The document provides an overview of essential surgical instruments used in peri-operative nursing, categorizing them into classifications such as cutting, grasping, clamping, and suturing instruments. It details the components of a general surgical set and describes various instruments along with their functions and usage, emphasizing the significance of material and design. The content aims to educate health care professionals on the principles and practices of peri-operative nursing.

1. SCHOOL OF PERI-OPERATIVE AND CRITICAL CARE NURSING
KORLE-BU
LEVEL 300 SECOND SEMESTER YEAR: 2017/2018
PON 328
PRINCIPLES AND PRACTICES OF PERI-OPERATIVE NURSING II
INSTRUCTOR: CAROLINE ANTWI-ASARE (MRS)
DATE: 9TH
AUGUST, 2018

2. GROUP MEMBERS
 AKORLI FRANCISCA PON/17/018
 AKURIGO ALICE PON/17/019
 AWOTWI ARABA SARAH PON/17/029
 CUDJOE BLAISE PON/17/041
 GBEMU COURAGE PON/17/046
 GYAMFI GYASI BENEDICTA PON/17/048
 KOTIN YABANYA EVELYN PON/17/
 OBUO .E. RITA PON/17/064
 OMARI-SIAW FRANK PON/17/071
 OWUSU JULIET PRISCILLA PON/17/073

3. TABLE OF CONTENT
 INTRODUCTION
 CLASSIFICATION OF INSTRUMENTS
 FUNCTIONS AND DESCRIPTIONS
 COMPONENTS OF A GENERAL SET
 MISCELLANEOUS
 ENDOSCOPES
 CARE OF ENDOSCOPES
 CONCLUSION
 REFERENCES

4. INTRODUCTION
Surgical instruments are specially designed tools, that assist
health care professionals to carry out specific actions during an
operation. These instruments are made of plastics, stainless
steel metals such as iron, chromium, carbon, brass etc.
These metals when combined add strength to the instruments
and makes them withstand corrosion during repeated
sterilization. Some of the surgical instruments are designed for
general use whiles others are for specific procedures but our
attention will be focused on general surgical instruments and
endoscopes.

5. CLASSIFICATION OF INSTRUMENTS
They can be classified into four (4) main categories
namely;
 Sharps
 Graspers
 Clamps
 Retractors

6. They can also be grouped under nine (9) headings.
 Cutting and dissecting
 Grasping and holding
 Clamping and occluding
 Exposing and retracting
 Suturing and stapling
 Viewing
 Suctioning and aspirating
 Measuring
 Dilating and probing

7. COMPONENTS OF A GENERAL SET
 Bard parker handle size 3 1
 Bard parker handle size 4 1
 Bard parker handle size 5 1
 Bard parker handle size 7 1
 Rampleys sponge holding forceps 6
 Long tooth dissecting forceps 1
 Short tooth dissecting forceps 1
 Mayo’s scissors(curved) 1
 Mayo’s scissors(straight) 1
 Nelson’s scissors(curved) 1
 Nelson’s scissors(straight) 1

8. COMPONENTS OF A GENERAL SET
CONT.
 Metzenbaum scissors 1
 Spencer Wells artery forceps(straight) 6
 Spencer Wells artery forceps(curved) 6
 Langenbeck retractor 2
 Morris retractor 2
 Army navy retractor 2
 Lister sinus forceps(long) 1
 Lister sinus forceps(short) 1

9. COMPONENTS OF A GENERAL SET
CONT.
 Long non-tooth dissecting forceps 1
 Short non-tooth dissecting forceps 1
 Lanes tissue forceps 2
 Kocher or ochsners clamp 2
 Babcock 2
 Boyd double ended scoop (currete) 1

10. COMPONENTS OF A GENERAL SET
CONT.
 Mayo’s needle holder 2
 Allis tissue forceps(short) 4
 Allis tissue forceps(long) 4
 Halstead mosquito artery forceps(curved) 6
 Halstead mosquito artery forceps(short) 6
 Aneurysm needle 1
 Silver probe 1

11. CUTTING AND DISSECTING
Cutting and dissecting instruments include scissors, scalpels
and other special ones such as curretes, bone nibblers, chisels
and saws.
Functions
They are used to;
 dissect,
 incise and
 excise tissues.

