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    Suturing Workshop

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    Marganda Apul Pardede
    Vascular surgery encompasses the diagnosis and management of disorders of the arterial, venous, and lymphatic systems, excluding the intracranial and coronary arteries. Vascular surgeons must possess advanced knowledge and skills to provide comprehensive care for patients with vascular diseases. This includes techniques for open and endovascular treatment of various vascular disorders, from occlusive diseases to aneurysms and trauma. Key skills include arterial and venous bypass procedures, endarterectomy, angioplasty, vascular access procedures, and the emergency treatment of conditions like aneurysms and limb ischemia.

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    Suturing Workshop

    Uploaded by

    Marganda Apul Pardede
    9 views24 pages
    Vascular surgery encompasses the diagnosis and management of disorders of the arterial, venous, and lymphatic systems, excluding the intracranial and coronary arteries. Vascular surgeons must possess advanced knowledge and skills to provide comprehensive care for patients with vascular diseases. This includes techniques for open and endovascular treatment of various vascular disorders, from occlusive diseases to aneurysms and trauma. Key skills include arterial and venous bypass procedures, endarterectomy, angioplasty, vascular access procedures, and the emergency treatment of conditions like aneurysms and limb ischemia.

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    Suturing-Workshop

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    Vascular surgery encompasses the diagnosis and management of disorders of the arterial, venous, and lymphatic systems, excluding the intracranial and coronary arteries. Vascular surgeons must possess advanced knowledge and skills to provide comprehensive care for patients with vascular diseases. This includes techniques for open and endovascular treatment of various vascular disorders, from occlusive diseases to aneurysms and trauma. Key skills include arterial and venous bypass procedures, endarterectomy, angioplasty, vascular access procedures, and the emergency treatment of conditions like aneurysms and limb ischemia.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    9 views24 pages

    Suturing Workshop

    Uploaded by

    Marganda Apul Pardede
    Vascular surgery encompasses the diagnosis and management of disorders of the arterial, venous, and lymphatic systems, excluding the intracranial and coronary arteries. Vascular surgeons must possess advanced knowledge and skills to provide comprehensive care for patients with vascular diseases. This includes techniques for open and endovascular treatment of various vascular disorders, from occlusive diseases to aneurysms and trauma. Key skills include arterial and venous bypass procedures, endarterectomy, angioplasty, vascular access procedures, and the emergency treatment of conditions like aneurysms and limb ischemia.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 24

    Vascular

    Surgery
    Concept :
    Suite & Tie
    Bedah Vaskular

    yang
    Definition of Vascular Surgery

    Vascular surgery encompasses the diagnosis and


    comprehensive, longitudinal management of
    disorders of the arterial, venous, and lymphatic
    systems, exclusive of the intracranial and coronary
    arteries

    Vascular Surgery Board of the American Board of Surgery


    Ahli Bedah Vaskular
    Suite and duty
    • vascular surgeons should possess the advanced knowledge and skills to
    provide comprehensive care to patients with vascular disease.
    • All elements of clinical evaluation; non-invasive testing including
    plethysmography, duplex ultrasonography, magnetic resonance imaging, CT
    scans, angiography, and other diagnostic tests utilized in the diagnosis of
    vascular disease.
    • Comprehensive management of vascular disease to include screening and
    surveillance, medical management, drug therapy, risk factor management,
    wound management including amputations, and other adjunctive procedures.
    • Indications and techniques relating to open and endovascular treatment of
    vascular disorders to include the entire spectrum of interventions used to treat
    vascular disorders including occlusive, aneurysmal, inflammatory disease,
    trauma, and neurovascular compressive syndromes involving the arteries and
    veins of the body (excluding the intracranial and coronary arteries).  This
    includes the aorta and its branches, the arteries of the neck, pelvis and upper
    and lower extremities, and the venous system.
    • The critical care of the vascular surgery patient.
    Procedural Skills (Surgical DOPS) and
    Procedure Based Assessments (PBAs).
    Aortic aneurysm Upper Limb
     Elective open repair tube graft  Brachial artery embolectomy
     Elective open repair bifurcated graft
     Endovascular repair Re-do Vascular Surgery
     Ruptured aneurysm repair  Removal of infected graft

    Carotid endarterectomy Varicose vein surgery


     Sapheno-femoral and sapheno-popliteal ligation.
    Infra-inguinal bypass  Endovenous LSV and SSV ablation
     Above knee run-off  Foam injection sclerotherapy
     Below knee popliteal run off
     Calf vessel run off Vascular access
     Popliteal artery exclusion bypass  AV fistula at wrist, upper arm
     Revision of failed AV fistula
    Emergency Lower Limb
     Femoral Embolectomy
    Vascular Surgery Curriculum, ISCP the Royal College of
     4 compartment fasciotomy Surgeons of UK and Ireland, Aproved by GMC, 2018
     Repair of false femoral artery aneurysm
    Technical skills in patient assessment and treatment

    a. Generic Vascular Ultrasound Skills


    i. B mode ultrasound, spectral Doppler and colour duplex
    ii. aortic ultrasound
    iii. ultrasound guided vascular access
    b. Generic Endovascular Skills
    i. the safe use of guidewires, sheaths and catheters
    ii. the exchange principle
    iii. available intervention options
    iv. cannulation for access
    v. guidewire manipulation
    vi. angiography
    vii. angioplasty
    c. Generic Open Vascular Surgery Skills
    i. patch angioplasty
    ii. end to side anastomosis
    iii. proximal aortic anastomosis
    Generic Open Vascular Surgery Skills

    i. patch angioplasty
    ii. end to side anastomosis
    iii. proximal aortic anastomosis
    1. Arteriotomi melintang
    2. Arteriotomi longitudinal
    3. Jahitan kontinyu vaskular
    patch angioplasty
    patch angioplasty
    Pitfall
    end to side anastomosis
    end to side anastomosis
    end to side anastomosis
    memakai graft vaskular
    End to End anastomosis

    Tehnik anastomosis dengan benang polypropylene 7–0 atau 8–0


    untuk anastomosis end-to-end

    David V Feliciano Trauma Surg Acute Care Open 2017


    End to End anastomosis

    Usahakan untuk ARTERI


    jahitan dari DALAM-ke-LUAR
    Sisi
    Vena
     untuk mencegah disekasi
    atau intima.
    protesa
    Setelah 1/3 dari end-to-end anastomosis selesai, tarik kedua ujung benang sampai rapat
    kedua permukaannya sambil klem didekatkan satu sama lain.

    David V Feliciano Trauma Surg Acute Care Open 2017;2:e000110


    Lanjutkan penjahitan bagian anterior dan biarkan kedua ujung terakhir tetap kendor untuk
    melakukan flushing darah menjamin aliran yang lancar .

    David V Feliciano Trauma Surg Acute Care Open 2017;2:e000110


    Tehnik alternatif untuk anastomosis End-To-End :
    1. Bisa mulai dengan mengikat kedua ujung
    2. Lanjut jahitan kontinyu
    3. Anastomosis selesai  ikatan asa dikedua ujung
    4. Melebarkan tepi anastomosis : irisan longitudinal
    5. Lanjut jahitan kontinyu tanpa mengikat kedua ujung
    Side to side anastomosis
    Castroviejo
    Needle holder
    Anjuran : ikat semua cabang, jangan diathermi
    Vascular
    clips
    Terimakasih atas perhatiannya

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