Surgical Instruments

Surgical Instruments

Instruments Instruments are classified by their function Cutting & Dissecting Grasping & Holding Clamping & Occluding Exposing & Retracting Suturing & Stapling Viewing Suctioning

Instruments Dilating & Probing Measuring Microinstruments Powered instruments

Cutting & Dissecting

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 #7 #4 #3

Knife Blades Blades with numeric prefix of 1 (e.g., 10, 11, 12, 15) fit #3 or #7 handles Blades with the numeric prefix 2 (e.g., 20, 21, 22, 23, 24) fit #4 handles

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 #10 #15 #11

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

Straight Mayo (Suture) Scissors

Bandage/Dressing Scissors

Tissue/Dissecting Scissors

Curved Mayo Scissors

Metzenbaum Scissors

Tenotomy scissors

Iris Scissors

Other cutting Instruments

Ronguer

Osteotome

Curette

Freer Elevator

Rasp

Grasping & Holding

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

Grasping & Holding Most instrument sets will include kocher, allis, babcock, adson, tissue, debakey forceps, sponge sticks & towel clips.

Forceps

Kocher

Allis

Babcock

Sponge Stick

Towel Clip

Adsons

Tissue

Ferris Smith

DeBakey

Russians

Clamping & Occluding

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

Clamping & Occluding Most instrument sets will include mosquito, crile, kelly, tonsil, peon, and right angle clamps.

Anatomy of a Clamp

Mosquito

Crile

Kelly

Tonsil

Peon

mosquito crile kelly tonsil peon

Right Angle

Non-crushing Clamps

Bowel Clamp

Vascular Clamp

Bulldogs

Exposing and Retracting

Exposing and Retracting Used to pull Soft tissue and muscle aside to expose surgical site 2 types: Hand held Self retaining

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

Hand Held Retractors

Skin Hooks

Senn

Cushing Vein Retractor

Volkman

Army-Navy

Malleable (Ribbon)

Richardson

Kelly

Harrington

Deaver

Self Retaining Retractors

Weitlaner

Cerebellar

Gelpi

Balfour

Bookwalter

Suturing and Stapling

Suturing and Stapling Needle holder sizes vary according to type of needle used Most instrument sets will have webster, crilewood, and mayo hegar type needle holders.

Suturing and Stapling Clip appliers place individual staples, available in reusable and disposable Disposable staplers

Needle Holders

Webster

Crilewood

Mayo Hegar

Castroviejo

Skin Stapler

Weck Hemoclip Applier

Ligaclip Applier

Staplers

Viewing

Viewing Surgeons can examine body cavities, hallow organs, or structures with viewing instruments Procedures may be performed through them

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

Powered Instruments 3Types Battery powered Air powered Electric powered

Stryker System 5

Midas Rex

TPS System

Arthroscopic Shaver

Minor Set

Major Set/Lower Tray

Major Set/Upper Tray

Major Retractor Set

Care & Handling of Instruments

Handling 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

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

Care of Instruments Do not saline on instruments. Do not allow blood to dry on instruments. Saline & blood can damage instrument surfaces causing corrosion and pitting.

Care of Instruments 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.

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