12. SCALPELS
Scalpels are often referred to as surgical blade but when
attached to the bard parker handle it is called the knife.
Scalpels come in various sizes which fit to different bard
parker handles.
Scalpel (sizes 10, 11, 12 and 15) fits on bard parker handle
size 3, 5 and 7.
Scalpel (sizes 20, 21, 22,23 and 24) fits on bard parker
handle size 4.

13. BARD PARKER HANDLE

14. SURGICAL BLADE

15. SCAPEL BLADE & HANDLE
(DISPOSABLE)

16. SURGICAL SCISSORS
Scissors are hand operated shearing tool that consist of a
pair of metal blade pivoted so that sharpened edges slide
against each other when the handles opposite the pivot are
closed.
They are in various sizes having straight or curved blades
with blunt or pointed tips. The handle of scissors may also
be long or short. Handles to reach deep into body cavities
are about 9inches long to allow visualization and better
control of the dissecting site.

17. SURGICAL SCISSORS CONT.
Tissues and dissecting scissors must have sharp blades. The
type and location of tissue to be cut determine the type of
scissors to use.
Example; Heavy scissors such as the curved Mayo are used
in cutting heavy tough tissue and lighter Metzenbaum
scissors are used to dissect delicate tissue.
Suture scissors have blunt point to structure close to the
suture from being cut.
Dressing or bandage scissors are used to cut drains and
dressings.

18. Examples of surgical scissors in a general set include;
 Mayo scissors curved
 mayo scissors straight
 Nelson scissors curved
 Nelson scissors straight
 Metzenbaum scissors [they have a longer handle to blade
ratio and are used for cutting fine or delicate tissues]

19. MAYO STRAIGHT
 Mayo scissors are made from stainless steel metals.
Mayo scissors have semi- blunt ends, a feature that
distinguishes them from most surgical scissors.
 The Mayo straight can also be referred to as suture
scissors.
 The straight bladed Mayo scissors are heavy and
designed for cutting body tissue near the surface of
a wound and also for cutting sutures and dressings.

20. MAYO CURVED
 It is also known as dissecting scissors or
heavy tissue scissors.
 Mayo curved have heavy and curved
blades.
 It is used for cutting thick tissue such as
those found in the uterus, muscles,
breast.
 It allows deeper penetration into the
wound than the straight Mayo.

21. METZENBAUM
 Metzenbaum scissors are surgical
scissors designed for cutting
delicate tissue and blunt
dissection.
 It comes in variable lengths and
have a relatively long shank- to-
blade ratio.
 The blades can be curved or
straight and have blunt tips and
are commonly used in organ
operation such as heart surgery.

22. NELSON (STRAIGHT/CURVED)
 Nelson scissors are designed to cut
delicate or soft tissue.
 Their design is longer than
Metzenbaum making them suitable
for thoracic procedures.

23. GRASPING AND HOLDING
Graspers are instruments designed to enable the surgeon
perform the desired maneuvers such as dissecting, retraction, or
suturing without injuring the surrounding tissues by holding and
grasping tissues in position.

24. Examples of graspers and holders include;
 Plain dissecting forceps
 Tooth dissecting forceps
 Lanes tissue forceps
 Allis tissue forceps
 Babcock tissue forceps
 Kocher or Ochsner clamp
 Backhaus towel clips
 Rampleys sponge holding forceps
 Lister sinus forceps long
 Lister sinus forceps short

25. ALLIS TISSUE FORCEPS
 They are finger ringed ratchet
forceps which have sharp teeth.
 It is used for grasping organs
and slippery or dense tissue
gently without damaging
 It has slightly curved in jaws
and possesses multiple sharp
teeth at the edges that enables
grasping to be effective.

