Basic Surgical Instruments

A. Cutting and Dissecting
Disposable Scalpel


Knife Handles

7 handle with 15 blade (deep knife) - Used to cut deep, delicate tissue.
3 handle with 10 blade (inside knife) - Used to cut superficial tissue.
4 handle with 20 blade (skin knife) - Used to cut skin.

Scissors

straight Mayo, curved Mayo, Metzenbaum (left to right)

Straight Mayo scissors - Used to cut suture and supplies. Also known as: Suture scissors.


EX: Straight Mayo scissors being used to cut suture.

Curved Mayo scissors - Used to cut heavy tissue (fascia, muscle, uterus, breast). Available in regular and long sizes.


Metzenbaum scissors - Used to cut delicate tissue. Available in regular and long sizes.


B. Clamping and Occluding

Clamping and occluding instruments are used to compress blood vessels or hollow organs for hemostasis or to prevent spillage of contents.

Kelly Hemostatic Forceps and Mosquito Hemostats

Both are transversely serrated. Mosquito hemostats (A) are more delicate than Kelly hemostatic forceps (B). Mosquito hemostats (A) have a smaller, finer tip.

Carmalt

Heavier than Kelly. Preferred for clamping of ovarian pedicals during an ovariohysterectomy surgery because the serrations run longitudinally.

Backhaus Towel Clamp

Locking forceps with curved, pointed tips.

C. Grasping and Holding

Grasping and holding instruments are used to hold tissue, drapes or sponges.

Needle holder: Hinged (locking) instrument used to hold the needle while suturing tissue. Good quality is ensured with tungsten carbide inserts at the tip of the needle holder.
Mayo-Hegar

Heavy, with mildly tapered jaws. No cutting blades.

Olsen-Hegar

Includes both needle holding jaw and scissors blades. The disadvantage to having blades within the needle holder is the suture material may be accidentally cut.

Forceps: consist of two tines held together at one end with a spring device that holds the tines open. Forceps can be either tissue or dressing forceps. Dressing forceps have smooth or smoothly serrated tips. Tissue forceps have teeth to grip tissue. Many forceps bear the name of the originator of the design, such as Adson tissue forceps.

Rat Tooth: A Tissue Forceps

Interdigitating teeth hold tissue without slipping. Used to hold skin/dense tissue.

Adson Tissue Forceps

Small serrated teeth on edge of tips. The Adsons tissue forceps has delicate serrated tips designed for light, careful handling of tissue.

Intestinal Tissue Forceps: Hinged (locking) forceps used for grasping and holding tissue.
Allis: An Intestinal Tissue Forceps

Interdigitating short teeth to grasp and hold bowel or tissue. Slightly traumatic, use to hold intestine, fascia and skin.

Babcock: An Intestinal Tissue Forceps

More delicate that Allis, less directly traumatic. Broad, flared ends with smooth tips. Used to atraumatically hold viscera (bowel and bladder).

Sponge Forceps

Sponge forceps can be straight or curved. Sponge forceps can have smooth or serrated jaws. Used to atraumatically hold viscera (bowel and bladder).

D. Retracting and Exposing

Retracting and exposing instruments are used to hold back or retract organs or tissue to gain exposure to the operative site. They are either "self-retaining" (stay open on their own) or "manual" (held by hand). When identifying retractors, look at the blade, not the handle.

Senn

Blades at each end. Blades can be blunt (delicate) or sharp (more traumatic, used for fascia)

Hohman

Levers tissue away from bone during orthopedic procedures.

Weitlaner

Ends can be blunt or sharp. Has rake tips. Ratchet to hold tissue apart.

Gelpi

Has single point tips. Ratchet to hold tissue apart.

Basic instruments handlings
1. Scissors and Hemostats:

The thumb and ring finger are inserted into the rings of the scissors while the index and middle finger are used to guide the instrument. The instrument should remain at the tips of the fingers for maximum control.


This is the wrong way to hold the scissors. The ring finger should be inserted into the ring

This is also the wrong way to hold the scissors. The tips of the scissors should be pointing upwards.

2. Correct way of holding a scalpel.
The scalpel should be held with the handle in the anatomical snuffbox (like holding a pen).

Correct way of holding a scalpel with the handle resting in the anatomical snuff box.

The scalpel is held with thumb, middle and ring finger while the index finger is placed on the upper edge to help guide the scalpel. Long gentle cutting strokes are less traumatic to tissue than short chopping motions.


Wrong way of holding a scalpel. The grip is
unstable.

The scalpel should never be used in a "stabbing" motion.

3. Correct way of holding a needle.
The needle should be held two-thirds of the way along the shaft from the tip. Holding it too close to the tip will blunt the needle and may not allow enough length for the needle tip to emerge from the tissue. Holding the needle to close to the suture will make the needle unstable.

Correct way. The needle is held two-third of the way from the tip.


Wrong way. The needle is held too close to the tip.

4. Correct way of holding a Thumb Forceps:

Thumb forceps are held like a pencil


Thumb Forceps are not called 'tweezers'. Thumb Forceps are not held like a knife.

http://library.sccsc.edu/surgtech/instrument.htm
http://cal.vet.upenn.edu/projects/surgery/1000.htm