Basic surgical techniques Practical Exam 1st semester, Academic year 2008/2009

1. Basic surgical techniques Practical Exam 1st semester, Academic year 2008/2009 If a student did not make up a missed subject, he/she could not carry out the exam station which is related to that subject.

2. Practical exam Scrub suite 1. Surgical hand scrub 10 points 2. Gowning and gloving 10 points 3. Knotting (Viennese and surgeon’s knots, Rt.and Lt.hands; 4x2,5 points)10 points 4. Questions of the surgical instruments (5x2 points) 10 points 5. Questions of the laparoscopic instruments (5x2 points) 10 points 6. Insertion of sutures in the pig tissue (2 sutures, 2x10 points) 20 points 7. Laparoscopic practice in a pelvitrainer 10 points 1. examiner 2. examiner Operating room 3. examiner 4. examiner 80 pont Theoretical exam Written exam 20 points Altogether 100 points, marks are given based on the reached points Dentistry Academic year 2008/2009 Examining Practical exam Scrub suite 1. Surgical hand srub 10 points 2. Gowning and gloving 10 points 3. Knotting (Viennese and surgeon’s knots, Rt.and Lt.hands; 4x2,5 points)10 points 4. Questions of the surgical instruments (5x2 points) 10 points 5. Questions of the microsurgical instruments (5x2 points) 10 points 6. Insertion of microsurgical sutures (2 sutures, 2x5 points) 10 points 7. Insertion of sutures in the pig tissues (2 sutures, 2x10 points) 20 points 1. examiner 2. examiner Operating room 3. examiner 4. examiner 80 points Theoretical exam Written exam 20 points Altogether 100 points, marks are given based on the reached points Examining General medicine Academic year 2008/2009

3. Scrub suite 1st examiner, scrub nurse, assistant 3rd examiner Operating room 4th examiner Operating room Operating room 2nd examiner Practical exam General medicine Academic year 2008/2009 1. Surgical hand scrub either 0 or 10 points can be given 0 point: anything which endangers the rules of the asepsis (e.g. not wearing a cap or mask, using a nail polish, not keeping the rules or duration of the scrubbing, not drying the hands with a tissue paper, touching any non-sterile object,rubbing the dry hands,shaking or hanging down the hands, etc.) 2. Gowning and gloving either 0 or 10 points can be given 0 point: anything which endangers the rules of the asepsis (e.g. not to wear the gown with two hands, not to give the tying band of the gown in front of oneself, during gloving: not to pull the inner side of the first hand gloves toward oneself or not to pull the outher side of the second hand gloves toward oneself.Adjustment of gloves when both hands are already gloved,is not a mistake!) 3. Knotting from 0 to 10 points can be given Viennese knot with right hand: 2,5 points Viennese knot wit left hand: 2,5 points surgeon’s knot with right hand: 2,5 points surgeon’s knot with left hand: 2,5 poinst 4. Questions of the surgical instruments from 0 to 10 points can be given 5 questions, 2 points for each correct answer 5.Questions of the laparoscopic instruments from 0 to10 points can be given 5 questions, 2 points for each correct answer 6. Insertion of sutures in the pig tissue from 0 to 20 points can be given insertion of 2 sutures: 10 points for each (simple interrupted/Donati/horizontal mattress sutures, simple running suture) instrument tie (apodactylic technique) Lose of points: wrong holding of the instruments (forceps, needle holder) , unsuitable distance from the wound edge or between the sutures, too tight or too loose sutures, in Donati suture: 4 stiches are not located in an imaginery line or these are not perpendicular to the surface of the wound, etc. 7. Laparoscopic practice in 2 pelvitrainers from 0 to 10 points can be given To place the elastic hairgrips from the right-to the left-side and then back from the left-to the right-side, according to the numbers The students will handle the camera by themselves. Limit of points: from 0 to 2 minutes 10 points from 2 to 2.30 minutes 9 points from 2.30 to 3 minutes 8 points from 3 to 3.30 minutes 6 points from 3.30 to 4 minutes 4 points from 4 to 4.30 minutes 2 points from 4.30 to 5 minutes 1 points more than 5 minutes 0 point