26. KOCHER
 Also known as Ochsner/ Koch/
Rochester-Ochsner clamp.
 It has one sharp teeth at the tip of the
jaw and two on the other side.
 It is used to hold heavy and tough
tissue.
 It is finger ringed and have ratchet
that enables it to lock.

27. DISSECTING FORCEPS
 They are also referred to as ‘pick
ups’.
 Used to grasps tissue during suturing
or dissecting.
 Can be toothed or non-toothed and
comes in varying lengths depending
on the purpose or design.
 These instruments are designed to
give balance and produce precise
handling of delicate tissue.

28. NON TOOTH/PLAIN DISSECTING
FORCEPS
 Also known as ‘thumb forceps’
 They are used on delicate thin
tissue without damaging them.
 It may be straight or curved and
comes in varied length for
different surgical purposes.
 It can also be heavy or fine.
 They are tapered and have
grooves at the tip.

29. TOOTHED DISSECTING FORCEPS
 They can be heavy or fine.
 The heavy ones are also referred to
‘rat toothed forceps’.
 The finer ones have delicate teeth for
handling soft or tender tissues.
 Toothed forceps have a single tooth
on one side that fits between two
teeth on the opposing side or may
have rolls of multiple teeth.
 They are used to grasp tough tissue
or slippery tissues in firm position.

30. RAMPLEYS
 It is a finger ringed forceps with or
without ratchet.
 It has a round tip with fenestrated
hole.
 It is used to hold gauze sponges
although they are also used to hold
body tissues.
 The sponge may be folded and
placed on the Rampley for prepping,
retracting and absorbing fluids.

31. BACKHAUS TOWEL CLIP
 It is a finger ringed locking forceps with
curved pointed tips.
 They are used to hold drapes in place
during surgery.
 They are also used to clip towels and
sponges to the end of a wound.
 The piercing ones damage both linen and
tissue hence must be used and handled
with care.

32. LANES TISSUE FORCEPS
 It is thumb holding forceps used for
holding tough tissue such as fascia
or diseased breast during
mastectomy.
 The end terminates to a bulb shape.
 It has a tooth at one tip of the blade
and a groove at the other tip of the
blade.
 It is also used for holding tough
structures.

33. BABCOCK FORCEPS
 It is thumb holding forceps with a curved
fenestrated jaws without teeth
(atraumatic).
 It is used to hold delicate tissues such as
appendix, ureters, ovaries without
causing damage to them during surgery.

34. CLAMPING AND OCCLUDING
Clamping and occluding instruments are used to apply pressure
that compresses blood vessels and other tubular structures with
the aim of controlling bleeding and to maintain hemostasis.
Most clamps used for occluding blood vessels have two
operating serrated meshed jaws and are stabilized by box lock.

35. They are controlled by ringed handles to prevent the clamp
from slipping off the blood vessel.
When the box is locked is closed, the handles remain locked
by ratchets. The jaws of a vascular clamp is designed to keep
clamp in position and to minimize trauma to delicate blood
vessels.

36. Types of Clamping and occluding instruments
 Hemostats
 Crushing clamps
 Non crushing vascular clamps

37. HEMOSTATS
They are the most common surgical instruments used to
clamp blood vessels. They are either curved, straight or
slender jaws that tapers to a fine point. The serrations go
across the jaws.
Examples of hemostats include;
 Halstead mosquito artery forceps straight and curved
Spencer Wells artery forceps straight and curved
Roberts artery forceps straight and curved

38. HALSTEAD MOSQUITO
ARTERY(STRAIGHT/CURVED)
 They come in straight and
curved forms.
 They are use in clamping
bleeding vessels to secure
homeostasis.
 They are also used to hold
stay sutures.
 Both are transversely
serrated.
 They have smaller and
finer tip.

