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OPERTION THEATRES
PRESENTED BY
MR.ROMAN BAJRANG
RELIANCE INSTITUTE OF NURSING
INTRODUCTION
Opertion room or opertion theatres (O.T .) as the name
suggests are the units in health care organsation which are
concerned with manifalation of human bodies for the purose of
tretment or dignosis of health disorders this they can be
considerder the areas in the hospital where operation surgeries
or operative procedures can be perfiormed either for dignostic
or tratment purpose . The operation theaters usually have
special units attached to them as pre and post operative
recoveries for care of the patients immediately before and affter
the surgery . Operating room are large lightet and easy to clean
rooms with typical overhead surgical light with special viveing
scrooms and monitars operating room generally do not have
window to create easy air conditioning and have a controlled
temperture .
CLASSIFICATION OF OT
1. Extent of surgery involved
2. Types of service provided
3. Sharing of OT
4. Urgency situation
a.Minor OT
b.Major OT
1. Extent of surgery involved
A. Minor OT :- There are the OT in which simple procedures such as suturing ,
dressing , easling minor debridements may be oerformed most of these are
operated under local anesthesia .
B. Major OT :- There are well equipped with all the arrangements for general
and spinal on anesthesia required for surgeries The Extebsive surgeris involving
deep tissue are performed here .
a. Out patient OT
b. Inpatient OT
2. Type of service provided
A. Outpatients OT :- May be located in the out patient department and
involves .The surgeries performed on outpatient basis usually they are minor
surgeries performed under local anaesthesia .
B. Inpatient OT :- In a hospital are usually used for in patients They are
usually located away form the outpatient department however some out patient
procedure requiring short stay may be perfarmed in patient OT .
A. Decentrlized
 Neurosurgery
 Orthopedic
 ENT OT
 Eye OT
 General surgery
 Gynec
 Renal
 Plastic OT
 Renal / urology OT
 Transplant OT
 Rediotherapy OT
B . Centralized
3. Sharing of OT
A. Decentrlized :- One means there are several operation theaters each
dedicated to particular surgical specially or localed near the specially
department for Example :-
 Neurosurgery
 Orthopedic
 ENT OT
 Eye OT
 General surgery
 Gynec
 Renal
 Plastic OT
 Renal / urology OT
 Transplant OT
 Rediotherapy OT
B . Centralized:- One means There as only one OT complex in the entre hospital
in one location shared by the different surgical specialies .
4. Urgency situation
A. Emergency OT
B. Elective OT
A. Emergency OT :- Thers OT are concerned with surgerise to be informed in
care of on Emergency These OT function like Emergency and have to be ready
all the time to hondle and surgery which is to be performed urgently .
B. Elective OT:- These are regular OT of hospital in which the routine planned
surgeris are performed as per the list of patients diedided at last one day prior to
the surgery .
STAFFING OF OT
The staffing can be measured in many
ways,
1. Number of hours worked .
2. Hours associated with direct
patient care.
3. Workload calculation.
Design
Major operating room
Recovery room
Sub sterilizing area
Sterile instruments supply and storage
Scrub area
Clean up area
Male dressing room
Female dressing room
Nurse station
Wheeled stretcher area
Benefits of good staffing
1. Improves patient outcome
2. Lowers mortality rate
3. Increase OT efficiency
4. Reduce patient wating time for
surgery
5. Balance workload
Essentials required for OT
1. Location with in the hospital
2. Quantity
3. Size
4. Design
5. Equipment required
OT staffing is based on
1. Total number of hours of cases
2. Number of cases operated per day
3. Type of cases
4. Nature of cases
5. Prescribed norms and policies and procedures
Policies of OT
1. Functions of OT .
2. Duties and responsibilities of doctors and nurses
and technicians .
3. Checklist for preparing OT for surgeries .
4. Manitenance of records of surgeries .
5. Methods of aseptic techniques should be followed .
6. Maintenance of sterility in different zones .
7. Disposal of Medical waste .
Staffing pattern of OT
OT in charge
Operating staff Support staff Nursing staff
Procurement
Nurse
TechniciansPerfutionist
Chief
surgeon
Supporting
surgeon
Anesthetist Circulating
Nurse
Helpers Scrub
Nurse
Members of OT Team
1. OT in charge .
2. Operating consultant .
3. Collaborating surgeons .
4. Scrub nurse .
5. Circuiting nurse .
6. Anaesthetists .
7. Percussionist .
8. OT technicians .
9. Pre recovery staffs .
10.Post recovery staffs .
