OT INSTRUMENTS

MS. REVATHY. A
 A surgical instrument is a tool or device for performing specific
actions or carrying out desired effects during a surgery or
operation, such as modifying biological tissue, or to provide access
for viewing it.

 Some surgical instruments are designed for general use in all sorts
of surgeries, while others are designed for only certain specialties
or specific procedures. 
 The nomenclature of surgical
instruments follows certain patterns,
such as a description of the action it
performs (scalpel, hemostat), the name
of its inventor(s) (the Kocher
 forceps), or a compound scientific
name related to the kind of surgery ( a 
tracheotome is a tool used to perform
a tracheotomy).
1. Scalpel
 A scalpel, lancet, or bistoury, is a small
and extremely sharp bladed instrument used
for surgery, anatomical dissection, podiatry.

 Surgical scalpels consist of two parts, a

blade and a handle.

 The handles are often reusable, with the

blades being replaceable. In medical
applications, each blade is only used once
(sometimes just for a single, small cut).
 The handle of medical scalpels come
in several basic types. 

 Blades are manufactured with a

corresponding fitment size so that
they fit on onaly one size handle.
2. Forceps
 Forceps are a handheld, hinged instrument used for grasping and holding objects.

 Forceps are used when fingers are too large to grasp small objects or when many
objects needed to be held at one time while the hands are used to perform a task.

 Surgical forceps are commonly made of high-grade carbon steel, which ensures

they can withstand repeated sterilization in high-temperature autoclaves.
 They are made of other high-quality stainless steel, chromium and vanadium alloys
to ensure durability of edges and freedom from rust.

 The invention of surgical forceps is attributed to Stephen Hales.

 There are two basic types of forceps: non-locking (often called "thumb forceps" or
"pick-ups") and locking, though these two types come in dozens of specialized
forms for various uses.
A) Thumb forceps

 Thumb forceps, known simply

as forceps in surgical specialties,
are commonly held in a pen grip
between the thumb and 
index finger (sometimes also the 
middle finger).
 Spring tension at the top end
holds the grasping ends apart
until pressure is applied.
 This provides an extended pinch and allows the
user to easily grasp, manipulate and quickly
release small objects or delicate tissue with
readily variable pressure.
 Thumb forceps are used to hold tissue still when
applying sutures, to gently move tissues out of
the way during exploratory surgery and to
access confined cavities that are hard to reach
with hands and fingers
 Thumb forceps can have smooth tips, cross-hatched tips or serrated
tips (often called "mouse's teeth").
 Serrated forceps are used on tissue; counter-intuitively, teeth will
damage tissue less than a smooth surface because one can grasp
with less overall pressure.
 Smooth or cross-hatched forceps are used to move dressings,
remove sutures and similar tasks.
B) Locking forceps

 Locking forceps, sometimes called clamps, are used to

grasp and firmly hold objects or body tissues, or to apply
external compression onto tubular structures such as 
blood vessels or guts.

 When they are specifically used to occlude an artery to 

forestall bleeding, they are called hemostats. 

  Another form of locking forceps is the needle holder,

used to guide a suturing needle through tissue.
 Many locking forceps use finger
rings/loops to facilitate handling.

 The finger loops are usually grasped by

the thumb and middle or ring fingers,
while the index finger helps stabilize and
guide the instrument.
a. Artery Forceps

 It is the main and essential instruments in

the surgical instrument tray.
 The main uses of artery forceps for
controlling bleeding and for the retraction
of tissues, skin, etc.
 Artery forceps are otherwise called as
Haemostatic forceps.
 The hemostat used to blocks the flow of
blood and tips close the blood vessels.
 Its also used to hold the tissue and skin.
b) Mosquito Forceps

 Mosquito artery Forceps are used as a hemostat for blood

vessels.

 Used to hold delicate tissues.

 Used in most of surgical cases.

c) Allis Forceps
 An Allis clamp (also called the Allis forceps) is a
commonly used surgical instrument.
 It was invented by Oscar Allis.
 The Allis clamp is a surgical instrument with sharp teeth,
used to hold or grasp heavy tissue. It is also used to
grasp fascia and soft tissues such as breast or bowel
 tissue. Allis clamps can cause damage, so they are often
used in tissue about to be removed.
 When used to grasp the cervix to stabilize the uterus,
such as when an intrauterine device is being inserted, an
Allis clamp has the advantage of causing less bleeding
than the more commonly used tenaculum.
d) Kocker’s Forceps

 Kocher Forceps contain 1x2 teeth on straight or

curved jaws to avoid slippage when trying to
grip arteries.
 This hemostatic forceps is typically used for
general surgeries, it may also be applied to
more specific procedures such as of the
gallbladder or removal of the thyroid.
 Helps to hold ribs during rib resection.

