This document describes various surgical instruments used in operations. It discusses forceps, scissors, scalpels, retractors, and other tools. Forceps are used for grasping, compressing, and clamping tissues. Scissors come in different styles for cutting sutures, soft tissues, or other materials. Scalpels have interchangeable handles and blades for making incisions. Retractors are employed to expose the surgical site by holding back surrounding tissues. A variety of instruments help surgeons perform tasks like excising, incising, draining, and closing wounds.

1. Surgical Instruments
Prof. Dr. Ram Sharan Mehta
1Prof. Dr. RS Mehta, BPKIHS

2. Objectives
Describe various surgical
instruments
Discuss the names of
various surgical instruments
2Prof. Dr. RS Mehta, BPKIHS

3.  Perform surgical procedures
 Chosen based on action
 These tools are used for
 Holding
 Pulling
 Clamping
 Cutting
 Crushing
 Closing a wound
3Prof. Dr. RS Mehta, BPKIHS

4. Definitions
 Excision – removal of tissues by surgical cuts
 Ecraseur – an instrument that permits
excision by a crushing action
 Incision – surgical cut made into a tissue of
organ
 Cannula – a tube that is inserted into a body
cavity for drainage of fluid
4Prof. Dr. RS Mehta, BPKIHS

5. Surgical Instruments I
• Forceps: for compressing or grasping tissue. Thumb
forceps and hemostats are typical forceps. Hemostats
aid in compressing tissue, especially blood vessels, to
stop bleeding (hemostasis).
• Needle holders: hemostat-like devices that hold
needles used to suture wounds closed.
• Needles: permanently attached suture material =
swaged-on. Tip may be blunt, tapered, sharp, cutting,
or some other configuration
• Scalpel handle and blades: size 10 blade most
popular, 11 has a straight edge and a sharp point.15
has a very small cutting edge, used for fine, delicate
surgery(e.g. eye). 20 is similar to 10 but larger. 5Prof. Dr. RS Mehta, BPKIHS

6. Surgical Instruments II
• Scissors: blunt-blunt, blunt-sharp, or sharp-sharp.
They may also be straight or curved. Some scissors
are serrated for cutting thick bandages or cartilage.
• Retractors: pull overlying tissue away from the
surgical site. Hand-held retractors and self-retaining
• Suture materials: thickest suture is given the
number 6.
• <6 = smaller diameter.
• Sutures having smaller diameter indicated by 0 (“aught”)
smallest suture is designated 12-0 (twelve-aught).
• Synthetic = nylon, or natural = silk or gut.
• Some absorbed by the body during the healing process, nylon
removed after wound heals, usually in 7–10 days.
• Gauze pads: sponges used for soaking up blood
and other fluids from the surgical site. 6Prof. Dr. RS Mehta, BPKIHS

7. Scissors
 Four different types
 Utility
 Suture
 Surgical
 Dissecting
SCISSORS
TYPES- ACCORDING TO CURVATURE- straight, curved or angled
“ “ USE - Dressing, stitch removal, tissue
“ “ the Tip - sharp or blunt
7Prof. Dr. RS Mehta, BPKIHS

8.  Utility
 Cut material that may dull the blade
8Prof. Dr. RS Mehta, BPKIHS

9.  Suture
 Remove sutures
 Type of utility
9Prof. Dr. RS Mehta, BPKIHS

10.  Operating
 Surgical
 Cut soft tissue
 Different sizes
 Blade can be straight, curved, blunt or pointed
10Prof. Dr. RS Mehta, BPKIHS

11.  Dissecting
 Separate and differentiate tissues
11Prof. Dr. RS Mehta, BPKIHS

12. Forceps
 Three Types
 Thumb forceps
 Clamping forceps
 Needle holders
 Look like tweezers
12Prof. Dr. RS Mehta, BPKIHS

13.  Thumb forceps
 Used for
 Grasping
 Compressing
 Cutting
 Pulling tissue
13Prof. Dr. RS Mehta, BPKIHS

14.  Clamping forceps
 Hemostats
 Control blood flow
14Prof. Dr. RS Mehta, BPKIHS

15.  Needle holders
 Locking forceps
 Similar to hemostats
 Holds suture needles when installing stitches
15Prof. Dr. RS Mehta, BPKIHS

16. Scalpels
 Very sharp knife
 Handle and blade are packaged separately
 Used to make surgical cuts called incisions
 Different sizes and styles
 Tenotome- dissecting scalpel used for fine
dissection and cutting or dividing tendons
16Prof. Dr. RS Mehta, BPKIHS

