THE COMMONLY USED INSTRUMENTS ARE EXPLAINED WITH USES AND PARTS

1. INSTRUMENTS
KRISHNA V GANDHI
LECTURER
GCSN

2. SPONGE HOLDING FORCEP
SERRATIONS
SHAFT
BOX LOCK
SHANK RATCHET :
3 C’s
CATCH,
CLAMP,
CRUSH
FINGER BOWS

3. Sponge holding forcep is a long, thin, sharp with
catches and finger bows that mean it is a long and
straight instrument with round fenestrated ends.
Braes that have transverse serrations on the inner
surface. It is 7 to 9.
Inches (18-20cm in length)
Also called Rampley’s swab holding forcep

4. The length of an instrument ensure that antiseptics
can be applied to the part be prepared for surgery
from a distance. So that the sterile gloved hand of
the surgeon does not come in contact with the
unprepared filled with operation. The fenestrations
in the blades accommodate the bulk of the sweep
and serrations are designed to give the instrument a
good grip.

5. USES
• Antiseptic dressing or preparation of an operated area
before operation.
• Holds antiseptic cotton swab and gauge before
surgery.
• For swabbing a cavity.
• To facilitate dissection.

6. CHEATLE FORCEP
SHAFT
SHANK
FINGER BOWS
BOX LOCK

7. • It is a large, heavy metal forcep with remark
curved blade.
• Inside the blade, there are large serration which
help to get while taking instrument vessels or
linen.
• There is no lock.
• As it is heavy long an good with serration ,
sterile articles can be safely transported from
one tray to another.

8. Cheatle Sterilizer Forceps are used to remove
sterilised instruments from boilers and formalin
cabinets.
They are used to ensure that as each item is
removed, others are not infected.
CHEATLE FORCEPS / TRANSFER FORCPS

9. • The forceps are placed in a container of methylated
spirits when not in use.
• Usually dipped in antiseptic solution like dettol or
carbolic lotion for ready use.

10. ARTERY FORCEP/
HOMEOSTASIS FORCEP
BOX LOCK SHANK
FINGER
GROOVE
RATCHET

11. • Artery forceps are also known as hemostats or
clamps.
• They have narrow tapering beaks with transverse
serration.
SIZE NAME
SMALL MOSQUITO /
HALSTED
MEDIUM SPENCER WELL
LARGE BAILEY FORCEPS

12. • Usually available as curved.
• The curve allows easier placement of ligatures around the
forceps.
• Allows easier placement of ligatures around the forcep.
• Mainly used to hold and cut fascia and peritoneum edges .
CURVED ARTERY FORCEP

13. USES
• To control the bleeding on site. Clamp the bleeding
vessels.
• Helps in suturing in absence of needle holder.
• To hold free ends or cut ends of suture.
• To open facial planes in different surgeries.
• To pass and ligature.
• To crush base of appendix.
NOTE:
Care should be taken as they are crushing forceps that can
damage delicate structures.

14. NEEDLE HOLDER
BOX LOCK
SHANK
FINGER
GROOVE
RATCHET
GROOVE

15. USES
• Used for grasping needle at the time of suturing.
• The inner of the tip is criss-cross serration and a small
grove for firm grasp of the curved needle.
• A needle holder, also called needle driver, is a surgical
instrument, similar to a hemostat, used to hold a suturing
needle for closing wounds during suturing and surgical
procedures.
• The box joint is placed very close to the tip to give adequate
pressure because of the lever effect

16. SR
NO
HAEMOSTATIC
FORCEP
NEEDLE HOLDER
1 Lighter instrument Heavier Instrument
2 Blades length 1/3 and
shaft length 2/3
Smaller blades
3 Transverse serration
on the inner side of
blades
Serrations – criss cross or
transverse and groove in
blade
4 Joint screw type or
may be box type
Joint is box type only

17. KOCHERS
FORCEP
BOX LOCK
SHANK
FINGER
GROOVE
RATCHET

18. • Kocher Forceps are a heavy instrument designed
to aggressively grasp medium to heavy tissue or
occlude heavy, dense vessels.
• They have horizontal serrations the entire length
of the jaw as well as 1 X 2 teeth at the tip.
• The combination of full serrations plus teeth
ensure a firm grip on the tissue or vessel being held.

