https://kat.cr/user/Blink99/ Contents UNIT ONE: INSTRUMENT PREPARATION 27 Ureteroscopy, 113 FOR SURGERY 28 Nephrectomy, 115 29 Laparoscopic Nephrectomy, 117 1 Care and Handling of Surgical Instruments, 1 30 Pubovaginal Sling/Anterior Repair, 119 2 Sterilization Container Systems, 24 31 Prostatectomy, 122 32 Laparoscopic Prostatectomy, 127 UNIT TWO: GENERAL SURGERY 33 Transurethral Resection of the Prostate, 128 3 Operating Room Suite/Basic Laparotomy, 31 34 Vasectomy, 130 4 Abdominal Self-Retaining Retractors, 39 35 Penile Prosthesis, 133 5 Small Laparotomy Set, 45 6 Minor Laparoscopic Set, 47 UNIT FIVE: ORTHOPEDIC SURGERY 7 Laparoscopy, 49 36 Basic Orthopedic Surgery, 136 8 Laparoscopic Adult MIS Set, 54 37 Power Saws and Drills, Battery Powered, 139 9 Laser Laparoscope, 60 38 Small Joint Arthroscope Set, 144 10 Laparoscopic Cholecystectomy, 61 39 Arthroscopic Carpal Tunnel Instruments, 145 11 Laparoscopic Bowel Resection, 63 40 Small/Minor Joint Replacement, 146 12 Bowel Resection, 69 41 Total Ankle Prosthesis, 148 13 Sigmoidoscopy, 71 42 Arthroscopy of the Knee/Shoulder, 150 14 Laparoscopic Bariatric Surgery, 72 43 Arthroscopic Anterior Cruciate Ligament Reconstruction 15 The da Vinci ® Surgical System and EndoWrist ® Instruments with Patellar Tendon Bone Graft Instruments, 154 (Robotic Instruments), 79 44 Total Knee Replacement, 157 16 Breast Biopsy/Lumpectomy, 84 45 Shoulder Surgery Instruments, 164 17 Mastectomy, 85 46 Hip Fracture, 166 47 Hip Retractors, 169 UNIT THREE: FEMALE REPRODUCTIVE SURGERY 48 Total Hip Replacement, 170 18 Dilatation and Curettage of the Uterus, 88 49 Total Hip Instruments (Zimmer-VerSys), 174 19 Hysteroscopy, 91 50 Spinal Fusion with Rodding, 179 20 Vaginal Laser, 94 51 Long Bone Rodding for Fracture Fixation, 185 21 Abdominal Hysterectomy, 96 52 ASIF Universal Femoral Distractor Set, 187 22 Supracervical Laparoscopic Hysterectomy, 99 53 Synthes Retrograde/Antegrade Femoral Nail, 188 23 Vaginal Hysterectomy, 103 54 Synthes Unreamed Tibial Nail Insertion and Locking 24 Laparoscopic Tubal Occlusion, 105 Instruments, 190 55 External Fixation of Fractures, 191 UNIT FOUR: GENITOURINARY SURGERY 56 ASIF Pelvic Instrument Set, 194 57 Universal Screwdriver/Broken Screw Set, 196 25 Cystoscopy, 108 26 Urethroscopy, 112 https://kat.cr/user/Blink99/ Instrumentation for the OPERATING ROOM A PHOTOGRAPHIC MANUAL https://kat.cr/user/Blink99/ YOU’VE JUST PURCHASED MORE THAN A TEXTBOOK! Evolve Student Resources for Tighe: Instrumentation for the Operating Room: A Photographic Manual, Ninth Edition, include the following: • Additional Images • Review Questions Activate the complete learning experience that comes with each NEW textbook purchase by registering at http://evolve.elsevier.com/Tighe/instrumentation REGISTER TODAY! You can now purchase Elsevier products on Evolve! Go to evolve.elsevier.com/html/shop-promo.html to search and browse for products. https://kat.cr/user/Blink99/ NINTH9 EDITION Instrumentation for the OPERATING ROOM A PHOTOGRAPHIC MANUAL Shirley M. T ighe, BA, RN, Retired AD in Applied Science in Photography Consultant for the Operating Room Lake Havasu City, Arizona with over 800 photographs https://kat.cr/user/Blink99/ 3251 Riverport Lane St. Louis, Missouri 63043 INSTRUMENTATION FOR THE OPERATING ROOM: A PHOTOGRAPHIC MANUAL, NINTH EDITION ISBN: 978-0-323-24315-5 Copyright © 2016 by Mosby, an imprint of Elsevier Inc. Copyright © 2012, 2007, 2003, 1999, 1994, 1989, 1983, 1978 by Mosby, Inc., an affiliate of Elsevier Inc. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechani- cal, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permis- sions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Library of Congress Cataloging-in-Publication Data Brooks Tighe, Shirley M., author. Instrumentation for the operating room : a photographic manual / Shirley M. Tighe. -- Ninth edition. p. ; cm. Includes bibliographical references and index. ISBN 978-0-323-24315-5 (alk. paper) I. Title. [DNLM: 1. Surgical Instruments--Atlases. WO 517] RD71 617.9’178--dc23 2014048834 Executive Content Strategist: Tamara Myers Senior Content Development Specialist: Laura Selkirk Publishing Services Manager: Pat Joiner Project Manager: Suzanne C. Fannin Designer: Margaret Reid Printed in the United States of America Last digit is the print number: 9 8 7 6 5 4 3 2 1 https://kat.cr/user/Blink99/ Thank you to PeaceHealth Southwest Medical Center and their staff for allowing me to use their faculties for the photographing to update Instrumentation for the Operating Room: A Photographic Manual textbook, ninth edition. It has been a real honor to work with the staff at PeaceHealth Southwest Medical Center in Vancouver, Washington. First, they were very knowledgeable about the work they were doing and were so willing to share it (so many new or improved instrumentation) with my staff who had worked in perioperative nursing. Second, they had their plan of what needed to be updated and were efficient in assisting us in photographing and labeling the instruments. Wendy Weir-Raynor and Denise Reese were definite assets to the entire undertaking of updating the ninth edition of this textbook. They are clinical educators with over 2 decades working in the perioperative services. Wendy is located second from the right in the front row, and Denise is located first on the left in the last row. This photo includes some of the clinical consultants and many technicians who work in the central sterile processing depart- ment, where instrumentation processing takes place. PeaceHealth Southwest Medical Center. Dedication v https://kat.cr/user/Blink99/ Left to right: Jack Sanders, Glen Tighe, Shirley Tighe, Pauline Vorderstrasse, Gwen Graham, and Beverly Burns, all of whom came out of retirement and assisted Shirley in another edition of her textbook. It has been an honor to work with these friends and many other consultants for over 4 decades on the textbooks. Sharing their expertise of operating room nursing and the time to complete the textbooks, one should really call it “their textbook.” Many thanks to all. Sincerely, Shirley M. Tighe, BA, RN, Retired, AD in Applied Science in Photography vi Dedication https://kat.cr/user/Blink99/ CONTRIBUTORS/CONSULTANTS CLINICAL EDITOR Denise A. Reese, RN, CNOR Clinical Educator─Perioperative Services PeaceHealth Southwest Medical Center Vancouver, Washington Wendy M. Weir-Raynor, BSN, RN Clinical Educator─Perioperative Services PeaceHealth Southwest Medical Center Vancouver, Washington NURSE/CONSULTANTS Marcia Frieze, CEO Case Medical, Inc. South Hackensack, New Jersey Cynthia C. Spry, MA, MSN, RN, CNOR(E), CBSPDT Independent Consultant, Sterilization, Disinfection, and Related Infection Prevention New York, New York CLINICAL CONSULTANTS Kathryn Diane Amer, BSN, RN Ambulatory Surgery PeaceHealth Southwest Medical Center Vancouver, Washington Joan Blackler, RN, CNOR RN Surgical Specialist─Orthopedic Surgery PeaceHealth Southwest Medical Center Vancouver, Washington M. Tiffany Brenton, BSN, RN RN Surgical Specialist─EENT/Plastics/Robotics Surgery PeaceHealth Southwest Medical Center Vancouver, Washington Sheryl A. Bundy, RN Pediatric Surgical Coordinator Legacy Emanuel Hospital and Medical Center Portland, Oregon Robert L. Nyberg, RN RN Surgical Specialist─Cardiovascular Surgery PeaceHealth Southwest Medical Center Vancouver, Washington Contributors/Consultants vii https://kat.cr/user/Blink99/ Katherine Schneider, RN, CNOR RN Surgical Specialist─Neurosurgery PeaceHealth Southwest Medical Center Vancouver, Washington Jack Som, RN RN Surgical