Surgery for breast cancer

1. MODIFIED
MODIFIED
RADICAL
RADICAL
MASECTOMY
MASECTOMY
Presented by:
Deraco, Adrea
Maldo, Gabrielle
Pulgo , Trixiemaxine
Sarino, Desiree
Tagimacruz, Krstyll

3. General Anesthesia
The patient is are completely asleep during the
operation.
General anesthesia is often combined with a local
anesthetic to reduce pain at the incision site.

4. are used during surgical
procedures to hold sponges and
swabs. They have a ratchet
mechanism towards the handles
and have looped serrated jaws.
Sponge Holding Forceps 10″ 6
1.
are used to hold sponges and swabs. Has
ratchet mechanism towards the handles
and have looped serrated jaws.
2. Towel Forcep 5″ 12
perforating clamp used for grasping
tissue, securing towels or drapes, and
holding or reducing small bone fractures.

5. 3. B.P. Handle No. 31
small and extremely sharp bladed
instrument used for surgery, anatomical
dissection, podiatry and various arts and
crafts.
intended for combined use with surgical
blades of varying shapes and sizes.
4. B.P. Handle No.41

6. 5. B.P. Handle No.71
Long is more rounded in shape and
contains a thin neck towards the top,
similar to a writing pen.
allow deeper penetration into the wound
than the type with straight blades.
6. Mayo Scissor Straight 7″1

7. 7. Mayo Scissor Curved 7″1
allow deeper penetration into the wound
than the type with straight blades.
are designed for both cutting delicate
tissue and for blunt tissue dissection
8. Metzenbaum Scissor Curved
7″1

8. 9. Dressing Scissor Sharp/Blunt
Straight 6″1
are used for general, multipurpose cutting
and dissecting.
are designed for cutting body tissues,
which are near to the wound. This type of
scissors is used when the wound is near to
the skin and don’t have to penetrate
10. Suture Cutting Scissor Heath 1

9. 11. Dissecting Forceps Plain 6″2
12. Dissecting Forceps Plain 8″ 1
used for grasping and holding objects, for
clamping large blood vessels and
manipulating tissue
Typically designed with serrated jaws or
blades. These non-traumatic teeth-like
structures allow the tissue to be firmly
held without damage.
13. Allies Tissue Forceps 8″ 2
14. Allies Tissue Forceps 6″6

10. 15. Mosquito Forceps Curved 5″12
are used in multiple procedures as a
hemostat for small blood vessels. The
ratcheted finger ring handle provides a
secure, locking grip to halt blood flow.
specialized device that surgeons use to
clamp blood vessels, especially small
arteries, during a variety of surgical
scenarios.
16. Crile Artery Forceps Straight 6″6

11. 17. Crile Artery Forceps Curved
6″6
Used for clamping blood vessels or tissue
before cauterization or ligation.
specialized device that surgeons in
different areas can use to manipulate
blood vessels, clamp their lumen and
control the blood flow, in order to achieve
adequate haemostasis.
18. Artery Forceps Curved 6″12

12. 19. Kocher Forceps Straight 6″ 6
are used in multiple procedures as a
hemostat for small blood vessels. The
ratcheted finger ring handle provides a
secure, locking grip to halt blood flow.
hand-held surgical device that allows
surgeons to retract and pull back the edges
or surgical incisions and wounds in order
to obtain maximum exposure of the
operating site.
Kelly Retractor Small 2

13. 21. Kelly Retractor Medium 2
hand-held surgical device that allows
surgeons to retract and pull back the edges
or surgical incisions and wounds in order to
obtain maximum exposure of the operating
site.
Wide L-Shaped Blade For Retracting Large
Tissue Sections. Terminal Blade Curve For
Avoiding Tissue Slippage.
can either effectively isolate the edges of a
surgical cut or wound, or can keep down
related organs and tissues, so body parts
under the cut might be perceived to.
22. US Army Retractor (Set of 2) 1

14. 23. Poole Abdominal Suction
Tube 1
suction large collections of fluids from
cavities where other tubes would struggle,
such as the abdomen
prime function is to steadily hold the
needle while applying sutures, thus
avoiding injury to the surrounding tissues
and to the surgeon's hand.
24. Needle Holder 6″ 2

15. 25. Stainless Steel Kidney Tray
are used in multiple procedures as a
hemostat for small blood vessels. The
ratcheted finger ring handle provides a
secure, locking grip to halt blood flow.
to cut tissue or coagulate bleeding.
26. Electrocautery (set 40/40) and
pad

16. 27. Yankauer Tip and
Yankauer Tube
a tracheostomy device used to clear blood,
saliva, and other secretions in the airway.
used to drain out all the drainage after a
surgical procedure.
28. Blake Drain

17. 29. Liga clip
designed for secure fixation on the
structure and increased resistance to
dislodgement of a formed clip.
unique wrinkle-weave that gives them loft
and bulk that protects wound areas.
30. Kerlix fluff

