Basic Surgical Techniques
2020/2021 Academic Year Second Semester
Location: Online (Zoom – link on Moodle)
16/February Andrea Ferencz: Introduction and the curriculum of the department. The structure and equipments of the operating room.
23/February József Sándor: Asepsis, antisepsis, desinfection. Surgeon in the operating room. Prevention of Surgical Site Infection (SSI).
2/March Andrea Ferencz: Basic surgical tools and suture materials.
9/March Andrea Ferencz: Basic and special suturing techniques in surgery.
16/March Györgyi Szabó: Classification and management of wounds, principle of wound-healing. Haemorrhage and bleeding control.
23/March Masashi Yoshida MD, PhD: Surgical procedures: acute, elective. Preoperative patient management. Surgical approaches.
30/March József Sándor: Basics of laparoscopic surgery.
Each group has seven practices in the semester, so you have to attend the course every second week. (Week ’A’ starts the Semester)
The topics of the practices:
- Basic suturing techniques on the skill models (simple interrupted suture). Basic surgical instruments and their usage.
- Getting acquainted with the operating room, rules and behavior in the operating room, scrubbing-in and preparation of the surgical field. Knotting techniques.
- Basic suturing techniques on ex-vivo animal model (interrupted sutures).
- Basic suturing techniques on ex-vivo animal model (continuous sutures).
- Demonstration of the laparoscopic tower and instruments.
- Practicing eye-brain-hand coordination and fine hand movements using a laparoscopic pelvitrainer.
- Practical exam
PLEASE NOTE! During each course proper nail hygiene is necessary (fingertip-high nails). In addition, use of nail-polish, artificial nails, any jewelry, including watches are prohibited. Offenders of this policy will take part in the practice but this will be an absent.
This is the correct version of the Schedule
The following practices should be retaken after consultation with you teacher:
University day: 13th April
Week ’A’ Tuesday, 5th practice – Gr. 5 and 7
Presence-absence at the practices
Presence-absence at the practices
„Basic surgical techniques” practices will be held seven times during the semester. The attendance is mandatory for each practice. The presence will be regularly checked and documented by the Department. EVERYBODY SHOULD VISIT THE GROUP PRACTICES IN WHICH HE OR SHE IS REGISTERED IN THE NEPTUN. Due to the fact that the capacity of the Operating Lab is limited it is not allowed to have more than 12 students in a group – 10 registered place + 2 free place for re-taking the missed practice. The number of missed practices and lectures may not exceed more than 25%. That means only ONE absence is acceptable during the semester. If any student misses two or more practices, the Department will refuse to sign the subject. Due to the limited capacity of the Operating Lab, only one absence can be repeated during the semester after registration (HERE) by joining another group.
Everybody should register for himself/herself. We do not register anybody!
Practice location From the 1st to 4th and the 7th practices are taking place in the Operating Lab (OL) in the NET building. OL is accessed from the Main Hall of the NET. Follow the signs down by the stairs. The 5th and the 6th practices will be held partly in the 1st Seminar room (gathering at OL).
Security and lost objects
Security and lost objects
At the first lesson, students will acknowledge in writing that they understand and accept the rules and regulations of the labor safety and fire service during the surgical practices. In the Operating Lab lockers are available to place all values. The Experimental Surgical Department recommends to practice vigilance and you must not leave your personal values – such as jeweler, watches or others – in unsafe areas or accidentally in the pockets of the scrubbing suits. The department and its management cannot be reliable for the lost or stolen items. On the other hand, if anything is being lost or misplaced, you may contact: Ibolya Schum and Karolina Csépke assistants (NET, Operating Theatre, Phone: tel:+36-1-459-1500 ext.: 56378; email: email@example.com)
The lost and found objects will be stored by the end of the semester. If nobody comes for them, they will be offered!
The textbook, the lectures, the practices and the videos give the basic knowledge for the exam.
The colloquium comprises of two parts:
1. a practical – and 2. a theoretical part
- Practical exam
The minimum test is deleted. For each group it will be during their 7. practice.
Stations (tasks) of it:
- Scrub-in, gowning and gloving
- Basic surgical intruments
- Hand-tie knots
- Suture in ex vivo tissue interrupted and continuous)
- Laparoscopic instruments
- Pelvitrainer exercise
If someone gets 0 points for both scrub-in-gowning-gloving and for suture stations the exam is finalized, she/he is failed.
- Theoretical exam will be a written test in the exam period.
Expected knowledge of the following topics:
List the periods of the history of surgery! What were the milestones!
When was the “Ether Day”? Who did and what on this day?
When and by whom was the chlorine water handwashing introduced? What were his findings?
Who created the “antiseptic theory”?
Who introduced the antiseptic theory?
Name 4 surgical instruments which refer to doctors involved in the development of surgery!
What does the acronym “NOTES” mean?
What is the definition of surgical intervention?
What do the septic and aseptic operating theatres stand for?
How shall the staff and the patient enter the operating room?
