Surgical Instruments Slides PDF

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
#7 #4 #3
widths & lengths
 Blades are attached
by slipping the slit
in the blade into the
groove on the
handle
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
short shallow
incisions
initial skin puncture
of tiny deep #10 #15 #11
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
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
 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
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
 Used to pull Soft tissue and muscle
aside to expose surgical site
 2 types:
– Hand held
– Self retaining
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
 Needle holder sizes vary according
to type of needle used
 Most instrument sets will have
webster, crilewood, and mayo
hegar type needle holders.
 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.

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Surgical Instruments

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