11. Sterillzation staffs .
12. Store keeper .
13. Helping staffs .
1. Pre operative check for the availability of the
materials for surgery .
2. Psychological preparation of the patient .
3.Follow correct aseptic techniques.
4.Positioning of the patient .
 Proper administrtion of medications as per policies .
 Delivering of high quality patient care .
 Nursing care based on EBP.
 Participate in risk assessment and reporting .
 Assess, plan , implement and evaluate care .
 Manitaining of resources.
 Organize and prioritize the workload .
 Support other staffs in maaintaining health .
General Principles
All staffs must
change to OT
attire
Aware of the dress
Policy
Must change
The attir if
Any soiling
occur
No one should go out after
change into OT attire
Focuses on
maintainng
Asepsis
Safety spectacles should be worn required
General Principles
1. All the ot staff and the patient most into OT attine on
enntering zone –I .
2. OT attine most inculude the OT pont shirts shoes or
slippers, cap mask and gown .
3. Any part of the OT attire must be changet when they are
visibly soiled .
4. No person should more should out of the OT area after
from the OT stock .
5. As for as possible the OT attire stok should have all sizes to
sait the needs of different people .
6. The discorded OT attire should be mored out of the OT
area as early as possible .
7. The discorded OT attire should be mored out of the OT
area as early as possible .
8. The OT room should focus on maintaining asepsis .
9. Adeauate and suitable and changing focitifs should be
provided for staff clothing and the atre attire .
10 . There should be adeuate provision for disposal of soiled
linen within changing room after daily use or if
contaminated before and end of shift reusable surgical attire
should be sent for loundering .
11. Safety spectalles or goggles mast be warm when it is
appropriatc .
1. All personnel in the operating suite stquled wear sterile gowns over the
OT suit while performing as a member of the operating team.
2. Gown should be changed immediately if it is soiled with blood or fluids
during surgery .
3. The procedure of wearing gown should be followed as per the
organization protocol .
1. Hair can be a sources of contamination so use of caps in the OT should
be mandatary .
2. The cap should cover all the hair completely .
3. If the cap has ties it the back they should be lied securely to avoid cap
faling during surgery .
4. Veiled personed should remove their vesils and put on asleril cover .
Air conditioning unit 1
Anaesthesia macnine 1
C/S set 1
Instrument table 1
Laparotomy set 1
Laryngoscope 1
OR light 1
OR table 1
Oxygen unit 1
Spinal set 1
B P apparatus adult 1
B P apparatus paediatric 1
Stethoscope 1
Suction apparatus 1
Wheeled stretcher 1
Operation theater zones
Zone 1
Zone 2
Zone 3
Zone 1
Also called as outer zone and unsterile zone or non
restricted zone or interchange area .
This zone avoids the exposure to
contaminated areas after changing to surgical
attire .
Zone 2
Also called as middle intermediate zone or semi
restricted area and should be in – between two
zones .
This should be large to receive supplies for
surgery .
Zone 3
Also called as inner most or most sterile area or
restricte zone .
SUTURES
SUTURES
Sutures are the theads used to dose
interrupted surface caused because of injury wound as surgical incision
anti healing occurs skill fal Clasure requrie not only the knowledge of
surgical procedues but also the knowledge of physical characteristics
and properties of the sutures and the needle a Numbers of different
shapes, sizes and thread materials are used in the surgery .
Criteria for the setection of sutures :-
1) Surgen perference .
2) Ansthetic healing .
3) Speed of healing.
4) Tissue contamination
5) Tension destred in wond closure .
6) Cost and ovailabitity .
SUTURES
The word “ suture “ describes any strand of material used to ligate (tie)
blood vessels or approximate ( sew ) tissues .
CLASSIFICATION OF SUTURES :-
 Absorbable / Nonabsorbable
 Natural / Synthetic
 Braided / Monofilament
Criteria for selection of suture
Surgeon
preference
Tissue contamination
Speed of
healing
Cost &
availability
Tension desired in wound healing
Aesthetic concern
1 . Essentials of sutures :-
 should be uniform throughout the lenglue ovoid breaking points .