Describe the structure of the operating room!
List 8 equipments /instruments within the operating room!
Explain the rules of behavior in the operating room!
Describe the general rules of the aseptic operating room!
Explain the definition of asepsis!
Explain the definition of antisepsis!
How to prevent the evolution of postoperative wound infections before the surgery?
How to prevent the evolution of postoperative wound infections during the surgery?
How to prevent the evolution of postoperative wound infections after the surgery?
What is the definition of sterilization!
What is the definition of disinfection!
Explain the steps of the two-phase surgical hand scrub!
What is the purpose of isolation? How do we do it?
List the basic surgical instrument groups!
What is the function of the dissecting instruments? List some of these dissecting instruments!
Explain the use of electric/diathermy knife! What kind of diathermy knifes do you know?
Is it accepted to use electric knife on patients with pacemaker?
What do you know about the ultrasonic cutting device?
Name the non-locking grasping instruments! Explain their functions!
List organ clamps!
List the hemostatic instruments! Explain their functions!
List the retracting instruments! Explain their functions!
What do you know about the CT and MRI examination of patient carrying metallic clips?
What is the Steri-Strip? When to use it?
List special instruments!
Describe the conventional (close-eye, French-eyed) needles!
Describe the atraumatic needles!
What are the main groups of the circular needles?
Explain the difference between conventional and reverse cutting needles!
What are the main characteristics of the surgical suture materials?
What are the advantages and disadvantages of natural and synthetic suture materials?
What does the term “thread memory” stand for?
What are the advantages of monofilament threads?
What are the disadvantages of multifilament (twisted or braided) threads?
Which one is better: monofilament or multifilament thread?
List the advantages and disadvantages of natural suture materials!
List the advantages and disadvantages of synthetic suture materials!
Describe the enzymatic and hydrolytic absorption processes of suturing materials!
What do you know about the size classification of the suturing materials?
What do you know about the simple interrupted suture?
What do you know about the vertical mattress suture?
Where do we use the simple continuous suture line?
Where do we use the purse-sting suture?
When it is suggested to remove the stitches? What are the influencing factors?
What is a wound?
What areas are injured in case of a simple wound?
What areas are injured in case of a compound wound?
What kind of wounds do you know based on their origin?
List the wounds of mechanical origin!
What do you know about the incised wound?
What do you know about the shot wound?
Classify the wounds according to bacterial contamination?
What does the primary wound managements stand for?
What does the term „primary delayed suture” stand for?
What is the „early secondary wound closure”?
What is the „late secondary wound closure”?
What holding positions of the scalpel do you know?
Describe the phases of wound healing!
What is happening in the granulation-proliferation phase of wound healing?
What is happening in the remodeling phase of wound healing?
Describe the types of wound healing!
List the influencing/delaying factors of wound repair!
What early complications of wound healing do you know?
What are the characteristics of the seroma?
What are the characteristics of the hematoma?
What are the characteristics of the wound disruption?
What forms of superficial wound infection do you know?
List the local and general symptoms of wound infection!
What are the late complications of wound healing?
What are the characteristics of hypertrophic scar?
What are the characteristics of keloids?
What is hemostasis and what are the factors of it?
What are the characteristics of diffuse bleeding?
What could be the direction of bleeding from clinical point of view?
What methods of surgical haemostasis do you know?
List the mechanical methods of surgical haemostasis!
List haemostatic methods based on thermal effects!
What are the mechanisms of haemostasis based on chemical and biological materials?
Give examples of vital, absolute, and relative indications!
What are the components of surgical risk?
What factors increase surgical risk?
What should be examined before the operation to estimate the surgical risk? Why does obesity increase surgical risk?
List the organs and systems whose preoperative examination is essential from the point of view of the assessment of surgical risk!
What can be applied for thrombosis prophylaxis during pre-, and postoperative phase?
List the forms of vertical laparotomy!
List the forms of transverse and oblique laparotomy!
What abdominal approaches would you suggest in case of open cholecystectomy, appendectomy, or gynecological surgery?
What do you know about the muscle-splitting incisions? What are the advantages and disadvantages?
What does thoracolaparotomy mean? When it is used?
What are the disadvantages of open surgery?
What are the advantages of laparoscopic surgery?
What does pneumoperitoneum mean?
What kind of gas can be used for pneumoperitoneum?
Introduce the usage of the Veress needle!
How and on what level of pressure can the pneumoperitoneum be used safely?
What type of telescope is popular in laparoscopy?
What do you know about the laparoscopic light sources?
List the difficulties of the laparoscopic technique!
How would you describe the main characteristics of patient safety in ambulatory surgery?
What are the contraindications of ambulatory surgery?
The results of the practical (maximum 60 points) and theoretical exam (maximum 40 points) is summarized.
0-59,99 points: failed (1)
60-69,99 points: satisfactory (2)
70-79,99 points: moderate (3)
80-89,99 points: good (4)
90-100 points: excellent (5)