SMR Surgery Set

SMR (Submucosal Resection) is a surgical procedure often performed in otolaryngology (ENT) to address nasal obstruction. This condition typically results from a deviated septum or hypertrophic turbinates. The procedure involves removing excess tissue from the nasal passages to restore proper airflow and alleviate symptoms like breathing difficulty or chronic sinus infections.

Instruments in the SMR Surgery Set

The SMR surgery set includes a variety of specialized instruments tailored to the specific needs of nasal surgery. Below is a breakdown of the key instruments:

1. Scalpels & Blades

• Purpose: Used to make precise incisions in the nasal mucosa.
• Description: These disposable blades create controlled incisions with minimal bleeding.
• Usage: Surgeons use scalpels to access underlying structures like the nasal septum or turbinates.

2. Nasal Speculum

• Purpose: Helps widen the nostrils for better visibility and access.
• Description: This tool gently spreads the nasal walls to create space for surgery.
• Usage: It prevents the tissue from collapsing during the procedure and keeps the site visible.

3. Surgical Forceps

• Purpose: To grasp, manipulate, or retract tissue during surgery.
• Description: Forceps come in various designs and sizes.
• Usage: Surgeons use forceps to hold tissue in place or assist with removing parts of the septum or turbinate.

4. Resection Instruments

• Purpose: To remove obstructive submucosal tissue or cartilage.
• Description: Instruments like microdebriders, punches, and surgical scissors are used for precise tissue removal.
• Usage: Microdebriders help in minimally invasive excisions, shaving or suctioning tissue without damaging surrounding areas.

5. Electrocautery/Diathermy

• Purpose: To control bleeding during surgery.
• Description: High-frequency electrical current is used to cauterize blood vessels.
• Usage: Electrocautery instruments seal blood vessels to minimize bleeding, ensuring a safer procedure.

6. Surgical Suction

• Purpose: To maintain a clean surgical field.
• Description: Flexible tubing and small tips remove blood, mucus, and debris during the procedure.
• Usage: Suction clears the nasal cavity, improving visibility and safety.

7. Nasal Endoscope

• Purpose: Enhances the surgeon’s view of the nasal cavity.
• Description: An endoscope with a camera allows detailed visualization of nasal structures.
• Usage: The surgeon uses the endoscope to ensure accurate resection and avoid damage to healthy tissue.

8. Bone Cutters and Rasp

• Purpose: To reshape nasal septum or turbinate bones.
• Description: These tools are designed to handle dense bone material for controlled removal.
• Usage: Bone cutters are used when the septum is deviated, requiring reshaping or removal of bone.

9. Nasal Packing Materials

• Purpose: To control bleeding and support healing after surgery.
• Description: Sterile gauze or balloons are used to apply pressure and reduce swelling.
• Usage: Nasal packing is usually removed within a few days after the procedure.

10. Sutures

• Purpose: To close incisions and aid in healing.
• Description: Absorbable sutures eliminate the need for removal.
• Usage: Sutures close any external or internal incisions made during surgery.

Procedure Overview

1. Preparation

The patient receives local anesthesia, sometimes combined with sedation. The nasal mucosa may be treated with a decongestant to shrink it, ensuring better visibility during surgery.

2. Incision

The surgeon uses a scalpel to make precise incisions inside the nasal cavity or externally, if necessary. This allows access to the obstructive tissue.

3. Resection

Excess or obstructive tissue, such as part of the septum or turbinate, is removed or reshaped using tools like microdebriders and bone cutters. This step restores airflow.

4. Coagulation

Electrocautery may be employed to seal any bleeding blood vessels, minimizing postoperative bleeding.

5. Closing

After removing the tissue and controlling bleeding, the surgeon closes the incisions and inserts nasal packing to support the healing process.

6. Recovery

The patient is monitored briefly after surgery. Nasal packing is removed within a couple of days, and full recovery can take several weeks.

Indications for SMR Surgery

SMR surgery is performed for various nasal obstructions, including:

• Deviated Septum: A crooked septum that causes breathing difficulty or recurrent sinus infections.
• Hypertrophic Turbinates: Enlarged turbinates obstructing the nasal passages.
• Chronic Sinusitis: Long-term sinus inflammation causing breathing difficulties.
• Nasal Polyps: Non-cancerous growths blocking airflow.

Conclusion

The SMR surgery set is essential for surgeons treating nasal obstructions due to structural issues like a deviated septum or hypertrophic turbinates. With precise instruments for tissue removal, bleeding control, and post-operative support, this set plays a crucial role in ensuring successful patient outcomes.