Breast and Thyroid Surgery

Breast Surgery
Surgical Technology for the Surgical Technologist
Chapter 11
Breast Anatomy
Mammary Glands

Lymphatics
Breast Biopsy/Lumpectomy
Pathology
Mass
Cyst
Spontaneous discharge from the nipple
Suspicious mammogram
Biopsy vs. Lumpectomy
Breast Biopsy
Supine position
Anesthesia
Wide prep
Draping
Instruments on the Mayo
2- #3 knife handles
Pickups with and without teeth
Metz and mayo scissors
4 – hemostats
2 – allis clamps
2 – needle holders
Suture scissors
2 Senn retractors
2 – Army-navy retractors
Mastectomy
Segmental
Simple
Radical
Modified Radical
Segmental
Mastectomy
Simple
Mastectomy
Radical
Mastectomy
Modified
Radical
Mastectomy
Surgical Considerations
In some mastectomies the surgeon will want to include the arm in the sterile field allowing them to manipulate the arm for better visualization of the axillary area. The surgical tech will need to have a stockingette to cover the arm, and a drape sheet to cover the arm board.
Surgical Considerations
When performing a mastectomy with reconstruction you will need to have two separate setups. One for the mastectomy and one for the reconstruction.

Why do you think they do this?
Surgery of the Breast
Biopsy after needle localization
Disc 1
Sentinel lymph node dissection for breast cancer
Disc 2
Segmental mastectomy with immediate partial reconstruction
Disc 2
Surgery of the Thyroid and Parathyroid
Anatomy
Thyroidectomy
The Procedure
Instrumentation/Supplies
Thyroid Set
Vessel Clips
Bipolar cautery fcps
Drapes
¼ inch penrose
Suture according to Dr’s preference

Pearl of Wisdom
Maintain the integrity of the sterile field until the patient has been extubated, is breathing freely and has left the room. Some of these pts have intense swelling following this procedure and will need to have a tracheotomy performed. If this is the case you will not have time to pull another sterile setup.
Tracheostomy

Reading assignment for the next Class
ST for the ST
OB/Gyn Anatomy, special Instrumentation/Room setup and positioning
Pages 478-495
Alexander’s
Instrumentation through dressings
Pages 466-468
Homework
Questions for further study page 549
All of them