 Should have good tensile strenght & elasti .
 Should be cost effective .
Suture are basically of two types :-
1) Absorbale suture
2) Non Absorbale suture
Types of suture
1) Absorbale suture :- These stures are usually made of tenton or foscia and
this gets absorbed into the tissue after a few .
2) Non Absorbale suture :-
1. These suturs the are on the skin and this have to be removed menually after the
incision heals .
2. On the basis of rew materials origin the suture may be also classified as :-
a. Natural :- The suture threds derived from collogen from momation in
teslines Examples of this types of suture are skil and cotgut .
b. Synthetic sutures :- These sutures are synthesized from non natural
saurcesexpet catgut and silk nerary all the ovoilable sutures can be considered
asx synthetic sutures .
3. On the basis of material & strure can be divided as monfilanent and
multifilament .
a. Manofilament :- These stures have single fibers or filaments Extending
throughat the length of the stures .
b. Multifilament :- These sutures are made up of multiple filomments
ossembled in different ways .
Types of suture
Absorption Meterial sturucture Material origin
Non
Absorption
Monofilament Multifilament Natural Synthetic
1. Polyglyctic 1. Silk
Acid 2. Catgut
3. Nylon
4. Polyster
2. Catgut
3. polydixone
1. Catgut 1. Polygly
cactin
2. Nylon 2. Polyester
silk
3. Stainless steel
4. Polypropylne
1. Silk 1. all other
2. Catgut available
suture
Absorption
Suture Tecniques
Interupting suturs Continuous
suturs
Mattress
suturs
Simple Sub
cuticular
Running Running
Intra dermal cuticular
pull out
Simple Interrupted
Sub cuticular
Continuous Stures
Running cuticular
Mattress suture
SURGICAL NEEDLES
• Surgical needles are necessary for the placement of sutures in Tissues
• NEEDLE ANATOMY :-
 Swage
 Body
 Point
NEEDLE SWAGE
Classification by the needle swage :-
• 1. Closed Eye
• 2. French Eye
• 3. Swage
INSTRUMENTS
Instrument is specially designeed lod or device for perfroming
specific action of carrying out desired Effects during a surgery or operation such
as modifying biological tissue or to provide access for viewing it .
Types of Instruments :-
1. Araspery such as forceps .
2. Petroctore used to sperad open skin ribs and other tissue .
3. Dilatons and specula for occess to narrow passage or incisions .
01 ). forceps :- Are a scisssor like instrument used almost in every surgery The
word forceps is derived from the latin word forca which menas a snare of trop .
Purposes of forceps :-
 To grip Tissue and wals of organe .
 To grosp suture needles without cousing damaged .
 Surgical forceps can mainpulate delicate T issue in the affected area .
 Forceps assist in the delivery of a body
There are two basis types of forceps :-
o Non locking forceps
o Locking forceps
Non loking forceps
These forceps are generaling called thumb perfrom these forceps
come in two forms hinged at one end away from the grosping end and
higed in the middle like scissore .
Locking forceps
These are hinged in the middle and have the provision of locking
like grop in aloved postion to help in manipulation or to indeppendentiy grosp
clamp or hoid on white the surgery is beging performed .
Some other commanly used name for forceps :-
Athought the basic function and structers is same they are used for
vairous function with same minor modification here are few categogires
that are commonly used.
• Anesthesia forceps.
• Artery forceps .
• Atroumtic forceps.
• Biopsy forceps .
• Bone forceps .
• Bone cuting forceps .
• Bone holding forceps.
• Catheter forceps.
• Cushing forceps.
• Dermal forceps & Nipplers.
• Derssing forceps .
• Ear forceps.
• Eye forceps .
• Gall bladder forceps .
• Hemostaic forceps .
• Hybterectomy forceps .
• Intestinal forceps.
• Micro surgery forceps.
• Nasal forceps .
• Obstetrical forceps.
• Post mortem forceps.
• Splinter forceps.
• Sponge forceps.
• Sterilizer forceps.
• Suture sundries forceps .
• Tenocalam forceps .
• Thorocis forceps .
• Thorocis surgical forceps.
• Thumb forceps .
• Tissue forceps.
• Tonge forceps .
• Tooth Extraching forceps.
• Tubing forceps.
