Surgical Instrumentation

Surgical
Instrumentation
OPERATING ROOM TECHNIQUES
Classification of Instruments
1) Cutting and Dissecting
 Used to incise, dissect, separate or excise tissue
 Scalpel, Knives, Scissors, Bone cutters and Debulking tools Blunt dissectors
2) Grasping and Holding

 Forceps such as Delicate, Adson, Bayonet, Smooth, Toothed, Allis, Babcock,
Lahey, Stone, Tenaculums, Bone Holders
3) Clamping and Occccluding

 Used to apply pressure
 Hemostatic forceps, Hemostats, Crushing clamps, Non crushing vascular clamps
4) Exposing and Retracting
 Pulling aside tissues, muscles and other structures for exposure
 Handheld retractors, Malleable retractors, Hooks, Self retaining retractors
5) Suturing or Stapling
 Needle holders, Tungsten carbide jaws, Cross hatched serrations, Smooth jaws,
Staplers, Clip appliers, Terminal end staplers, internal anastomosis staplers, End to
end circular staplers
6) Viewing
 Speculums, Endoscopes, Hallow/Lensed endoscopes
7) Suctioning, Irrigating and Aspirating
 Suction, Poole abdominal tip, Frazier tip, Yankauer tip, Autotransfusion, Aspiration,
Trocar, Cannula
Scalpels
 Number 10 blades are rounded toward the tip and are often used to open the
skin
 Number 11 blades have a linear edge with a sharp tip. Can be used to make
initial skin puncture for tiny deep incisions
 Number 12 blades have a curved cutting surface like a hook. Commonly used
for tonsillectomy
 Number 15 blades have a short rounded edge for shallow short controlled
incisions
 Number 20 blades are shoed similar to 10 but larger
Tissue dissecting scissors
 Blades needed to cut tough tissues are heavier
 Curved or angled blades are needed to reach under or around structures
Suture scissors
 Have blunt point to prevent structures close to the structure from being cut
Wire scissors
 Short heavy blades
 Used to cut stainless steel sutures
Short jaw sharp tip scissors
 For deep areas such as the nasal cavity
Sharped tipped angled scissors
 For vascular surgery
 E.g., Potts angled
Dressing bandage scissors
 Used to cut drains and dressings and to open items such as plastic pockets
Small scissors with specially shaped tips
 Tenotomy scissors
Metzenbaum scissors
Bone Cutters Debulking tools
 Osteotomes
Biopsy Forceps and punches
 A small piece of tissue for pathologic exam
Curettes
 Tissue or bone is removed by scraping with the sharp edge of the loop or scoop
Snares
 A loop or wire may be put around a pedicle to dissect tissue such as a tonsil
Bishop Eye forceps
 Fine tissues such as eye tissue are held with delicate forceps
Adson forceps
 Used to pick up or hold soft tissues during closure
Bayonet forceps
 Angled to prevent the users hand from occluding vision in a small space
Smooth Forceps
 Also referred as thumb or pick ups. It resembles tweezers.
 Will not injure delicate structures
Toothed forceps
 Heavy types are referred to as rat toothed forceps
 Provides a firm hold on tough tissues including skin
Allis forceps
 Has a scissors action. Each jaw curves slightly inward and there are a row of teeth
at the end
Babcock forceps
 End is rounded to fit around a structure or to grasp tissue without injury
Lahey forceps
 Ends are sharp points for grasping tough organs or tumors
Stone forceps
 Either curved or straight to grasp calculi such as kidney stones or gallstones
 Have blunt loops or cups at the end of the jaws
Tenaculums
 Curved or angled points used to penetrate tissue to grasp firmly such as a uterine
tanaculum
 E.g., Hulka tenaculum
Bone Holders
 Grasping forceps, Vice grip forces
Hemostatic forceps
 Used for occluding blood vessels have two opposing serrated jaws
Hemostats
 Most commonly used for surgical instruments and are used primarily to clamp
blood vessels
 Have a crushing action, either straight or curved
Crushing clamps
 Used to crush tissues or clamp blood vessels
Non crushing vascular clamp
 Used to occlude peripheral or major blood vessels temporarily which minimizes
tissue trauma
Volkmann rake retractor
Army navy retractor
Malleable retractor
 “ribbon” may be bent to the desired angle and depth
Freeman face lift retractor
Harrington sweetheart retractor
Eastman retractor
Mayo retractor

Surgical Instrumentation

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Surgical

2) Grasping and Holding

3) Clamping and Occccluding

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