17. KNIVES
Interchangeable handles and blades
No 3 handle for # 15 blade – for small incisions
And #11 blade – i& d of abscesses
N04 handle for #24 etc for larger incisions
17Prof. Dr. RS Mehta, BPKIHS

18. Tubes
 Cannula
 Wound healing
 Different lengths
 Types
 Trocar
 Catheters
18Prof. Dr. RS Mehta, BPKIHS

19.  Trocar
 Release fluid or gas build-ups
 Sharp stylet inside cannula
19Prof. Dr. RS Mehta, BPKIHS

20.  Catheters
 Either metal or rubber
 Inserted into body structures
20Prof. Dr. RS Mehta, BPKIHS

21. Surgical instruments
21Prof. Dr. RS Mehta, BPKIHS

22. Scalpels
 Bard-Parker Small Handles:
 #3
Scalpels
22Prof. Dr. RS Mehta, BPKIHS

23. Scalpels
 Bard-Parker Small Handles:
 #7
23Prof. Dr. RS Mehta, BPKIHS

24. Scalpels
 Bard-Parker Small Handles:
 #9 (round)
24Prof. Dr. RS Mehta, BPKIHS

25. Scalpels
 Bard-Parker Large Handles:
 #4
25Prof. Dr. RS Mehta, BPKIHS

26. Scalpels
 Blades:
26Prof. Dr. RS Mehta, BPKIHS

27. Scissors
 Mayo
 Curved:
 Straight:
27Prof. Dr. RS Mehta, BPKIHS

28. Scissors
 Metzenbaum
 Curved:
 Straight:
28Prof. Dr. RS Mehta, BPKIHS

29. Scissors
 Suture Scissors:
29Prof. Dr. RS Mehta, BPKIHS

30. Scissors
 Lister Bandage Scissors:
30Prof. Dr. RS Mehta, BPKIHS

31. Thumb Forceps
31Prof. Dr. RS Mehta, BPKIHS

32. Thumb Forceps
 Adson:
32Prof. Dr. RS Mehta, BPKIHS

33. Thumb Forceps
 Adson-Brown:
33Prof. Dr. RS Mehta, BPKIHS

34. Thumb Forceps
 DeBakey:
34Prof. Dr. RS Mehta, BPKIHS

35. Thumb Forceps
 Russian:
35Prof. Dr. RS Mehta, BPKIHS

36. Needle Holders
 Mayo-Hagar:
36Prof. Dr. RS Mehta, BPKIHS

37. Needle Holders
 Olsen-Hagar:
 The ones with built-in scissors
37Prof. Dr. RS Mehta, BPKIHS

38. Needle Holders
 Castroviejo:
38Prof. Dr. RS Mehta, BPKIHS

39. Hemostatic Forceps
 Halsted Mosquito:
 We have the curved ones!
39Prof. Dr. RS Mehta, BPKIHS

40. Hemostatic Forceps
 Kelly:
40Prof. Dr. RS Mehta, BPKIHS

41. Hemostatic Forceps
 Crile:
41Prof. Dr. RS Mehta, BPKIHS

42. Hemostatic Forceps
 Rochester-Carmalt:
42Prof. Dr. RS Mehta, BPKIHS

43. Hemostatic Forceps
 Satinsky:
• cardiovascular
• allow occlusion of only
a portion of vessel
43Prof. Dr. RS Mehta, BPKIHS

44. Hemostatic Forceps
 Oschner:
44Prof. Dr. RS Mehta, BPKIHS

45. Tissue Forceps
 Allis:
45Prof. Dr. RS Mehta, BPKIHS

46. Tissue Forceps
 Babcock:
46Prof. Dr. RS Mehta, BPKIHS

47. Tissue Forceps
 Doyen: Intestinal
47Prof. Dr. RS Mehta, BPKIHS

48. Other Forceps
48Prof. Dr. RS Mehta, BPKIHS

49. Forceps
 Vulsellum:
49Prof. Dr. RS Mehta, BPKIHS

50. Forceps
 Alligator:
50Prof. Dr. RS Mehta, BPKIHS

51. Forceps
 Serrefine (Bulldog Clamp):
Used for temporary occlusion of medium sized vessels
51Prof. Dr. RS Mehta, BPKIHS

52. Towel Clamps
 Backhaus:
Drape to skin
52Prof. Dr. RS Mehta, BPKIHS

53. Towel Clamps
 Edna:
Nonpenetrating towel clamp
Attach drape to drape or instruments to
drapes (suction, cautery)
53Prof. Dr. RS Mehta, BPKIHS