39. SPENCER WELLS
(STRAIGHT/CURVED)  They are used for holding
bleeders.
 For splitting internal
oblique and transverse
abdominis during operation
of appendectomy.
 The jaws are serrated and it
can be curved or straight.
 Both curved and straight
are non toothed.
 It is smaller compared to
the Robert.

40. ROBERTS
(STRAIGHT/CURVED)
 They are larger with
longer handles than
Spencer Wells.
 It has serrated jaws and
are non toothed.
 It can be curved or
straight.
 They are used holding
bleeders from larger
vessels.

41. CRUSHING CLAMPS
Different type of hemostatic forceps are used to clamp body tissues
and blood vessels. The jaws of these instruments may be straight,
curved or angled. Their serrations may be horizontal, diagonal and
longitudinal. The tips of these instruments can be rounded, pointed,
smooth or plain and comes in varying length.
The features of the instrument will determine its usage. Fine points
are needed for smaller vessels and structures whiles the longer and
heavier jaws are needed for larger vessels and thicker tissues.

42. Examples of crushing clamps include;
 Large Spencer Wells artery forceps
 Payrs intestinal clamps
 Blalock clamps

43. PAYRS INTESTINAL CRUSHING
CLAMP
 This is a lever action clamp.
 The clamp has four(4) joints.
 The three joints in proximity are for the handle and
they operate the distal joint.
 The jaws may or may not have pins but the presence of
pins enhances the gripping ability of the clamp.
 The clamp is used to occlude the lumen of intestine to
prevent spillage of gut content.
 When applied, they also occlude blood supply of the
diseased part of the gut.

44. NON CRUSHING CLAMPS
It is used to occlude peripheral and major blood vessels
temporally. The jaws have rolls of fine serrated teeth and
may be straight, curved or angled shaped.
Examples;
Doyen intestinal clamps

45. DOYEN INTESTINAL CLAMP
They are light weight non crushing clamp
used to temporarily occlude lumen of
bowel.
They have longitudinal serrations.
They have long jaws and shorter shanks.
They are available straight or curved and
are slightly malleable.

46. EXPOSING AND RETRACTING
They are designed for exposure of operating site. They can be
classified into two groups.
1. HAND HELD EXPOSING RETRACTORS
They are those held in place by a member of the surgical team. Their
handles may be notched, hook shaped or ring to give the holder a
firmer grip without tearing the structures.
The blades are usually at right angled to the shaft and can be smooth,
raked or hooked. The hand held retractors are often used in pairs.

47. Examples are;
 Morris retractor
 Langenbeck retractor
 Malleable/Ribbon retractor
 US Army retractor
 Richardson retractor

48. MORRIS RETRACTOR
It is hand held retractor with the
lower end of the blade curved
inward.
It looks like the letter L.
It is used for retracting strong
structures like abdominal wall
muscles during appendectomy.
Some Morris retractors have double
ended blade.

49. LANGENBECK RETRACTOR
It is hand held retractor with single or
double blades.
The blade is bent at right angled to the
retracting handle.
It is used in providing better
visualization of the operative field and
minimizing tissue handling.

50. SELF RETAINING RETRACTOR
They do not employ any member to actively hold them in place during
its usage. There two (2) types of self retaining retractors. Those with two
blades held apart with a ratchet and those with frames to which various
blades are attached.
Examples of self retaining retractors are;
Weitlaner mastoid retractor
Balfour retractor
Millins retractor
Pozzi retractor
Jolls thyroid retractor