4. Academic year 2008/2009 Practical exam Dentistry Scrub suite 1st examiner, scrub nurse, assistant 1. Surgical hand scrub either 0 or 10 points can be given 0 point: anything which endangers the rules of the asepsis (e.g. not wearing a cap or mask, using a nail polish, not keeping the rules or duration of the scrubbing, not drying the hands with a tissue paper,touching any non-sterile object,rubbing the dry hands,shaking or hanging down the hands, etc.) 2. Gowning and gloving either 0 or 10 points can be given 0 point: anything which endangers the rules of the asepsis (e.g. not to wear the gown with two hands, not to give the tying band of the gown in front of oneself, during gloving: not to pull the inner side of the first hand gloves toward oneself or not to pull the outher side of the second hand gloves toward himself. Adjustment of gloves when both hands are already gloved, is not a mistake!) 3. Knotting from 0 to 10 points can be given Viennese knot with right hand: 2,5 points Viennese knot wit left hand: 2,5 points surgeon’s knot with right hand: 2,5 points surgeon’s knot with left hand: 2,5 poinst 4. Questions of the surgical instruments from 0 to 10 points can be given 5 questions, 2 points for each correct answer 5. Questions of the microsurgical instruments from 0 to10 points can be given 5 questions, 2 points for each correct answer Operating room 2nd examiner Operating room 3rd examiner 6. Insertion of microsurgical suturesfrom 0 to10 points can be given insertion of 2 sutures with the help a microscope or lupe, 5 points for each 7. Insertion of sutures in the pig tissue from 0 to 20 points can be given insertion of 2 sutures: 10 points for each (simple interrupted/Donati/horizontal mattress sutures, simple running suture) instrument tie (apodactylic technique) Lose of points: wrong holding of the instruments (forceps, needle holder) ), unsuitable distance from the wound edge or between the sutures, too tight or too loose sutures, in Donati suture: 4 stiches are not located in an imaginery line or these are not perpendicular to the surface of the wound, etc. Operating room 4th examiner

5. Questions Surgical instruments General Medicine Dentistry

6. 2. • - Select the conventional scalpel! • Show the fiddle bow handling style of the • scalpel! • In which type of incision is used this type of • handling? • Take a french needle into the Mathieu’s needle • holder! • - Take monofilament thread into the needle! 1. Select 5 instrument suitable for tissue dissection and name them! • 3. • - Select the abdominal wound retractor! • - Select the small operation sponge! • Take a french needle into the Mathieu’s needle • holder! • - Take the twisted thread into the needle! • Show the proper handling of Mathieu’s needle • holder! 4. - Select the abdominal wound retractor! - Take the tupfer into the towel clamp! - Show the big operation sponge! - Show the anatomical forceps! - Show the proper handling of it! • 5. • - Select the scalpel’s handle! • - Show the pencil handling style of thebe scalpel! • In which type of incision is used this type of • handling? • - Show the Sonnenburg’s table! • - What is the function of it? 6. - Show straight dull-dull scissors! - What is it used for? - Show the proper handling of it! - Show the lyre! - What is it used for? 7. Show 5 grabbing instruments and name them! 8. - Show the Backhaust! - Show the proper handling of it! - Show how to open it with right and left hand! - Show the tupfer! - Make a handled swab! 9. - Show the Weitlaner’s self retractor! - Show thewound hook! - Show the small operation sponge! - Make a handled swab! - Show the proper handling of towel clamp! 10. - Show the maybug! - Show the use of it! - Show the Gosset’s self retractor! - Show how it works! - Show the Sonnenburg’s table!

7. 11. Show 5 instruments for haemostase and name them! • 12. • - Show the dental forceps! • - Show the proper handling of it! • Take a french needle into the Mathieu’s needle • holder! • - Take the twisted thread into the needle! • - Show the lamp corrector! 13. - Show the kneed scissors! - Show the abdominal Péan! - Show the proper handling of it! - Show the Hegar’s needle holder! - Show the proper handling of it! 14. - Show the lamp corrector! - Show the use of it! - Show the dissector! - What is it used for? - Show the hand part of monopolar diathermy! • 15. • - Show the straight Mosquito! • Show how to open and close it with right and • left hand! • - Show the kneed scissors! • - Show the Michel’s clip applier! • - Show the round ended probe! 16. - Show the Gosset’s self retractor! - Show the Péan! - Show the proper handling of it! - Show the indifferent electrode of the diathermy! - What is its function and position? 17. Show 5 instruments for tissue retraction and name them! 18. Show 5 instruments/materials for tissue rejoining and name them! 19. - Show a straight sharp-sharp scissors! - What is it used for? - Show the ophthalmologic forceps! - Show the proper handling of it! - Show the curved Mosquito! 20. - Show the hooked forceps! - Show the proper handling of it! - Show the Lister’s scissors! - What is it used for? - Show a linear stapler!

