practicing surgical skills at home

[avgjoe]

We keep hearing that we should be practicing surgical skills, technique, etc at home to be 'ready' as soon as they ask us to do stuff in the OR. What besides practicing tying can we do at home?
What did you senior residents do in yr first months of internship that you felt helped you get the basic skills?

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[Blade28]

You can suture at home too. Or play around with instruments in either hand, make sure you're very proficient in holding and using them.

 

[supercut]

Tie knots too. The Ethicon knot tying manual is online. Make sure you can do square ones (use a shoelace or something and compare yours with the picture to make sure it's correct)

 

[cytoskelement]

You can suture at home too. Or play around with instruments in either hand, make sure you're very proficient in holding and using them.

I haven't started doing it yet... but I've heard you should practice opening and closing needle drivers, especially without your fingers in the holes.

If you're up for it... you can buy some pigs feet from your local butcher (i have no idea where one is) and practice suturing on those.

 

[njbmd]

Hi there,
When I was a third year medical student, I practiced on the cadavers in the Gross lab. I had honed all of my sutures by closing the back skin on several bodies. It made some of the first years a bit ticked but our surgery preceptors recommended that we do some closures in the Gross Lab.

Chicken breasts are good to practice on and so are concord grapes. Some of my classmates sutured banana peels too. The only problem with pigs feet are that they are not very tasty after you are done. My dogs would not even eat them.

I practiced my knots while watching TV or at the movies. I figured that if I could do them in the dark, I would never have a problem in the OR. I also practiced palming instruments too. I used fishing line for practicing ties and always practiced wearing non-sterile gloves.

njbmd

 

[nzdavid]

that ethicon knot tying manual is awesome.

does anyone know a similar kind of manual with step by step instructions and pictures for suturing?

 

[cytoskelement]

BTW... you can call ethicon. they will send you a knot tying board, a practice dual-colored string, and a hard copy of the manual.


NJBMD... thanks for the ideas. And... pigs feet are tasty. Just kidding!

 

[oldman]

in reality as a student you don't do enough to get good at it.

as a resident it'll get better cause we do it on the real deal more often. it'll come with time. i haven't done much at home other than tying

at the end of cases, ask the scrub nurse for left over clean suture. they'll happily give you some to practice with.

 

[avgjoe]

Hi there,
When I was a third year medical student, I practiced on the cadavers in the Gross lab. I had honed all of my sutures by closing the back skin on several bodies. It made some of the first years a bit ticked but our surgery preceptors recommended that we do some closures in the Gross Lab.

Chicken breasts are good to practice on and so are concord grapes. Some of my classmates sutured banana peels too. The only problem with pigs feet are that they are not very tasty after you are done. My dogs would not even eat them.

I practiced my knots while watching TV or at the movies. I figured that if I could do them in the dark, I would never have a problem in the OR. I also practiced palming instruments too. I used fishing line for practicing ties and always practiced wearing non-sterile gloves.

njbmd

thanks all - i definitely wasn't ready to go buy pigs feet (could barely even look at them when we had to use them during third year) so will try the banana peel idea.
still working on the palming instruments and opening the needle driver without fingers in the holes - the problem is that the little needle driver that the nurses on the wards can give you isn't even half as big as the ones we use in the OR, and we're not allowed to take those to practice on. Is there a way we can buy one somewhere?

 

[kate_g]

Hey, two thoughts from the veterinary left field... The trouble with banana peels is they're not nearly as tough as real skin. This might be less of an issue working on us thin-skinned humans, but you'd end up really surprised trying to cut open a tough old critter for the first time, anyway. So it might be overkill for you, but veterinary types sometimes practice on a cheap pair of soft leather work gloves from the hardware store. (If you're just looking to get the motor patterns down, bananas and oranges seem to be the thick-skinned fruits of choice.)

Also, for buying your own instruments to practice with, try eBay (really!). You can get cheap ones for $10-$20.

 

[Amy]

We keep hearing that we should be practicing surgical skills, technique, etc at home to be 'ready' as soon as they ask us to do stuff in the OR. What besides practicing tying can we do at home?
What did you senior residents do in yr first months of internship that you felt helped you get the basic skills?

Play plenty of video games to get better at laparoscopic surgery.

 

[Dunce]

I haven't started doing it yet... but I've heard you should practice opening and closing needle drivers, especially without your fingers in the holes.

Anybody have advice on a type of hemostat / needle drivers for a med student to get just to play around with at home?
Is something like a 5.5" Kelly pretty standard to get used to using and help "get the feel of things?"

these things are dirt cheap
http://www.allheart.com/forceps.html

 

[njbmd]

Anybody have advice on a type of hemostat / needle drivers for a med student to get just to play around with at home?
Is something like a 5.5" Kelly pretty standard to get used to using and help "get the feel of things?"

these things are dirt cheap
http://www.allheart.com/forceps.html

Hi there,
Anything is better than nothing at all. I have some of the cheap disposable hemostats which have worked well for practice palming. The disposable needle drivers are pretty flimsy but again, they are better than nothing. Get expired suture material from the OR nurses/techs and you are set. It's not perfect but you will get some practice.

njbmd

 

[energy_girl]

Where can one get sutures? It's difficult to get them from the OR at my hospital (scrubs nurses watch equipment like hawks). Any sutures for sale on the web somewhere?

 

[Blade28]

eBay

 

[Jocomama]

So much wasted - ask OR purchasing department person - or head scrub nurse, or residents
So much available that is tossed out -
\
Ask your resident.
The only thing you may want to buy, or ask OR is for old set of Adson (w/teeth) forceps and a needle driver
Go to big grocery store and buy pigs feet - closest thing.
That's what I did back in 1985, and pigs feet haven't gone up much in price - HA

Where can one get sutures? It's difficult to get them from the OR at my hospital (scrubs nurses watch equipment like hawks). Any sutures for sale on the web somewhere?

 

[bostonsurg]

Try esutures.com- you can purchase pretty much any kind of suture material in a variety of needles sizes. Mostly expired or close to expiring stuff. I would still try to get some from the OR though...Good luck!

 

[oldman]

Where can one get sutures? It's difficult to get them from the OR at my hospital (scrubs nurses watch equipment like hawks). Any sutures for sale on the web somewhere?

they watch them like hawks, but you can ask the scrub nurses for extra "clean" sutures. they'll give you some that's not been contaminated by blood.

if you want equipment like a needle driver, that'll be more difficult. i was able to borrow some from the OR cause i needed some equipment for a clinic patient, they actually gave a whole tray of equipment with a bunch of needle drivers. so of course we took those out to let the students on the team practice. the chief of surgery here is awesome though cause he came to the work room and went through basic suturing and tying with the students. if you can get an attending to do that, he'll be able to scrounge up equipment too.