• Vterine forceps.
QUESTIONS
???
Ot setup

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Ot setup

  • 1.
  • 2. OPERTION THEATRES PRESENTED BY MR.ROMAN BAJRANG RELIANCE INSTITUTE OF NURSING
  • 4. Opertion room or opertion theatres (O.T .) as the name suggests are the units in health care organsation which are concerned with manifalation of human bodies for the purose of tretment or dignosis of health disorders this they can be considerder the areas in the hospital where operation surgeries or operative procedures can be perfiormed either for dignostic or tratment purpose . The operation theaters usually have special units attached to them as pre and post operative recoveries for care of the patients immediately before and affter the surgery . Operating room are large lightet and easy to clean rooms with typical overhead surgical light with special viveing scrooms and monitars operating room generally do not have window to create easy air conditioning and have a controlled temperture .
  • 5. CLASSIFICATION OF OT 1. Extent of surgery involved 2. Types of service provided 3. Sharing of OT 4. Urgency situation
  • 6. a.Minor OT b.Major OT 1. Extent of surgery involved
  • 7. A. Minor OT :- There are the OT in which simple procedures such as suturing , dressing , easling minor debridements may be oerformed most of these are operated under local anesthesia . B. Major OT :- There are well equipped with all the arrangements for general and spinal on anesthesia required for surgeries The Extebsive surgeris involving deep tissue are performed here .
  • 8. a. Out patient OT b. Inpatient OT 2. Type of service provided
  • 9. A. Outpatients OT :- May be located in the out patient department and involves .The surgeries performed on outpatient basis usually they are minor surgeries performed under local anaesthesia . B. Inpatient OT :- In a hospital are usually used for in patients They are usually located away form the outpatient department however some out patient procedure requiring short stay may be perfarmed in patient OT .
  • 10. A. Decentrlized  Neurosurgery  Orthopedic  ENT OT  Eye OT  General surgery  Gynec  Renal  Plastic OT  Renal / urology OT  Transplant OT  Rediotherapy OT B . Centralized 3. Sharing of OT
  • 11. A. Decentrlized :- One means there are several operation theaters each dedicated to particular surgical specially or localed near the specially department for Example :-  Neurosurgery  Orthopedic  ENT OT  Eye OT  General surgery  Gynec  Renal  Plastic OT  Renal / urology OT  Transplant OT  Rediotherapy OT B . Centralized:- One means There as only one OT complex in the entre hospital in one location shared by the different surgical specialies .
  • 12. 4. Urgency situation A. Emergency OT B. Elective OT
  • 13. A. Emergency OT :- Thers OT are concerned with surgerise to be informed in care of on Emergency These OT function like Emergency and have to be ready all the time to hondle and surgery which is to be performed urgently . B. Elective OT:- These are regular OT of hospital in which the routine planned surgeris are performed as per the list of patients diedided at last one day prior to the surgery .
  • 15. The staffing can be measured in many ways, 1. Number of hours worked . 2. Hours associated with direct patient care. 3. Workload calculation.
  • 16. Design Major operating room Recovery room Sub sterilizing area Sterile instruments supply and storage
  • 17. Scrub area Clean up area Male dressing room Female dressing room Nurse station Wheeled stretcher area
  • 18. Benefits of good staffing 1. Improves patient outcome 2. Lowers mortality rate 3. Increase OT efficiency 4. Reduce patient wating time for surgery 5. Balance workload
  • 19. Essentials required for OT 1. Location with in the hospital 2. Quantity 3. Size 4. Design 5. Equipment required
  • 20. OT staffing is based on 1. Total number of hours of cases 2. Number of cases operated per day 3. Type of cases 4. Nature of cases 5. Prescribed norms and policies and procedures
  • 22. 1. Functions of OT . 2. Duties and responsibilities of doctors and nurses and technicians . 3. Checklist for preparing OT for surgeries . 4. Manitenance of records of surgeries .
  • 23. 5. Methods of aseptic techniques should be followed . 6. Maintenance of sterility in different zones . 7. Disposal of Medical waste .