19. USES : FOR SECURING HEMOSTASIS
• To hold securely superior thyroid pedicle
vessels
• Hold retracting cut ends of vessels in tough
fibrous tissue
• Holds ribs during ribs resection
• To cause artificial rupture of gestational
membrane

20. ALLIS TISSUE FORCEP
BOX LOCK
SHANK
FINGER
GROOVE
RATCHET
4-5 SHARP
TEETH

21. • Also called as Allis clamp.
•4-5 teeth on each tip with curved ends
•The Allis tissue Forcep 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 tissue Forcep can cause damage, so they are
mainly used in tissue about to be removed.

22. USES
• To hold tough and non bulky tissue
• To hold the anterior lip of cervix in D &E operation.
• To hold the apex of the episiotomy wound during
repair.
• To catch hold the margins and angles of the uterine
flaps in LSCS after the delivery of the baby.
• To catch hold the margins of the peritoneum, rectus
sheath and vaginal mucosa.

23. SINUS
FORCEP BLADE
SHANK
FINGER
BOWS

24. • It is a straight, long , delicate and slender metal
instrument with about 24 cm long.
• It has 2 blades, shaft and handles.
• The distal tip is round, blunt and smooth
serrations horizontally inside the tip.
• Long handles with finger bows but there is no
lock or catch for grip.

25. • The instrument is long and slander because it
may be required to transverse the long and
narrow track of sinus.
• The blades are serrated to get a firm grip on the
foreign bodies or granulation tissues to be
removed from a sinus to get a grip on a sterile
gauze piece or a drain to be introduced in a
sinus.
• A sinus is a blind track line by unhealthy
granulation tissue which are end of which opens
to exterior.

26. THUMB FORCEP /
NON TOOTHED DISSECTING
FORCEP
FIXED
HINGE
SHANK
JAW
TIP

27. • Small grooves, but no teeth on the tips
• Hold tissue by pressure applied to the handles
• The shaft of the forcep is by thumb and finger so it
is known as thumb forcep

28. USES:
•Grasping
•Compressing
•Blunt dissection
•Pulling tissue
•Holding delicate structures

29. TOOTHED DISSECTING
FORCEP

30. •Tips have small teeth
•Size and number of teeth vary
•Teeth penetrate tissue to hold it
•Preferred by most surgeons over thumb forceps
because:
• Less crushing injury
• More secure hold with less finger pressure

31. USES:
• To hold tough structures.
• Used to hold scalp while
suturing.
• to grasp tiny particles and
tissues for biopsy
purposes.

32. SCISSORS
• They are sharp cutting instruments widely used as
surgical technique.
• There are variety of scissors used for specific purpose
for cutting, stiching, for cutting bandages and tissues
etc.
• They are small, medium , or large in size
• Straight or curved end, narrow blade or wide bladed,
sharp pointed or blunt.

33. CLASSIFICATION OF SCISSORS
1.According to Curvature and angles.
1-Straight Scissors
2-Curved in edge scissors
3- Angle on edge scissor
2. According to points on tip.
1-Blunt pointed scissor
2-Sharp pointed scissor
3. According To Use
1-Stich scissor
2- Tissue scissor

34. Curve on edge scissor:- They are used at depth where the space to
work is very much confluent.
Angle on edge scissor:- They are used generally for cutting structure
which are directly used.
Sharp pointed scissor:- It is used where the surgeon have no risk of
injury to important structure.
Blunt pointed scissors:- They are used where the surgeon damage to
important structure

35. SUTURE CUTTING SCISSOR
Used to cut sutures on
skin and mucous
membranes.

36. CURVED SCISSOR
Cutting heavy tissue
such as muscle, fascia
and uterus.

37. LARYNGOSCOPE

38. A laryngoscope (larynx + scope) is a device that is used to
visualize the larynx and adjacent structures mainly for inserting a
tube into tracheobronchial tree.
History The first laryngoscope was invented by Manuel García
in 1854
Alfred Kirstein developed direct vision laryngoscope in1895
It was popularized by Sir Robert Mackintosh and Sir Ivan Magill in
early 1940

39. TYPES OF BLADES
1. MACINTOSH (Curved) Most popular
• The tongue has gentle curve that extends to the tip
• In cross section ,the tongue, web and flange form reverse
• It is positioned in the vallecula anterior to the epiglottis lifting it out
of the visual pathway
• Size ranges from 1-4, Most adults require size 3