 To rupture the gestational membrane.

 e) Babcock Forceps

 Babcock forceps are one of the most recognized

surgical instruments and continue to be widely
used by surgeons today.
 As atraumatic tissue forceps, they allow the
surgeon to manipulate bowel and are often used
in bowel anastomosis and cardiothoracic
procedures.
 They are helpful in grasping delicate tissue.
 Helps to hold intestine, fallopian tube, ovaries ,appendix etc.
f) Sponge-holding Forceps
 Sponge forceps, also known as
sponge holding forceps, are used for
holding swabs or sponges in medical
procedures.
 The jaws themselves are normally
rounded.
 Elongated tips may be included for
delicate operations.
 Medical sponge forceps allow minor
surgical operations to be performed
without excessive trauma or damage.
g) Needle Holder

 A needle holder, also called needle

driver or needle forceps, is a 
surgical instrument similar to a hemostat,
used by doctors and surgeons to hold and
push a suturing needle when performing 
wound closure, ligation and other 
surgical procedures that require 
re-anastomosis.
h) Right angled artery forceps
3. RETRACTOR
 A retractor is a surgical instrument used to separate
and manipulate the edges of a surgical incision or 
wound, or to hold back underlying organs and tissues
 so that body parts underneath may be accessed.
 The broad term retractor typically describes a simple
steel tool possessing a curved, hooked, or angled
blade, which when in place helps to maintain the
desired position of a given region of tissue during
surgery. 
 Retractors can also be "self-retaining," and not need to be held once
inserted, having two or more opposing blades or hooks which are
separated via spring, ratchet, worm gear or other method.
 The term retractor is also used to describe distinct, hand-cranked
devices such as rib spreaders (also known as thoracic retractors, or
distractors) with which surgeons may forcefully drive tissues apart to
obtain exposure.
 Different surgery specialties can have specific kinds of retractors 
 1. Hand Retractors - (Manual) must be
held by an assistant, a robot or the
surgeon during a procedure. 
Categories
2. Self Retaining Retractors - (Stay
open on their own) have a screw, ratchet
or some type of clamp to hold the tissue
by itself. These allow the surgeon with
two free hands.
 A) Langenbeck Retractor

 Langenbeck Retractor is a very popular surgical device that

allows surgeons to pull back soft tissues and incision or wound
edges during a wide range of general surgeries.

 Versatile L-Shaped tip for retracting wide slices of tissue.

 Terminal downward curve for protecting surrounding structures.

 B) Doyens Retractor

 Mainly used in abdominal OB/GYN procedures

like procedures for ectopic pregnancies,
abdominal hysterectomies, cesarean section
deliveries
 Available in stainless steel material finish
 As a gynecological instrument, it is specifically
made to be used in pelvic operations
 Used to hold organs back while
surgery is being conducted
 Coming in passivated, ultrasonic
cleaned and dull-polished finish
 Provides for left hand/right-hand
usage
 Also used by surgeons to either
actively separate edges of the
surgical incision or wound
C) Kelly Retractor

 Kelly Retractors are used for deep exposure.

 The retractors have a long flat blade and a finger ring
handle for a secure grip.
 This retractor is commonly used to pull back, or retract, the edges
of wounds in order to expose the surgical area. 
D)Skin hook
E) Devers
Retractor

 Used to retract deep abdominal

or chest incisions.
 Used
in Cholecystectomy (removal
of gallbladder) for retraction of
right lobe of liver.
 Used in Truncal vagotomy
(division of the main trunk of
the vagus nerve)  for retraction
of left lobe of liver. 
F) Morris Retractor

 Used while making and closing

abdominal incisions for ease of
working in the deeper layers.
 Used to retract Pectoralis major in
MRM for better visualization during
axillary dissection.
 Self-retaining retractors have locking mechanisms that keep the
blades apart and in place while spreading the edges of the incision
and holding other tissue in place, thus freeing the surgeon's and
assistant's hands for other tasks.
G) Weitlaner and
Gelpie Retractors