  • 25. OT in charge Operating staff Support staff Nursing staff Procurement Nurse TechniciansPerfutionist Chief surgeon Supporting surgeon Anesthetist Circulating Nurse Helpers Scrub Nurse
  • 27. 1. OT in charge . 2. Operating consultant . 3. Collaborating surgeons . 4. Scrub nurse . 5. Circuiting nurse . 6. Anaesthetists . 7. Percussionist . 8. OT technicians . 9. Pre recovery staffs . 10.Post recovery staffs . 11. Sterillzation staffs . 12. Store keeper . 13. Helping staffs .
  • 28.
  • 29. 1. Pre operative check for the availability of the materials for surgery . 2. Psychological preparation of the patient . 3.Follow correct aseptic techniques. 4.Positioning of the patient .
  • 30.  Proper administrtion of medications as per policies .  Delivering of high quality patient care .  Nursing care based on EBP.  Participate in risk assessment and reporting .  Assess, plan , implement and evaluate care .  Manitaining of resources.  Organize and prioritize the workload .  Support other staffs in maaintaining health .
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  • 35. General Principles All staffs must change to OT attire Aware of the dress Policy Must change The attir if Any soiling occur No one should go out after change into OT attire Focuses on maintainng Asepsis Safety spectacles should be worn required
  • 36. General Principles 1. All the ot staff and the patient most into OT attine on enntering zone –I . 2. OT attine most inculude the OT pont shirts shoes or slippers, cap mask and gown . 3. Any part of the OT attire must be changet when they are visibly soiled . 4. No person should more should out of the OT area after from the OT stock . 5. As for as possible the OT attire stok should have all sizes to sait the needs of different people . 6. The discorded OT attire should be mored out of the OT area as early as possible . 7. The discorded OT attire should be mored out of the OT area as early as possible .
  • 37. 8. The OT room should focus on maintaining asepsis . 9. Adeauate and suitable and changing focitifs should be provided for staff clothing and the atre attire . 10 . There should be adeuate provision for disposal of soiled linen within changing room after daily use or if contaminated before and end of shift reusable surgical attire should be sent for loundering . 11. Safety spectalles or goggles mast be warm when it is appropriatc .
  • 38.
  • 39. 1. All personnel in the operating suite stquled wear sterile gowns over the OT suit while performing as a member of the operating team. 2. Gown should be changed immediately if it is soiled with blood or fluids during surgery . 3. The procedure of wearing gown should be followed as per the organization protocol .
  • 40.
  • 41.
  • 42. 1. Hair can be a sources of contamination so use of caps in the OT should be mandatary . 2. The cap should cover all the hair completely . 3. If the cap has ties it the back they should be lied securely to avoid cap faling during surgery . 4. Veiled personed should remove their vesils and put on asleril cover .
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  • 47. Air conditioning unit 1 Anaesthesia macnine 1 C/S set 1 Instrument table 1 Laparotomy set 1 Laryngoscope 1 OR light 1 OR table 1 Oxygen unit 1 Spinal set 1 B P apparatus adult 1 B P apparatus paediatric 1 Stethoscope 1 Suction apparatus 1 Wheeled stretcher 1
  • 48. Operation theater zones Zone 1 Zone 2 Zone 3
  • 49. Zone 1 Also called as outer zone and unsterile zone or non restricted zone or interchange area . This zone avoids the exposure to contaminated areas after changing to surgical attire .
  • 50. Zone 2 Also called as middle intermediate zone or semi restricted area and should be in – between two zones . This should be large to receive supplies for surgery .
  • 51. Zone 3 Also called as inner most or most sterile area or restricte zone .
  • 53. SUTURES Sutures are the theads used to dose interrupted surface caused because of injury wound as surgical incision anti healing occurs skill fal Clasure requrie not only the knowledge of surgical procedues but also the knowledge of physical characteristics and properties of the sutures and the needle a Numbers of different shapes, sizes and thread materials are used in the surgery . Criteria for the setection of sutures :- 1) Surgen perference . 2) Ansthetic healing . 3) Speed of healing. 4) Tissue contamination 5) Tension destred in wond closure . 6) Cost and ovailabitity .
