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.