DAFTAR INSTRUMENT DAN ALKES YANG DIGUNAKAN

DALAM TINDAKAN OPERASI

Tanggal :……………………. Nama :……………………. No. CM :……………………. Diagnosa :…………………....

Status :……………………

Jam :……………………Umur :……………………Jenis Kelamin :……………………..Ruangan :…………………….Tindakan operasi :……………………

Set Instrument :………………………

No Nama Instrument / Alkes Pre op Post op Keterangan1 Towel Forcep (Duk Klem)2 Scaple Handle No 3 (Gagang Pisau)3 Scaple Handle No 4 (Gagang Pisau)4 Metzeinboum Tissue Scissor (Gunting Jaringan)5 Suture Scissor (Gunting Benang)6 Needle Holder (Nald Poeder)7 Anatomic Dissecting Forcep(Pinset Anatomis)8 Cirurgic Tissue Forcep(Pinset Sirurgis)9 Artery Pean Haemostatic Forcep Straight (Klem Lurus)10 Artery Pean Haemostatic Forcep Curved (Klem Bengkok)11 Kocher Haemostatic Forcep Straight (Kocher Lurus)12 Kocher Haemostatic Forcep Curved (Kocher Bengkok)13 Sponge Holding Forcep (Ovarium Klem)14 Langen Beck Retractor (Hak Langen Beck)15 Roux Retractor (Roux Hak)16 Doyen Abdominal Retractor (Hak Doyen)17 Richardson Retractor (Hak Sedang)18 Reverdin Abdominal Spatula (Spatula Besar)19 Ochner Abdominal Spatula (Spatula Sedang)20 Collin Abdominal Retractor (Hak Prostat)21 Balfour Automatic Abdominal Retractor (Hak Prostat)22 Cussing Vein Retractor (Hak Ureter)23 Randall Stone Tank24 Artery Pean Haemostatic Forcep Curved 18”(Klem Bengkok)25 Hysterectomy Haemostatic Forcep (Klem Histerectomy)26 Trocar27 Tenaculum Forcep (Cunam)28 Allis Tissue Forcep (Alis Klem)29 Four Prong Volkman (Hak Gigi)30 Yankeur Canula (Kanul Suction)31 Small Bowel 0,16 L (Kom Kecil)32 Bowel 0,4 L33 Selang Suction34 Knopt Sonde (Slip Sonde)35 Probe Sonde (Guide)36 Deaver Retractor

Mengetahui operator

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Instrumenter

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