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Instruments and Implants in Hand Surgery
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
Anil K Bhat, Ashwath M Acharya, Mithun Pai G
1.Mayo scissors: These are heavy scissors available in multiple designs. Straight scissors are used for cutting sutures (“suture scissors”), while curved scissors are used for cutting heavy tissue (e.g. Fascia) (Figure 15.4A).Metzenbaum scissors: These are lighter scissors used for cutting delicate tissues and for blunt dissection (Figure 15.4B).
Reoperation for hyperparathyroidism
Published in Demetrius Pertsemlidis, William B. Inabnet III, Michel Gagner, Endocrine Surgery, 2017
Masha J. Livhits, Michael W. Yeh
The third step is identification of the RLN. This is best accomplished in an “outside-in” fashion using the trachea and carotid sheath as the main landmarks. We perform almost all of this dissection sharply with the Metzenbaum scissors. The surgeon should be opportunistic at this stage, pursuing relatively less scarred areas first and then exploiting these areas to gain safe access to more intensely scarred areas as necessary. These windows of opportunity for safer dissection are individual for each case. The surgeon can deduce where the bulk of the initial surgery was performed by the intensity of the scar tissue. The reoperation should deliberately be focused away from those areas initially. We often accomplish this by starting very inferiorly in the neck and identifying the RLN at the level of the thoracic inlet, and then tracing it superiorly into the scarred field.
Adhesiolysis
Published in P Ronan O’Connell, Robert D Madoff, Stanley M Goldberg, Michael J Solomon, Norman S Williams, Operative Surgery of the Colon, Rectum and Anus Operative Surgery of the Colon, Rectum and Anus, 2015
Dissecting and dividing adhesions with scissors is the most popular technique with surgeons using Metzenbaum scissors, with some preferring the more robust curved Mayo scissors (Figure 4.5.3a). There is a potential for harm with the long-handled Metzenbaum when using the ‘opening’ technique to develop a plane as excessive traction forces may be applied to the tissues by virtue of the mechanical advantage effect created by the long handles and short blades with the fulcrum closer to the blades, which may result in tissues being torn, especially the friable bowel wall (Figure 4.5.3b). Using the scissors closed in a pushing manner may be as effective. The author uses scissors for dissection deep in the pelvis but, again, will use an irrigation technique with a pool sucker in close proximity. The author uses diathermy in preference to scissors for superficial easy accessible adhesions as the heat generated by the diathermy opens up tissue planes, with similar principles to irrigation, in that the gas can open up the planes between loops of small bowel and aid with better visualization of the serosa of the bowel in the dissection process.4
Utilization of Perifascial Loose Areolar Tissue Grafting as an Autologous Dermal Substitute in Extremity Burns
Published in Journal of Investigative Surgery, 2023
Burak Özkan, Burak Ergün Tatar, Abbas Albayati, Cagri Ahmet Uysal
A 5-cm-long incision was made 2 to 3 cm superior to the inguinal crease from the medial to the lateral side. Superior and deep fascial layers were dissected until the rich areolar vascular layer over the rectus fascia was visualized (Figure 1). An incision was made to the PAT without lacerating the rectus and external oblique muscle fascia. PAT grafts can be elevated superiorly or inferiorly depending on the defect. Surgical retractors were placed according to the direction of harvesting. Nontraumatic forceps were used to handle the PAT. Metzenbaum scissors or low-energy cautery was used to harvest the PAT graft. Perforator vessels raised from the fascia were carefully cauterized. Meticulous dissection was performed to harvest the PAT graft en bloc. Harvesting from the opposite direction without making an excessive skin incision was performed when a bigger PAT graft was needed. A suction drain was placed, and the skin was closed in layers after the graft was harvested.
Long-Term Management of Vascular Access Ports in Nonhuman Primates Used in Preclinical Efficacy and Tolerability Studies
Published in Journal of Investigative Surgery, 2020
Lucas A. Mutch, Samuel T. Klinker, Jody J. Janecek, Melanie N. Niewinski, Rachael M. Z. Lee, Melanie L. Graham
The simple instrument tray used at our center for VAP placement is shown in Figure 1. This tray includes: a scalpel with 11 and 15 blades; a mayo scissors; a blunt and fine Metzenbaum scissors; Mixter, medium, small, and small fine clamps; Adson and DeBakey tissue forceps; and a fine needle driver.
Selective block of grey communicantes in upper thoracic sympathectomy. A feasibility study on human cadaveric specimens
Published in British Journal of Neurosurgery, 2020
Vicente Vanaclocha, Nieves Sáiz Sapena, Marlon Rivera, Juan Manuel Herrera, José María Ortiz-Criado, Ana Monzó-Blasco, Ricardo Guijarro-Jorge, Leyre Vanaclocha
The sympathetic chain and the grey rami communicantes could be identified under the pleura (Figure 3). The pleura could be easily incised with right angle monopolar hooks. The pleural opening and grey rami communicantes dissection could be achieved with endoscopic Metzenbaum scissors.