Surgical instruments with names and uses

Instruments are classified by their function

• Cutting & Dissecting
• Grasping & Holding
• Clamping & Occluding
• Exposing & Retracting
• Suturing & Stapling
• Viewing
• Suctioning
• Dilating & Probing
• Measuring
• Microinstruments
• Powered instruments

Cutting & Dissecting

- Cutting instruments have sharp edges. They are used to dissect, incise, separate, or excise tissue.

- Most instrument sets will include #3 and #7 knife handles & suture, curved mayo, metz and tenotomy scissors.

Knife Handles

- Come in various widths & lengths

- Blades are attached by slipping the slit in the blade into the groove on the handle

Knife Blades

- #10 are used for large skin incisions

- #15 are used for short shallow incisions

- #11 are used for initial skin puncture of tiny deep incisions

Other Knife handles

- Long handles are used inside deep incisions (e.g., open abdominal cases)

- Beaver knifes are used for small delicate cases

Scissors

- Blades of scissors may be straight, angled, or curved

- Tips may be pointed or blunt, handles may be long or short

- Should be used only for their intended purpose

- Most instrument sets will include:

• Straight Mayo (Suture) Scissors
• Bandage/Dressing Scissors
• Curved Mayo Scissors
• Metzenbaum Scissors
• Tenotomy scissors
• Iris Scissors

Other cutting Instruments

• Ronguer
• Osteotome
• Curette
• Freer Elevator
• Rasp

Grasping & Holding

- These instruments are used to grasp tissue and hold it in place without injuring surrounding tissues

- Forceps can be ringed or the thumbed variety

- Most instrument sets will include kocher, allis, Russians , Ferris Smith, babcock, adson, tissue, debakey forceps, sponge sticks & towel clips.

Clamping & Occluding

- These instruments are used to apply pressure

- Some clamps are designed to crush the structure when applied

- Others are noncrushing and are used to occlude or secure tissue

- Most instrument sets will include mosquito, crile, kelly, tonsil, peon, and right angle clamps, Bowel Clamp, Vascular Clamp, Bulldogs.

Exposing and Retracting

- Used to pull Soft tissue and muscle aside to expose surgical site

• 2 types: Hand held & Self retaining

- Most instrument sets will include small hand held , army-navy, malleable, weitlaner, and richardson retractors.

Hand Held Retractors

Skin Hooks, Skin Hooks, Senn, Cushing Vein Retractor, Volkman, Army-Navy, Malleable, Richardson, Kelly, Harrington, Deaver.

Self Retaining Retractors

Weitlaner, Cerebellar, Gelpi, Balfour, Bookwalter.

Suturing and Stapling

- Needle holder sizes vary according to type of needle used

- Most instrument sets will have webster, crilewood, Castroviejo, Skin Stapler, Weck Hemoclip Applier, Ligaclip Applier, Staplers, and mayo hegar type needle holders.

- Clip appliers place individual staples, available in reusable and disposable

- Disposable staplers

Viewing

- Surgeons can examine body cavities, hallow organs, or structures with viewing instruments

- Procedures may be performed through them

- Most instrument sets will include:

• Nasal Speculum
• Vaginal Speculums
• Rectal Speculums
• Rigid Endoscope
• Laparoscopic Trocars
• Laparoscopic Instruments
• Thorascopic Trocars
• Arthroscopy Cannulas
• Cystoscopy Sheath
• Camera & Light Cord
• Flexible Bronchoscope
• Flexible Ureteroscope
• Proctoscope

Suctions

• Yankauer
• Frazier
• Poole

Probes & Dilators

• Uterine Dilators
• Uterine Sound
• Urethral Sounds
• Lacrimal Duct Probe
• Vascular Tunnelers

Measuring

• Rulers
• Depth Gauge
• Total Hip Trials

Microinstruments

• Castroviejo Needle Holder
• Micro Scissors
• Bishop Harman Forceps

Powered Instruments

3 Types

• Battery powered
• Air powered
• Electric powered

Care & Handling of Instruments

- Instruments are placed firmly into the surgeon’s palm in such a manner that it is ready of immediate use.

- Ringed instruments are handed with the box locks closed.

- Curved instruments are passed with the curve in the direction of intended use.

- To facilitate suturing the needle is secured about 1/8 inch down from the tip of the needle holder and about a third of the distance from the eye or swaged end

During the procedure, used instruments should wiped with a damp sponge or placed in a basin of sterile distilled water.

- Do not saline on instruments.

- Do not allow blood to dry on instruments.

- Saline & blood can damage instrument surfaces causing corrosion and pitting.

- Flush suction tips with sterile distilled water periodically to keep lumens patent.

- Flush all lumened instruments thoroughly at the end of case to prevent blood from drying inside lumens.

- Powered hand pieces and batteries should not be immersed in liquid as this could damage internal mechanisms.

You can view pictures of all the mentioned surgical instruments in this file: Surgical Instruments and Their Uses Illustrated.