 Two of the most commonly used

self-retaining retractors are the
Weitlaner and Gelpie retractors.
 These are used to retract skin edges
for superficial procedures.
 Care must be taken not to puncture
vital tissues or oneself with the
sharp points of these retractors.
H) Balfour and Bookwalter
Retractors
 The Balfour and the Bookwalter are self-
retaining abdominal wall retractors with
various deep and shallow blades that can be
attached and removed as needed.
 The Balfour retractor is placed within the
incision, spread apart as needed, and locked
in place by tightening of a wing nut.
 The Bookwalter retractor has a single post
that attaches to the table's side rail. This
attachment takes some practice to master.
 A crossbar mounted on the post holds an
oval or round ring to which various sizes of
Richardson, malleable, and Deaver-like
blades may be attached with adjustable,
ratcheted “clips”.
 I) Goligher Retractor and Iron Intern.

 The Goligher retractor is used for abdominal operations in the

superior regions of the peritoneal cavity, particularly for gallbladder,
liver, and stomach procedures.
 It is easily attached to a crossbar placed onto the head of the OR
table.

 The Iron Intern uses a series of locking arms and joints to position
retractors within the abdomen or pelvis.
Thyroid retractor
 Aka Jolls retractor.
 During a thyroidectomy, perfect exposure of the vascular
nerve structures, parathyroid gland, trachea, larynx,
esophagus, and lymphnodes is crucial to facilitate the
surgeon in the meticulous dissection.
 It is an atraumatic self-retaining thyroidectomy retractor
specifically designed for thyroid surgeries.
  It is a sterile, single-use device which keeps the surgical
wound and the neck muscles retracted allowing the proper
exposure of the operatory field
  A rib spreader, also known as Finochietto
Rib Retractor retractor, is a type of retractor specifically
designed to separate ribs in thoracic surgery
Mastodon Retractor

 Mastoid retractor is used commonly in mastoid surgeries.

 Each of these prongs has 4 teeth. The teeth not only helps in holding the soft tissue apart,
it firmly anchors the retractor to the bone.
 Also used in head & neck surgeries like tracheostomy & thyroidectomy.
3. Scissors
 Surgical scissors are scissors specially manufactured as surgical instruments, typically
used for cutting sutures, dressings, and cutting and dissecting biological tissue.
 Surgical scissors are usually made of surgical steel. 
A) Mayo Scissors

 Used to cut the fascia during surgery.

 Straight- and curved-blade varieties of Mayo
scissors exist, each of which is particularly
suited to specific surgical, including 
veterinary and podiatric surgery applications.
 Straight-bladed Mayo scissors are designed for cutting
body tissues near the surface of a wound. As straight-bladed
Mayo scissors are also used for cutting sutures, they are also
referred to as "suture scissors"..
 Curved-bladed Mayo
scissors allow deeper penetration
into the wound than the type with
straight blades.
 The curved style of Mayo scissor
is used to cut thick tissues such as
those found in the uterus, muscles,
breast, and foot.
 Mayo scissors used for dissection
are placed in tissue with the tips
closed.
 The scissors are then opened so
that the tips open and spread out
the tissue during the dissection
process
B) Metzenbaum scissors

 Metzenbaum scissors are surgical scissors designed for cutting

delicate tissue and blunt dissection. 
 The blades can be curved or straight, and the tips are usually
blunt.
 This is the most common type of scissors used in organ-related
operations.
C) Plaster cutting Scissors

 Bandage Scissors are a versatile instrument with multiple uses.

 They are commonly used for sizing dressings and removing
circumferential bandages
 They may also be used to cut tougher material such as plaster,
fabric, and occasionally umbilical cord.
 The jaws of the Bandage Scissors are angled with the lower
blade being slightly longer.
 The tip of the lower blade features a flattened blunt nodule that
is intended to slide between bandages and skin without cutting
the skin.
D) Iris Scissors

 Iris scissors are a type of scissors with short blades that was originally developed for 
ophthalmic surgery.
 Iris scissors are very small, with an extremely sharp and fine tip. Some iris scissors have
curved blades for certain types of precision tasks, while others may have straight blades. [
Miscellaneous
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