Instruments😍

Surgical Instruments Overview

Open Surgical Instruments

1. Holders

• RAMPLEY'S SPONGE HOLDER:



• Fenestrated blade with serrations.
• Grips sponges for part preparation.

• Mixter

• BP (BRAD PARKER) HANDLE:



• Mounts surgical blades.
• Holding positions: paint brush or palming grip.

• NEEDLE HOLDER:



• Grips needle during suturing.
• Hold needle at 1/3 to 2/3 junction.
• Enter skin at 90-degree angle.
• Note: Toothed forceps also used for needle grip.

2. Suction & Clips

• YANKAUER’S SUCTION CANNULA:



• Suctions blood and fumes.
• Types: plastic, metallic.

• TOWEL CLIPS:
• Holds towels after draping.
• Holds suction catheters or cautery.
• Holds tongue during resection.
• Types: Doyen's, Mayo's.

3. Forceps

• General: Spring loaded.

• Plain Forceps:



• Transverse serrations, no teeth.
• A-traumatic for delicate tissues.

• Toothed Forceps:



• Have teeth.
• Traumatic, for tougher structures.

• Russian Forceps:



• Criss-cross serrations.
• Prevents needle movement.

• DeBakey's Vascular Forceps:



• Minute serrations, raised edges.
• Delicately grips vascular structures.

• Adson

4. Scissors

• Heavy (Mayo Scissor):



• Screw joint, blades.
• Cuts sutures and sheaths.
• Considered traumatic.

• Metzenbaum Scissors:



• Lighter.
• Tissue dissection scissors (avoid for sutures).

• McIndoe Scissors:



• Finer.
• Cuts skin and fat.
• Common in ophthalmic, ENT surgeries.

• Note: Skin suturing instruments include needle holder, toothed forceps, and scissors

5. Retractors

• Non-Self Retaining Retractors:
• Held manually during surgery.
• Skin Hooks:



• Holds raised flaps (mastectomy, thyroidectomy, parotidectomy).
• Single or double handles.
• Cat's Paw Retractor: Retracts superficial tissue.
• Langenbeck Retractor:



• Right-angle, for superficial tissue.
• Fenestrations (lighter), broader (cholecystectomy).
• Army Navy/ Czerny's Retractor:





• One 90-degree end, one clawed with gap.
• Suturing tissues while retracted.
• Morris Retractor:





• Broader than Langenbeck's.
• Better grip, prevents slipping.
• Lighter.
• Doyen's Retractor:



• Convexity for easy retraction.
• Common for bladder retraction.
• Deaver’s retractor
• Retract liver

• Malleable Retractor:
• Common for bowel retraction in abdominal surgeries.

Self-Retaining Retractors:

• Allows instruments to self-retract.

• Mastoid Retractors: Superficial tissue (thyroid, parotid surgeries).







 

• Balfour Self-Retaining Retractor:



• Deeper abdominal structures.
• Bar, blades for retraction, space for Doyen's.

• Bookwalter Retractor:



• Complex abdominal malignancy surgeries.
• Ring attaches to table, space for multiple retractors.

6. Artery Forceps

• Spencer Wells Forceps:
• Straight, various sizes.
• Holds bleeders.

• Curved Artery Forceps:
• Holds bleeders, better visualization.
• Smallest type: Mosquito forceps.

7. Special Forceps

Kelly's Forceps:

• Curved, larger, gradual curve.

• Used in abdominal surgeries.

Mixters Right Angle Forceps:

• Right-angle curve.

• Used to tag pedicles.

Allis Forceps:

• Green Armytage foreceps

• Blades with serrations and teeth.

• Traumatic, holds tough structures (sheaths, fascia).

• Mnemonic: Alli → Pallu (at ends)

Babcock Forceps:

• Gap between two fenestrated ends.

• Holds tubular structures (appendix, vas deferens, fallopian tubes) without crushing.

• Mnemonic: Babcock → hold cock like tubular structured

Kocher Tissue Forceps:

• Interlock to crush tissue → ARM

• Holds tough structures and cervix (hysterectomy).

• Mnemonic: Koch crush cheyyum

Lister's Sinus Forceps

• Uses:
• For blunt dissection
• During Hilton's method of abscess drainage to break bacterial loculi.
• For inserting or removing packing in sinus cavity.

Desjardin's Choledocholithotomy Forceps

• Uses:
• For CBD stone removal.
• May also be used for removal of kidney, ureteric, or bladder stones.

• Features:
• Long and slender instrument.
• Finger bows present, but no catch.
• Shaft is curved.
• Blades are small, without serrations, and centrally fenestrated.
• Mnemonic: Desjarine → stones eduth Jaril idum

Cord Holding Forceps

• Use:
• Typically used to hold spermatic cords.

Pile Holding Forceps

• Use:
• Used to hold hemorrhoids.

Thoracotomy Instruments

• Periosteal Elevator (Farabeuf’s): Raises periosteum over a rib.

• Rib Raspatories:



• One for each side.
• Resects periosteum and muscles.
• Held laterally, convexity up, tip down.

• Rib Cutter:



• Blunt lower edge (prevents pleural injury).
• Bone cutters have sharp edges.

• Bone Nibbler:
• Nibbles sharp edges after bone cutting.

• Lung Retractor (Allison Lung Retractor):
• Fenestrated blade allows lung expansion on retraction.

• Lung Forceps:



• Resects small tissues (hamartomas, nodules).
• Triangular end provides bloodless field.

• Joll’s Thyroid Retractor: (Obsolete) Involved 4 retractors to retract thyroid.

Vascular Surgical Instruments

• Bulldog Clamp:



• Self-retaining clamp.
• "Pinch cock effect" with serrations.

• Satinsky Vascular Clamp:
• Curved clamp with serrations.
• Applied over pedicle for better visualization.

• Aneurysm Needle:
• Hook with an opening at the end.
• Used for aneurysm ligation.

Other Instruments

• Ovum Forceps:



• Two convex ends with fenestrations.
• Removes retained placental or fetal tissue.

• Cystolithotomy Forceps:



• One full thumb ring, one open port.
• No lock (prevents stone crushing).
• Studs at end for grip.

• Bowel Clamps:
• Non-crushing (Doyen's Intestinal Clamp):



• Longitudinal serrations (prevents tissue crushing).
• Prevents spillage of fecal matter.
• Payrs crushing clamps



• Removes portion of bowel

• Cheatle’s Forceps: Two ends, no lock. Picks up gauze pieces.

• Pyelolithotomy Forceps: (Obsolete)



• Varied angulations for calyceal access.
• Transverse serrations at ends, no lock.

• Choledocholithotomy Forceps (Desjardin’s Forceps):



• Brings down CBD (Common Bile Duct) stones.
• Notably, no serrations.