40. 2. MILLER (Straight)
• The tongue is straight
with a slight upward
curve near the tip
• The flange, web, and
tongue form a C with the
top fattened
• It is positioned posterior
to the epiglottis, trapping
it while exposing vocal
cords and glottis
• Size ranges 0-4

42. USES
• Endotracheal Intubation
• Insertion of nasogastric tube and transesophageal
echocardiac probe
• Foreign body removal
• Upper airway lesion biopsy
• Visualizing and assessing the upper airway (vocal
cords and larynx)

43. HARTMANN AURAL SPECULUM

44. USES
This is a funnel shaped speculum that has no slit on the body.
The broader end is thickened for better grip.
• Examination of the external ear canal and tympanic
membrane.
• Removal of wax, foreign body or ear discharge.
• In operative procedures like myringotomy, myringoplasty.
• For transcanal injections.

45. KNIFE HOLDER SCALPEL /
BARD PARKER HANDEL
DISTAL END
SHAFT
PROXIMAL
END

46. Knife Holder Scalpel
• It is metal instrument used to attach different
types of blade at the distal end.
• Shaft is 1cm in breath at the middle.
• Distal end is narrow enough to fix the blades
with an adjustment to fix all the handle
• The proximal end is round
• Different size of handles are required to fix
different size of blades according to their uses.

47. Handle
No.
Knife No.
3 10,12
4 20,21,22,23
5 24,11,15

49. • Where the no. of knife is increasing, it is used in skin
and where decreasing, it is used for tissue.
• Knife no. decreasing , the sharpness is increasing.
• 12 no. knife is used for tonsil operation.
• 22 no. knife is used for spinal operation.
• 11 and 15 no. knife is used for tissue operation.
• Scalpel consist of a blade and handle.
• They are of two types.
1-Combine blade and handle scalpel.
2-Interchangable blade and handle scalpel.

50. USES
• It is the most important instrument in surgery.
• Some handle are used for repairing the skill to
cut the flexia or to open the peritoneum.
• Round proximal end of handle may be used
on muscles of the abdomen after cutting of the
flexia over it.

51. Quality of an ideal Scalpel
• It should be light.
• Blade should be fairly sharp.
• The handle should give a good grip.
• The blade should have straight back.
*STERILIZATION IS DONE BY AUTOCLAVING

53. INSTRUCTIONS FOR INSTALLING AND REMOVING
SCALPEL BLADES
1. To install the scalpel blade, align the blade with the scalpel handle as
shown. WARNING: Scalpel blades are extremely sharp. Always
hold the back of the blade. Never force the blade. Use pliers to hold
the blade securely if it becomes stuck on the handle.
2. 2. Align the blade into the groove in the handle and gently slide it
toward the scalpel handle.

54. 3. Continue to slide the blade onto the scalpel handle
until it locks in place.
4. To remove the blade, carefully lift the bottom of
the blade until it unlocks from the scalpel handle as
shown.
5. Slide the blade off the scalpel handle, moving it
away from the handle as shown.

56. MOUTH GAG
Mouth gap
Tongue blade
Chest piece
with
connecting
rod

57. The mouth gag name after designers.
Boyler Devis Gag
It is self retaining mouth gag consist of following parts
-Mouth gap properly
-Tongue blade
-Chest piece with connecting rod

58. USES :
• For correct use, hold the instrument with the blade
downward and pointed towards the patient.
• It is introduced into the mouth cavity (Oral care
mainly unconscious patient) in such a fashion that
the teeth of instrument guarded with rubber tubes.
• The two blade is used to retract the lower jaw till the
mouth cavity opens wide.
• The instrument consist of tongue blade attached to
mouth gag which can be opened by sliding
arrangement to retract jaw to open jaw and retract in
oral surgery

59. PROCTOSCOPE
OBTURATOR
HANDEL OBTURATOR
OUTER TUBE
OUTER TUBE

60. • It is used for visualizing anal canal and lower
end of rectum.
• It is made up of steel material.
• It has two parts :-
1-Outer tube attached with handle
2- Inner is of obturator

61. How To Use Proctoscope ?
• To examine the rectum and anus, first insert
the proctoscope and then remove the obturator
and observe that part.
• Patient placed left lateral position initiating
the anus is observed for hemorrhoid fissures
and cracks.