51. WEITLANER MASTIOD RETRACTOR BALFOUR RETRACTOR

52. MILLINS BLADDER RETRACTOR POZZI RETRACTOR

53. JOLLS THYROID RETRACTOR

54. 5. SUTURING AND STAPLING
Suturing and stapling is achieved using a needle holder or staplers.
Needle holder
It is used to grasp, hold and pass suture through tissues. They provide the
surgeon with control of the needle for precise handling. They are designed
to grasp the suture needle securely and do not damage it when making a
knot. They have ratchets that allows easy opening and closing during
handling. The serrations of the inner surface may differ depending on the
design and intended purpose. For suturing to be effective, the size of the
needle holder should match the size of the needle. Some needle holders
are designed to play a dual role of suturing and cutting.
Types of needle holders
 Tungsten carbide jaws
 Crosshatched serrations
 Smooth jaw

55.  Tungsten carbide jaws
It is a hard metal jaw with an insert of solid tungsten carbide with
diamond cut teeth. They are designed specifically to eliminate
twisting and turning of the needle in the needle holder. They are
identified by gold plating of the handles.
 Crosshatched jaws
The serrations on the inside surface of the jaws are criss crossed
rather than grooved. Crosshatching provides a smoother surface
and prevent damage to the needle.
 Smooth jaws
These are needle holders without serrations. They are used with
smaller needles most especially in plastic surgery. Examples of
needle holders include;
Mayo needle holder

56. MAYO NEEDLE HOLDER
 It is also called the needle
driver.
 It is used in grasping needle at
the time of suturing.
 It has three parts; the jaw, joint
and the handle.
 To maintain a firm grip on the
needle the jaws are often
textured and shorter
compared to the shank.
 It also has a lock mechanism
that holds the needle in place.
 The jaws have criss cross
serrations; available versions
with a groove for better
grasping of the suture needle.

58. STAPLERS
Surgical staplers are specialized staplers used in surgery in
place of sutures to close skin wounds, connect or remove part
of the bowel or lungs. The use of staples over sutures reduces
the local inflammatory response and the time it takes to close.
Staples exist as re useable or disposable. The re useable ones
have many movable parts.

59. They are disassembled before cleaning and re assemble
before using. They are normally used in abdominal,
thoracic, gynecological and neck surgeries.
Staplers when used are non crushing which promote
nutrient supply to cut edges through the staple line. It
promotes healing and reduces necrosis. They non reactive
hence prevent infection.

60. TYPES OF STAPLERS
 Clip appliers
 Terminal end staplers
 Internal anastomosis staplers
 End to end circular staplers
 Ligating and dividing staplers
 Michelle clip set

61. MICHELLE CLIP SET
COMPONENTS
 A Clips
 B Carrier
 C Approximator
 D Applicator
 E Remover

62. 6. SUCTIONING AND ASPIRATION
Suctioning involves the application of pressure mechanically or
manually to withdraw blood or fluid usually for visibility at the
operation site. It is done with suction tip that have lumen. The suction
tip is generally connected to a suctioning tube to achieve suctioning.
The tips can be disposable or re useable. Examples of suction tips;
 Yankauer suction tip
 Poole abdominal suction tip
 Frazier suction tip
 Millin suction tip

63. Yankauer suction tip
It is a hollow tube which is chromium plated and
has an angled tip. It is very useful in aspiration of
blood or body fluid. Its use enhances visualization
especially during ruptured aneurysm. Tissues may
be aspirated normally by using yankauer to
obtain specimen for laboratory examination or
obtain bone marrow for transplantation.

64. YANKAUER

65. Poole suction tip
It is a straight hollow tube with a perforated
removable outer filter shield. The outer shield
prevents adjacent tissues from being pulled into
suction apparatus. It is used during abdominal
laparotomy or within any cavity in which copious
amount of fluid or pus are encounted.

66. POOLE

67. FRAZIER
 It is a right angled tube
with a small diameter. It is
used to suction capillary
bleeding and irrigating
fluid in brain, spinal, plastic
or orthopedic procedures.
 It is used when fluid to be
suction is little. It keeps the
field dry without the need
for sponging.

