................101
Inspection and examination .............................101
Procedures end-to-end anastomosis.............101
Chapter 14 Appendectomy................................104
Appendix anatomy summary ..........................104
Appendectomy indications ..............................104
Appendectomy procedure................................105
Appendectomy risks and complications ........107
Laparoscopic appendectomy............................107
Chapter 15 Surgical Repair of Inguinal Hernias............................110
Introduction to inguinal hernia........................110
Classification of inguinal hernias ....................110
Indication for an inguinal hernia surgery ......111
Non surgical treatment......................................111
Anatomy of the inguinal region.......................111
Surgical procedure of open inguinal hernia repair................................................................112
Laparoscopic procedures for inguinal hernias..............................................................115
Using mesh..........................................................115
Postoperative care..............................................116
Chapter 16 Minimally Invasive Surgery and Surgical System.....................117
Minimally invasive surgery..............................117
Laparoscopic cholecystectomy.........................119
Introduction of a surgical system ....................122
Part Ⅱ.Practice
Chapter 17 Guideline for Practice Experiments....................................129
Experiment 1 Introduction of Operative Instruments.........................................................129
Objectives and requirements............................129
Experimental instruments for each group......129
Operative instruments.......................................129
Practice.................................................................131
Questions.............................................................131
Experiment 2 Aseptic Technique ................131
Objectives and requirements............................131
Necessary surgical supplies for each group......131
Preparation before surgery...............................131
Questions.............................................................134
Experiment 3 Basic Operative Technique....134
Objectives and requirements............................134
Necessary surgical supplies for each group...134
Tying knots .........................................................134
Hemostasis with hemostatic forceps practiced by two students ..........................135
Cutting suture practiced by two students ...135
Removing suture................................................136
Experiment 4 Laparotomy.............................136
Objective and requirements..............................136
Necessities of each group..................................136
Procedure for a laparotomy..............................136
Experiment 5 Debridement...........................137
Objective and requirements..............................137
Necessary surgical supplies for the
operation .........................................................137
Experimental procedure....................................138
Attention points..................................................140
Postoperative treatment....................................140
Questions.............................................................140
Experiment 6 Tracheotomy...........................140
Objectives and requirements............................140
Necessary surgical supplies for the
operation .........................................................140
Experimental procedure....................................140
Attention points..................................................141
Questions.............................................................142
Experiment 7 Exposure of the Femoral
Artery....................................................................142
Objectives and requirements............................142
Necessary surgical supplies for the
operation .........................................................142
Experimental procedure....................................142
Attention points..................................................142
Question ..............................................................142
Experiment 8 Splenectomy............................142
Objectives and requirements............................142
Necessary surgical supplies for the
operation .........................................................142
Experimental procedure....................................143
Attention points..................................................144
Questions.............................................................144
Experiment 9 Mimic a Human Body
Appendectomy..................................................144
Objectives and requirements............................144
Necessary surgical supplies for the
operation .........................................................144
Experimental procedure....................................144
Attention points..................................................145
Questions.............................................................146
Experiment 10 Resection and
Anastomosis of the Small Intestine ............146
Objectives and requirements............................146
Necessary surgical supplies for the
operation .........................................................147
Experimental procedure....................................147
References ........................................................................150
Theory
內容試閱：
Dear Readers：
If you want to become an excellent doctor, whether a surgeon, physician, or other professional doctors, in addition to needing extensive knowledge, high ethical standards, you also need a pair of dexterous hands. As a doctor, there are many cases in which surgical procedures are necessary to treat your patients. When you are on the campus of a medical school, this will be a course that you may become quite interested in. In this course, you will experience the wonderful process of surgery, touching living visceral organs and tissues for the first time, and feel the magic of life. You can gain professional skills through practice and serve the human race in the future. This interesting course is Operative Surgery, and Basics of Operative Surgery is the introductory textbook you need in this course.
The course of Operative Surgery is an indispensable bridge which connects medical students and doctors. It is also a course integrating basic medical knowledge, basic theory and clinical practice skills. Basics of Operative Surgery focuses on the training your clinical abilities, paying special attention to surgical aseptic techniques and basic surgical techniques, incorporating hands-on training, teamwork and love of the injured in a series of surgical skills training and animal surgery. The textbook also reviews numerous obstacles in the history of operative surgery and the great contributions that generations of surgeons have made to overcome these obstacles. Meanwhile, the book also introduces the most recent cutting-edge advances in operative surgery, including laparoscopic surgery and robotic surgery. Such contents will certainly have a strong appeal to medical students from all over the world. With the help of this textbook, you will be introduced to that yesterday, today and tomorrow of operative surgery are all very interesting. You will be able to make it even better in the future with your own professional advancement.
This textbook can be used for the teaching of operative surgery of international medical students in China, and it can also be used as guidance to young doctors in various countries for basic surgical training. So even if you are already a surgeon, this book can still be of a benefit.
Basics of Operative Surgery is compiled by the teachers from Department of Operative Surgery
of Basic Medical Sciences School Tianjin Medical University. This book also benefited from
the contributions of a numerou of professor of Nankai University, China Medical University and Tianjin University of Traditional Chinese Medicine. We hereby give them our heartfelt appreciation.
Editors, 2018
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