62. USES:
• To find out piles
• To find out ulcer or any growth is in
rectum.
• To examine rectum and anus.

63. NASAL SPECULUM /
THUDICHUM

64. • It is light weight metal instrument which has
two thin blades connected with “V” shaped
ring
• The blades are like two wings and attached.
• Right angle to a flat metal joined middle part
act as a handle.

65. USES:
• The blades are broughtly together before
introducing in the nasal cavity and expended
after introduction to the nose.
• Used to clear the area in nasal surgery.
• Used for both diagnostic and therapeutic
purpose.

66. INTRODUCTION TO THE NOSE
• The speculum should be
inserted as the skin with
blades are close.
• The pressure on the rim of
speculum gradually
released, the blades more
apart allowing sufficiently
inspection on the interior
part of the nasal cavity.

67. PINNARD FETOSCOPE
AURAL
END
ABDOMINAL
END
A device used to obtain
information about a fetus
within the uterus.

68. TUNNING FORK
STEM
FOOT PIECE
PRONGS
BASE
SHOULDER

69. • A tuning fork is a two-pronged metal fork that can be
used as an acoustic resonator.
• It is usually made up of steel, magnesium or
aluminum that is used to tune , it vibrates sinusoidally
to generate a pure tone
• Longer forks vibrates at slower frequency
• It is activated by striking against examiners elbow,
heel of hand

70. MAYO’S TOWEL CLIP
SHARP POINTS
BOX LOCK
SHANK
FINGER
GROOVE
RATCHET

71. USES
• HOLDS drapes so that only operative field is
exposed
• Fix suction tube with drapes
• Holds ribs
• Retract cord during hernial repair

72. DOYENS RETRACTOR
BLADE
HANDLE

73. Doyens Retractor are Non self retaining
Blades are
I. Blunt
II. Broad
III.Curved
Long handle

74. USES
Used to retract bladder and bowel during laparotomy
Obstetric uses:
1. Retract the bladder during LSCS.
2. Retract the abdominal wall.

75. MORRIS
RETRACTOR
BLADE
FENESTRATED
HANDLE

76. USES:
• Used while making and closing abdominal incision for
ease of working in the deeper layer.
• to retract pectoralis major during surgery.
• To hold back the abdominal wall during abdominal or
thoracic procedures.
It is a long retractor with a broad operating end.

77. SINGLE HOOK RETRACTOR
HOOK
SHAFT

78. USES
• To retract skin edges
• To retract tough fascia

79. DOUBLE HOOK RETRACTOR
SHAFT
HOOK
HOOK

80. USES
• To retract skin edges
• To retract tough fascia

81. PINNARD FETOSCOPE
AURAL
END
ABDOMINAL
END
A device used to obtain
information about a fetus
within the uterus.

82. BLAKE’S UTERINE CURETTE
SHARP, SMALLER END BLUNT, LARGE END

83. • Commonly used in D + C for incomplete abortion.
• In D+E operation, the curettage is done by blunt end as the
uterine wall is soft
• It can also be used in D+C operation one week following
evacuation of hydantiform mole

84. SIMS SPECULUM

85. • Non self retaining posterior vaginal speculum.
• Two blades of unequal breath.
• Handle in between
• Groove in the handle
USES
• To inspect cervix and vagina
• OPD
- PAP SMEAR
- IUCD INSPECTION
- ENDOMETRAL BIOPSY

86. OBSTETRIC USES:
• Confirm / identify PROM
• identify local cause of traumatic bleeding
GYNECLOGICAL USES:
• Hysteroscopy / hysterectomy
• Vaginal surgeries

87. ADVANTAGES
• Groove in the centre drains secretion and keeps area
clean
• More expose of the vaginal wall than cuscos
speculum
• Difference in the blade size facilitate introduction into
vagina depending upon space available.

88. URETHRAL DILATOR

89. USES
• Double end
• Curved on both sides
• Graduated set of dilators of different sizes
• To dilate cervix before pregnancy
• While performing gynecological surgeries
• Diagnosis of cervical incompetence in non pregnant
women
• To dilate cervix before procedures like D&E, D&C

90. THANKS