68. SUCTION TUBES

69.  Aspiration is done to obtain specimen [blood, body fluid or tissue] for
laboratory examination. It is also done to obtain bone marrow for
transplantation.
 A trochar and cannular is the instrument of choice for aspiration but
frequently the syringe and needle are used.
Trochar
It is a surgical instrument with a three sided cutting point enclosed in a
tube, used for withdrawing fluid from a body cavity.
Cannular
It is a hollow instrument with a blunt end a perforation around the tip. It
can be ridged or flexible. It may be used to aspirate fluids without cutting
into tissues.

71. 7. DILATING AND PROBING
 A dilator is an instrument used to enlarge orifices
and duct such as dilation of uterine tubes. Eg;
Urethral dilator.
 Probe is used to explore a structure or locate an
obstruction. They are also used to explore depth
of a wound or trace the path of a fistula. Eg
Silver probe.

72. URETHRAL DILATORS PROBE

73. 8. MISCELLANEOUS
Many miscellaneous instruments or extras are used in addition
to basic instruments.
 Silver probe
 Aneurysm needle
 Collin Wood Stewart hernia ring
 McDonald dissector
 Boyd double ended scoop {curette}
 Suction tubes
 Sinus forceps
 Intestinal /bowel depressor
 Desjardin forceps

74. SINUS ANEURYSM NEEDLE

75. EXTRA INSTRUMENTS FOR SPECIFIC SURGERIES
Extras for amputation
 Amputation shield
 Amputation saw
 Amputation knife
 Bone file - for smoothing bone
 Periosteal elevators straight and curved
 Bone cutter
 Gigli saw with handle
 Wire cutter

76. • Periosteal elevators Bone cutter

77. Amputation saw Gigli saw with handle

78. Bone file Wire cutter

79. Extras for prostatectomy
 Millin retractor
 Millin bladder neck spreader
 Valselum forceps
 Millin boomerang needle holder
 Young prostatic delivery forceps
 Boomerang ligature carrier

80. Millin retractor Millin bladder neck spreader

81. Millin boomerang needle holder Boomerang ligature carrier

82. Extras for thyroidectomy
 Joll self-retaining retractor
 Lahey artery forceps
 Aneurysm needle
 Kocher thyroid enucleator plain
 Kocher thyroid enucleator fenestrated

83. Joll Lahey artery forceps

84. Extras for cholecystectomy
 Maingot common bile duct dilators
 Desjardin gall stone forceps
 Moynihan cholecystectomy
 Maingot gall stone forceps
 Ochsner gall stone forceps
 Ochsner gall bladder trocar
 Large scoop- upcold spoon
 Deaver retractor

85. Extras for laparotomy [Gastrectomy]
 Deaver retractor
 Pozzi self-retaining retractor
 Payr’s crushing clamps
 Doyen’s soft intestinal clamps
 Lane twin stomach clamps OR Swanson twin stomach
clamps

86. Pozzi Payr’s crushing clamps

87. Extras for laparotomy[bowel resection]
 Third blade for Pozzi self-retaining retractor
 Pozzi self-retaining retractor
 Payr’s crushing clamp
 Doyen’s soft intestinal clamp

88. Doyen’s soft intestinal clamp

89. Extras for laparotomy [sigmoidectomy]
 Sigmoidoscope tube
 Obturator
 Third piece with light/magnifying glass
 Inflation bellows
 Handle
 Biopsy forceps

90. Extras for herniorrhaphy
 Collingwood Stewart hernia ring
Extras for appendicectomy
 Babcock tissue forceps

91. Extras for mastectomy
 Kelly’s retractor
 Lane’s tissue forceps
Extras for urethroplasty
 Urethral dilators
 Fine set

92. Extras for colostomy
 Payr’s crushing clamp
 Doyen’s soft intestinal clamp
 Deaver’s retractor
 Pozzi self-retaining retractor

93. ENDOSCOPES
They are instruments used to examine the interior
or a hollow organ or cavity of the body. Unlike
most medical imaging techniques, endoscopes
are inserted directly into the organ through a small
skin incision.

