Surgery setup images for Simple Mastectomy

Simple Mastectomy-mayo-stand-setupSimple Mastectomy-backtable

Mayo stand and back table instruments for Simple Mastectomy surgery setup

Clamping & Occluding

  • Hemostatic Clip Applier

    Hemostatic Clip Applier

  • Penetrating Towel Clamp

    Penetrating Towel Clamp

  • Curved Hemostat

    Curved Hemostat

  • Right Angle Clamp

    Right Angle Clamp

  • Kocher Forceps

    Kocher Forceps

  • Tonsil Clamp

    Tonsil Clamp

  • Allis Forceps

    Allis Forceps

Cutting & Dissecting

  • #3 Knife Handle

    #3 Knife Handle

  • Metzenbaum Scissor

    Metzenbaum Scissor

  • Curved Mayo Scissor

    Curved Mayo Scissor

  • Straight Mayo Scissor

    Straight Mayo Scissor

Grasping & Holding

  • Toothed Forcep

    Toothed Forcep

  • Smooth Adson

    Smooth Adson

  • Adson Forceps

    Adson Forceps

  • Russian Tissue Forceps

    Russian Tissue Forceps

  • Ferris Smith Tissue Forceps

    Ferris Smith Tissue Forceps

  • Non toothed Pickup

    Non toothed Pickup

  • Debakey Forceps

    Debakey Forceps

Retracting & Exposing

  • Freer Skin Hook

    Freer Skin Hook

  • Freeman Rake

    Freeman Rake

  • Weitlaner Retractor

    Weitlaner Retractor

  • Army-Navy Retractor

    Army-Navy Retractor

  • Senn Retractor

    Senn Retractor

  • Richardson Retractor

    Richardson Retractor

  • Harrington Retractor

    Harrington Retractor

  • Deaver Retractor

    Deaver Retractor

  • Gelpi Retractor

    Gelpi Retractor

Suctioning

  • Yankauer Suction

    Yankauer Suction

Suturing & Stapling

  • Ryder Needle Holder

    Ryder Needle Holder

  • Crile Wood Needle Holder

    Crile Wood Needle Holder

  • Mayo-Hegar Needle Holder

    Mayo-Hegar Needle Holder

What to expect during Simple Mastectomy

A Simple Mastectomy is a surgical procedure that involves the complete removal of the breast tissue, including the nipple and areola. This procedure is commonly used to treat breast cancer and is recommended for patients who have large tumors or tumors in multiple areas of the breast. The procedure is typically done under general anesthesia and requires a hospital stay of a few days. After the procedure, the patient may choose to have breast reconstruction surgery to restore the appearance of the breast.

Step 1: Incision and Dissection
The first step in a Simple Mastectomy is making an incision with either a 15 or 10 blade on a #3 knife handle. After the incision is made, the surgeon will begin dissection using adson pickups, metzenbaum scissors, and a bovie. Adson pickups are used to grasp tissue and hold it in place, while metzenbaum scissors are used to cut and dissect delicate tissue. The bovie is used to cauterize and control bleeding during the procedure.

Step 2: Retraction
As the dissection continues, the surgeon will need to retract the surrounding tissue to maintain visibility and access to the breast tissue. Retractors will gradually get bigger, starting with skin hooks or senns, and move up to richardsons or a harrington. Skin hooks or senns are used to lift the skin, while richardsons or a harrington are used to retract the deeper tissue layers.

Step 3: Ties and Clips
To control bleeding, ties should be loaded onto tonsils, and clips should be ready for use. Ties are used to ligate (tie off) blood vessels, while clips can be used to occlude (clamp shut) blood vessels or ducts.

Step 4: Longer Pickups
After a little bit of breast dissection, the surgeon will move onto longer pickups, usually debakeys. Debakeys are longer than adson pickups and have a wider jaw, making them better suited for handling and manipulating larger tissue structures.

Step 5: Smoke Plume Management
During the use of the bovie, smoke plume may be generated, which can be hazardous to the surgical team. The bovie smoke plume should be suctioned using the yankauer, a surgical suction instrument with a rigid, angled tip.

Step 6: Specimen Handling
Breast specimens should quickly be passed off of the surgical field and taken to pathology for examination.

Step 7: Closure
Closure will happen in layers, and the needle drivers used will depend on the suture needle size and how deep the surgeon is in the incision. Needle drivers are used to grasp and manipulate sutures during closure.

Step 8: Drain Placement
A drain may be placed at the end of the procedure to help remove excess fluid and blood from the surgical site. The type of drain used will depend on the surgeon’s preference and the specific needs of the patient.

The Surgery Sparknotes

  1. Make incision with 15/10 blade and #3 knife handle.
  2. Use adson pickups, metzenbaum scissors, and bovie for dissection.
  3. Use skin hooks/senns and richardsons/harringtons for retraction.
  4. Load ties onto tonsils and have clips ready for bleeding control.
  5. Switch to longer debakeys for larger tissue structures.
  6. Suction bovie smoke plume with yankauer.
  7. Quickly pass breast specimens off of the surgical field to pathology.
  8. Use appropriate needle drivers for sutures during closure.
  9. Consider placing a drain at the end of the procedure.

7 thoughts on “Simple Mastectomy

    • Diana Lei-aloha says:

      You should not need a separate table for closure in a simple mastectomy unless it’s the surgeon’s preference. There’s no “dirty” or contaminated portion that would warrant a separate table.

  1. Serena Munsinger says:

    Scrub tech student here! I have two questions…
    #1 Is it true that your type of irrigation should be sterile water instead of normal saline due to the saline spreading cancer? or is that dependent on the doctors preference? We’re taught this in my program but every time I’ve mentioned it others don’t seem to know if there is a difference.
    #2 what sutures are used for closing?

    • Joshua Roosevelt says:

      Great questions!

      The first question is a tough one and one of those that is still under debate. Some surgeons may prefer to use sterile water for irrigation, while others may prefer to use normal saline. There is no evidence to suggest that one type of irrigation is superior to the other.

      The type of sutures used for closing a simple mastectomy will vary depending on the surgeon’s preference. From my experience, Vicryl is used for deep layers and monocryl is used for top layers.

    • Joshua Roosevelt says:

      The simple answer is to say a clean and dirty table is required for mastectomy and breast reconstruction at the same time. This is because the mastectomy part of the surgery is considered to be a clean procedure, while the breast reconstruction part is considered to be a dirty procedure. This is because the breast reconstruction part of the surgery involves placing implants or flaps into the body, which increases the risk of infection. By using a clean and dirty table, the surgeon can help to reduce the risk of infection.

      The clean table is used for all of the instruments and supplies that will be used in the mastectomy part of the surgery. The dirty table is used for all of the instruments and supplies that will be used in the breast reconstruction part of the surgery. The two tables are kept separate to help to prevent the spread of infection.

      However, some would argue that the infected cells are in the recipients body already and that the extra work isn’t necessary. I recommend following the CDC (in the US) or PHAC (in Canada), your hospitals, or the doctors guidelines for a case like this.

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