8. 21. Select 5 haemostatic instrument and name them! 22. - Make a handled swab! - Selectthe Payr s probe! - Select the monofil suture material! - Select the raspatory! - Select the amputating knife! • 23. • Select the foot pedal of the monopolar • diathermy! • - Select the mallet! • - Select the Deschamp ligation needle! • - Select the surgical forceps! • - Show the correct holding of it! 24. - Select the Deschamp ligation needle! - Select the curved sharp-sharp scissor! - Show the correct holding of it! - Select the raspatory! - Select the Roux-retractor! • 25. • - Select the Lumnitzer! • Show the opening and closing of it with both • right and left hand! • - Select the amputating knife! • - Select the Kochert! • - Show the correct holding of it! 26. - Select the skin hook! - Select the bipolar forceps! - Show the correct holding of it! - Select the Roux-retractor! - Select the self-adhesive strips! 27. Select 5 retracting instruments and name them! 28. Select 5 tissue unifying instruments and materials and name them! 29. - Select the anatomical forceps! - Show the correct holding of it! - Select a saw! - Select the Volkmann curette! - Show the using of it! 30. - Select the Lumnitzert! - Show the correct holding of it! - Select the rake retractor! - Select the Michel clip remover! - Show the use of it!

9. 31. - Select the Klammert! - When do we use it? - Select the round-ended probe! - Select the suction tip! - Select the Payr clamp! 32. - Select the bulldog! - When do we use it? - Select the chisel! - Show the guard! - What is the function of it? • 33. • - Select the Hegar needle holder! • - Show the correct holding of it! • - Select the hernia mesh! • - Show the diathermy device! • Select the hand portion of the monopolar • diathermy! 34. - Select the Satinsky clamp! - Show the correct holding and using of it! - Select the Payr clamp! - When do we use it?? - Select the chisel! 35. - Select the instrument called Blalock! - Show the using of it! - Select the suction tip! - Select the Mathieu needle holder! - Show the correct holding of it! 36. - Select the Mathieu needle holder! - Show the correct hoding for it! - Select the vascular prosthesis! - Select the attraumatic needle-thread complex! - Take it with the Mathieu needle holder! 37. - Select the Allis clamp! - What is the function of it? - Select the French-eyed circular needle! - Take it with the Hegar needle holder! - Show the correct holding of the Hegar needle holder! 38. - Select the gall bladder forceps! - Show the correct holding of it! - Select the French-eyed cutting needle! - Take it with the Hegar needle holder! - Show the correct holding of the Hegar needle holder! 39. - Select the Babcock forceps! - Show the correct holding of it! - Select a multifilament thread! - Select the conventional scalpel! - Show the fiddle bow holding of it! 40. - Select the sponge-holding forceps! - Show the correct holding of it! - Select the Langenbeck retractor! - Select the attraumatic needle-thread complex! - Take it with the Mathieu needle holder!

10. Questions Laparoscopic instruments Only for General Medicine

11. 1. - Choose the Veress-needle! - Show how to use it! - Where do you connect the insufflator tube? - Choose the monitor! - What is connect to the monitor? 2. - Choose one of the 30 degree optik! - Show of this ocular end! - Choose the leg pedal of the electrical appliance! - What is mean to press down the yellow pedal? - What is mean to press down the blue pedal? 3. - Choose the parrot needle holder! - Show that this correct holding! - Choose the 30 degree optic! - Where do you have to connect the light cable? - Show the filter of the CO2 gas! • 4. • - Choose the 10 mm not safety conic trocar! • Where do you place the insufflator tube on the • trocar? • - Choose the Hook! • - Review of this using! • - Which gas we use in the laparoscopic surgery? • 5. • - Choose the 10 mm safety trocar! • Choose the hand-part of the irrigation/suction • device! • Put it into irrigation function! • - Choose the Roeder-loop! • - Choose the light cable! 6. - Choose the most commonly used not safety 5 mm trocar! - Show of this using! - What instruments can you transzmit into this? - Choose the insufflator instrument! - Choose the light! • 7. • - Choose the 11 mm safety trocar! • - Put one of the instrument into this! • - Choose the electrical instrument! • Choose the Hook and connect it to the • instrument! • - Choose the pelvitrainer! 8. - Choose the Veress-needle! - Show of this correct holding! - Choose the light cable! - Which end do you connect where? - Choose the Endoloop! 9. - Choose the camera! - Show that where do you have to connect the 2 end of this! - What is the function of the focus ring? - Choose the irrigation/suction device! - Choose the Hook! 10. - What we need to collect the optic system? - Collect the optic system! - Choose the Veress-needle! - Choose the dissector! - Choose the scissors!