18. 31. Steri Strips
help seal wounds by pulling the two sides
of the skin together without making any
contact with the actual wound
have soft inner linings, which prevent
pain or skin sensitivity on healing
incisions or scars. Some post-mastectomy
bras come equipped with pockets to
accommodate surgical drains as well.
32. Kerlix fluff

19. PACKS/DRAPES
Extra drape sheets
Extra Mayo tray cover
The affected arm, once
draped with stockinette,
is brought through the
fenestration.
Major Lap pack
Impervious stockinette

21. 3-0 Vicryl Suture

22. 4-0 Monocryl Suture

23. 3-0 Nylon Suture

27. Modified radical mastectomy is a surgical
procedure used to treat breast cancer.
It involves the removal of the entire breast,
including the nipple and areola, as well as some
of the surrounding lymph nodes.
This procedure is done to ensure that all of the
cancerous tissue is removed, reducing the risk of
recurrence and improving overall outcomes.

28. It's important to note that modified radical
mastectomy may also impact the appearance
and function of the affected breast, requiring
additional treatment such as reconstructive
surgery or physical therapy to address any
physical changes.

30. Ensures that the circulating
nurse has checked the
equipment
Ensures that the theater has
been cleaned before the
trolley is set
Prepares the instruments and
equipment needed in the
operation
Uses sterile technique for
scrubbing, gowning and
gloving
Receives sterile equipment via
circulating nurse using sterile
technique
Performs initial sponges,
instruments and needle count,
checks with circulating nurse
Surgical nurse:

31. Perform assisted gowning and
gloving to the surgeon and
assistant surgeon as soon as they
enter the operation suite
Assemble the drapes according to
use. Start with towel, towel clips,
draw sheet and then lap sheet.
Then, assist in draping the patient
aseptically according to routine
procedure
Place blade on the knife handle
using needle holder, assemble
suction tip and suction tube.
Bring mayo stand and back
table near the draped patient
after draping is completed
Secure suction tube and cautery
cord with towel clips or allis
Prepares sutures and needles
according to use
Surgical nurse:

32. Surgical nurse:
Provide 2 sponges on the operative site prior
to incision
Passes the 1st knife for the skin to the
surgeon with blade facing downward and a
hemostat to the assistant surgeon
Hand the retractor to the assistant surgeon
Watch the field/ procedure and anticipate the
surgeon's needs
Pass the instrument in a decisive and positive
manner
Watch out for hand signals to ask for
instruments and keep instrument as clean as
possible by wiping instrument with moist
sponge

33. Surgical nurse:
Always remove charred tissue from the
cautery tip
Notify circulating nurse if you need
additional instruments as clear as possible
Keep 2 sponges on the field
Save and care for tissue specimen
according to the hospital policy
Remove excess instrument from the sterile
field
Adhere and maintain sterile technique and
watch for any breaks

34. Surgical nurse:
Maintain sterility throughout the
procedure.
" Awareness of the patient's safety
Adhere to the policy regarding
sponge/ instruments count/ surgical
needles.
Arrange the instrument on the mayo
table and on the back table .

35. Undertake count of sponges and
instruments with circulating nurse
Informs the surgeon of count result .
Clears away instrument and
equipment.
After operation: helps to apply
dressing.
Removes and siposes of drapes.
De-gown.
Prepares the patient for recovery
room.
Completes documentation .
Hand patient over to recover room.
Surgical nurse:

36. Checks all equipment for
proper functioning such as
cautery machine, suction
machine, OR light and OR table
Make sure theater is clean
Arrange furniture according to
use
Place a clean sheet, arm board
(arm strap) and a pillow on
the OR table
Collect necessary stock and
equipment
Turn on aircon unit
Help scrub nurse with setting
up the theater
Assist with counts and records
Circulating nurse:

37. Turn on OR light
Assist the anesthesiologist in
positioning the patient
Assist the patient in assuming the
position for anesthesia
Anticipate the anesthesiologist’s
needs
Reposition the patient per
anesthesiologist’s instruction
Attached anesthesia screen and
place the patient’s arm on the arm
boards
Apply restraints on the patient
Expose the area for skin
preparation
Catheterize the patient as indicated
by the anesthesiologist
Perform skin preparation
Circulating nurse: Circulating nurse:

38. Circulating nurse:
Remain in theater throughout
operation
Focus the OR light every now and
then
Connect diatherapy, suction, etc.
Position kick buckets on the operating
side
Replenishes and records sponge/
sutures
Ensure the theater door remain
closed and patient’ s dignity is upheld
Watch out for any break in aseptic

39. Circulating nurse:
Assist with final sponge and
instruments count
Signs the theater register
Ensures specimen are properly
labeled and signed
break in aseptic technique

40. Circulating nurse:
Hands dressing to the scrub nurse
Helps remove and dispose of
drapes
Helps to prepare the patient for
the recovery room
Assist the scrub nurse, taking the
instrumentations to the service
(washroom)
Ensures that the theater is ready
for the next case

41. Thank you for
listening!