94. ENDOSCOPY
It is a medical procedure that enables a physician to look
at the gastro intestinal tract with the flexible instrument
called an endoscope.

95. INDICATIONS
 To diagnose ailments
 To screen for diseases such as colorectal cancer
 To remove foreign body
 To treat many disease and conditions of the GIT
 Bowel duct and pancreas

96. TYPES OF ENDOSCOPES
HOLLOW ENDOSCOPE
 It is a rigid hollow sheath that permits viewing in
a forward direction through the endoscope. The
sheath is made of brass, stainless steel or plastic.
It has a light carrier supplied by a fiberoptic
cable which provides illumination.

97. HOLLOW ENDOSCOPE

98. LENSED ENDOSCOPE
 It is made up of rigid or flexible sheath. It has an eyepiece with
telescopic lense system for viewing in several directions. Lighting is
provided through fiberoptic cable and an electric lamplight source.
 Examples: Anuscope, Protoscope, Sigmoidoscope,
Oesophagoscope, Cystoscope and Bronchoscope

99. Lensed endoscope

100. CYSTOSCOPE AND OBTURATOR
USES- For examination of the
bladder under local anaesthesia
A. cystoscope and the eye
piece
B. obturator
C. bridge : used to bridge the
gap between the telescope and
the cystoscope

101. SIGMOIDOSCOPE
 It is used for examination of the
sigmoid colon. It is used
together with a lubricant an a
light source under local
anaesthesia.
 A. Sigmoidoscope
 B. Obturator
 C. Handle
 D. Eye piece
 E. Bellow

102. CATHETERIZING CYSTOSCOPE AND
TELESCOPE
 It is used for a pyelogram.
 A. cystoscope
 B. stilet
 The stilet makes the
ureteric catheter steady
as it is being passed
through the cystoscope.
The contrast medium is
then injected through the
catheter.

103. ANUSCOPE AND OBTURATOR
It is used for examination of the
anus for haemorrhoids.

104. PROTOSCOPE
USES- For examination of the
rectum
A. Protoscope
B. Obturator

105. BRONCHOSCOPE
The holes on the side of the
bronchoscope are passages for
anaesthetic gases and oxygen.
The posterior hole is for
suctioning of fluid.
USES
 For removing foreign bodies in
the tracheobronchial tree.
 For diagnosis

106. CARE OF ENDOSCOPES
 Rigid endoscopes should be thoroughly cleaned with long narrow
brushes.
 Lumens should be inspected for cleanliness.
 They should be dried before sterilization.
 Inspect endoscopes for dents, roughened edges or deep scratches
on the surface to prevent tissue damage when used.
 Do not swing or drop the light cable of the fiberopotic types when
carrying them to avoid damaging the filaments inside the cord.

107.  Autoclave cables according to manufacturer’s instruction.
 Coil cables loosely when not in use and avoid kinking and sharp
bending.
 Frequently test the integrity of the cables by holding one end to a
bright light and inspect the opposite end.
 Dark spots are an indication that some of the fibers are broken.
 Telescopes should be cleaned, dried and returned to its case.

108. CLEANING OF ENDOSCOPES
 Rigid endoscopes can be cleaned with soap and water.
 Flexible endoscopes can be washed with soap and water, then
soaked in activated glutaraldehide.
 Telescopes should be held vertically by its ocular end and
repeatedly wiped with downward strokes using gauze sponges or a
soft brush saturated with soap and water.
 Attention should be given to surface joint and crevices that may
retain mucus.
 Dry after cleaning.

109. HAZARDS OF ENDOSCOPES
 Perforation: major organs and vessels can be perforated.
This is very common with sharp and rigid endoscopes.
 Bleeding: oozing of blood from biopsy site and peddicles
of a polyp. This results in pooling of blood in cavities.
 Hypothermia: carbon dioxide gas is colder than body.