12. 11. - Choose the light source! - What type of incandescent is it in this? - Choose the laparoscopic clips! - Choose an hand-instrument without insulation! - What gas do we use in laparoscopy? 12. - Choose one hand-instrument with insulation! - Choose an 5 mm safety trocar! - For what safety the instrument? - Show of this correct holding! - Choose one optic! • 13. • - Choose the 5-11 mm trocar! • - What does this sign mean? • - Show the correct holding of the trocar! • - Choose the camera! • Where do you have to connect the 2 end of the • camera? 14. - Choose the Endoloop! - What can we use this? - Choose the unit of the camera! - What gas we use for the insufflation? - How is the steril gas get into the abdomen? 15. - Choose the insufflator’s appliance! - Which parameters can we monitoring on this? - Which of these can we change? - Choose the clip applier! - Into how mm trocar can we transmit it? 16. - Choose the 12 mm safety trocar! - Why safety this trocar? - Show the correct holding of the trocar! - Which instrument secure the light? - What type of incandescent is it in this? 17. - What needle-shape we use in laparoscopy? - Choose it from the table! - Choose the monitor! - What is connect to the monitor? - Show the correct holding of the Veres-needle! • 18. • Choose the hand-part of the irrigation/suction • device! • - Put it into sucking function! • - Put it into irrigation function! • - Choose the pelvitrainer! • - What is the function of this? • 19. • - Choose the leg pedal of the electrical appliance! • - What is mean to press down the yellow and the • blue pedal? • - Choose the clip applier! • - Choose the clips! • Show the correct holding of the parrot needle- • holder! 20. - Choose the irrigation/suction device! - Choose the pelvitrainer! - For what can we use it? - Choose one not safety trocar! - When can we transmit it into the abdomen?

13. 21. • - Choose the Veress-needle! • - Show how to use it! • Choose the trocar put into the abdominal • wall, which is used after the Veress-needle! • What dose the mm-sized classification of the • trocars mean? • - Choose one scissorrs! • 22. • - Choose an optic! • - What is the system of this optic? • What is the practical difference between the 0 • and 30 degree optics! • - Choose one dissector! • - Show how to use it! • 23. • - Choose the source of light! • - Where does the light cable contact? • - Choose the stapler! • What kind of clips can be used in the • laparoscopy? • - Choose the insufflations-machine! • 24. • - Choose the pelvitrainer! • - What is it good for? • - Choose the insufflation-machine! • - What intraabdominal pressure is used? • What can be the consequence of the too high • intraabdominal pressure? 25. - What does pneumoperitoneum mean? - What pressure must be kept? - Which gas is used for it? - Choose the Hook! - Choose a coated instrument! 26. - Choose a dissector! - Is it possible to contact it with electricity? - Show the electric machine! - Choose the Roeder-loop! - Choose the parrot needle holder! 27. - Choose a scissors! - Is it possible to contact it with electricity? - Choose the monitor! - What is connected to it? - What is the difference between the safe and not safe trocras? 28. - Choose the flamingo needle holder! - Is it possible to contact it with electricity? - Choose the Veress needle! - Explain how to use it! - Show the correct handling! • 29. • - Choose the corkscrew trocar! • - Choose a not coated manual instrument! • Choose the manual part of the lavage- • system! • - Turn it into suction-function! • - Turn it into lavage function! • 30. • - Choose a 10 mm sized safety sheath! • - Choose an optic! • - What is the system of this optic? • What is the practical difference between the 0 • and 30 degree optics? • - Choose a 10 mm sized safety trocar!

14. 31. • - Choose a 10 mm sized corkscrew trocar! • - Show how to use it! • - Choose a 30 degree optics! • How can you view around without moving the • optic? • - Choose a scissors! 32. - Choose a dissector! - Show the correct handling of it! - Show how to turn around the top! - Choose the source of light! - What kind of lamp is inside? 33. - Choose the stapler! - Choose a not coated manual instrument! - Choose the insufflators! - Choose the manual part of the lavage system! - Turn it into suction function! • 34. • - Choose the fan retractor! • - Show how to use it! • - Which gas is used in the laparoscopy? • What secures that only sterile gas can get • into the abdominal cavity? • - Show where it is! 35. - Choose a scissors! - What is the black coating good for? - Choose a 10 mm sized safety trocar! - Show how does it work! - Show the correct handling of it! 36. - Choose the flamingo needle holder! - Show the correct handling! - Choose a 0 degree optic! - Show the ocular end of it! - Show where the camera is connected! • 37. • - Choose the Veress needle! • - Show the correct handling of it! • - What IAP is used in the practice? • - Choose the Hook! • What kind of apparatus can be connected to • this? 38. - Choose the 0degree optic! - Show where the camera is connected! - Choose the light cable! - Connect it to the optic! - Choose the fan retractor! • 39. • - List the part of the laparoscopic tower! • - Which gas is used in the laparoscopy? • Choose a 10 mm sized tapered non safety • trocar! • Where can be the insufflation cable • connected on the trocar? • - Why is it a non safety trocar! • 40. • What does the black coating of this • instrument mean? • - Choose the laparoscopic needle holders! • - Name them! • - Choose the insufflation machine! • - What parameters can be read on it?