  • 54. SUTURES The word “ suture “ describes any strand of material used to ligate (tie) blood vessels or approximate ( sew ) tissues . CLASSIFICATION OF SUTURES :-  Absorbable / Nonabsorbable  Natural / Synthetic  Braided / Monofilament
  • 55. Criteria for selection of suture Surgeon preference Tissue contamination Speed of healing Cost & availability Tension desired in wound healing Aesthetic concern
  • 56. 1 . Essentials of sutures :-  should be uniform throughout the lenglue ovoid breaking points .  Should have good tensile strenght & elasti .  Should be cost effective . Suture are basically of two types :- 1) Absorbale suture 2) Non Absorbale suture Types of suture
  • 57. 1) Absorbale suture :- These stures are usually made of tenton or foscia and this gets absorbed into the tissue after a few . 2) Non Absorbale suture :- 1. These suturs the are on the skin and this have to be removed menually after the incision heals . 2. On the basis of rew materials origin the suture may be also classified as :- a. Natural :- The suture threds derived from collogen from momation in teslines Examples of this types of suture are skil and cotgut . b. Synthetic sutures :- These sutures are synthesized from non natural saurcesexpet catgut and silk nerary all the ovoilable sutures can be considered asx synthetic sutures . 3. On the basis of material & strure can be divided as monfilanent and multifilament .
  • 58. a. Manofilament :- These stures have single fibers or filaments Extending throughat the length of the stures . b. Multifilament :- These sutures are made up of multiple filomments ossembled in different ways .
  • 59. Types of suture Absorption Meterial sturucture Material origin Non Absorption Monofilament Multifilament Natural Synthetic 1. Polyglyctic 1. Silk Acid 2. Catgut 3. Nylon 4. Polyster 2. Catgut 3. polydixone 1. Catgut 1. Polygly cactin 2. Nylon 2. Polyester silk 3. Stainless steel 4. Polypropylne 1. Silk 1. all other 2. Catgut available suture Absorption
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  • 65. Suture Tecniques Interupting suturs Continuous suturs Mattress suturs Simple Sub cuticular Running Running Intra dermal cuticular pull out
  • 71. SURGICAL NEEDLES • Surgical needles are necessary for the placement of sutures in Tissues • NEEDLE ANATOMY :-  Swage  Body  Point
  • 72. NEEDLE SWAGE Classification by the needle swage :- • 1. Closed Eye • 2. French Eye • 3. Swage
  • 73.
  • 74.
  • 75. INSTRUMENTS Instrument is specially designeed lod or device for perfroming specific action of carrying out desired Effects during a surgery or operation such as modifying biological tissue or to provide access for viewing it . Types of Instruments :- 1. Araspery such as forceps . 2. Petroctore used to sperad open skin ribs and other tissue . 3. Dilatons and specula for occess to narrow passage or incisions .
  • 76. 01 ). forceps :- Are a scisssor like instrument used almost in every surgery The word forceps is derived from the latin word forca which menas a snare of trop . Purposes of forceps :-  To grip Tissue and wals of organe .  To grosp suture needles without cousing damaged .  Surgical forceps can mainpulate delicate T issue in the affected area .  Forceps assist in the delivery of a body There are two basis types of forceps :- o Non locking forceps o Locking forceps Non loking forceps These forceps are generaling called thumb perfrom these forceps come in two forms hinged at one end away from the grosping end and higed in the middle like scissore .
  • 77. Locking forceps These are hinged in the middle and have the provision of locking like grop in aloved postion to help in manipulation or to indeppendentiy grosp clamp or hoid on white the surgery is beging performed . Some other commanly used name for forceps :- Athought the basic function and structers is same they are used for vairous function with same minor modification here are few categogires that are commonly used. • Anesthesia forceps. • Artery forceps . • Atroumtic forceps. • Biopsy forceps . • Bone forceps . • Bone cuting forceps . • Bone holding forceps. • Catheter forceps.
  • 78. • Cushing forceps. • Dermal forceps & Nipplers. • Derssing forceps . • Ear forceps. • Eye forceps . • Gall bladder forceps . • Hemostaic forceps . • Hybterectomy forceps . • Intestinal forceps. • Micro surgery forceps. • Nasal forceps . • Obstetrical forceps. • Post mortem forceps. • Splinter forceps. • Sponge forceps. • Sterilizer forceps. • Suture sundries forceps . • Tenocalam forceps . • Thorocis forceps . • Thorocis surgical forceps.
  • 79. • Thumb forceps . • Tissue forceps. • Tonge forceps . • Tooth Extraching forceps. • Tubing forceps. • Vterine forceps.
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