54. Hand-held Retractors
54Prof. Dr. RS Mehta, BPKIHS

55. Hand-held Retractors
 Senn:
55Prof. Dr. RS Mehta, BPKIHS

56. Hand-held Retractors
 Army-Navy:
56Prof. Dr. RS Mehta, BPKIHS

57. Hand-held Retractors
 Ribbon (Malleable):
57Prof. Dr. RS Mehta, BPKIHS

58. Hand-held Retractors
 Hohmann:
58Prof. Dr. RS Mehta, BPKIHS

59. Hand-held Retractors
 Farabeuf:
59Prof. Dr. RS Mehta, BPKIHS

60. Hand-held Retractors
 Meyerding:
60Prof. Dr. RS Mehta, BPKIHS

61. Self-Retaining Retractors
61Prof. Dr. RS Mehta, BPKIHS

62. Self-Retaining Retractors
 Gelpi:
62Prof. Dr. RS Mehta, BPKIHS

63. Self-Retaining Retractors
 Weitlaner:
63Prof. Dr. RS Mehta, BPKIHS

64. Self-Retaining Retractors
 Balfour: Abdominal retractor
64Prof. Dr. RS Mehta, BPKIHS

65. Self-Retaining Retractors
 Finochietto: Rib retractor
65Prof. Dr. RS Mehta, BPKIHS

66. Self-Retaining Retractors
 Meyerding:
66Prof. Dr. RS Mehta, BPKIHS

67. Ovariohysterectomy Hooks
67Prof. Dr. RS Mehta, BPKIHS

68. Ovariohysterectomy Hooks
 Snook:
68Prof. Dr. RS Mehta, BPKIHS

69. Suction Tips
69Prof. Dr. RS Mehta, BPKIHS

70. Suction Tips
 Poole:
70Prof. Dr. RS Mehta, BPKIHS

71. Suction Tips
 Yankauer:
71Prof. Dr. RS Mehta, BPKIHS

72. Suction Tips
 Frazier:
72Prof. Dr. RS Mehta, BPKIHS

73. Rongeurs
73Prof. Dr. RS Mehta, BPKIHS

74. Rongeurs
 Lempert:
74Prof. Dr. RS Mehta, BPKIHS

75. Rongeurs
 Kerrison:
75Prof. Dr. RS Mehta, BPKIHS

76. 76
 Rumen (Bloat) Trocar
Prof. Dr. RS Mehta, BPKIHS

77. Bone-Holding Forceps
77Prof. Dr. RS Mehta, BPKIHS

78. Bone-Holding Forceps
 Kern:
78Prof. Dr. RS Mehta, BPKIHS

79. Bone-Holding Forceps
 Serrated Reduction:
79Prof. Dr. RS Mehta, BPKIHS

80. 80
 Galt Trephine
Prof. Dr. RS Mehta, BPKIHS

81. 81
 Osteotome
Prof. Dr. RS Mehta, BPKIHS

82. 82
 Jacob Chuck
Prof. Dr. RS Mehta, BPKIHS

83. 83
 Duckbill Rongeurs
Prof. Dr. RS Mehta, BPKIHS

84. 84
Bone Rasp
Prof. Dr. RS Mehta, BPKIHS

85. 85
 Tap Handle
Prof. Dr. RS Mehta, BPKIHS

86. Retracting and Exposing
Instruments
 A Deaver retractor (manual) is used to retract deep
abdominal or chest incisions. Available in various
widths.
86Prof. Dr. RS Mehta, BPKIHS

87. EXPOSING & RETRACTING
•BALFOUR ABDOMINAL RETRACTOR
Prof. Dr. RS Mehta, BPKIHS 87

88. EXPOSING & RETRACTING
•ARMY NAVY
FARABEUF Retractor
Prof. Dr. RS Mehta, BPKIHS 88

89. EXPOSING & RETRACTING
•GELPI Perineal Retractor
Prof. Dr. RS Mehta, BPKIHS 89

90. EXPOSING & RETRACTING
•Weitlaner Retractor
Prof. Dr. RS Mehta, BPKIHS 90

91. EXPOSING & RETRACTING
•Senn Retractors
Prof. Dr. RS Mehta, BPKIHS 91

92. EXPOSING & RETRACTING
•Finochietto Retractor
Prof. Dr. RS Mehta, BPKIHS 92

93.  A Richardson retractor (manual) is used to retract
deep abdominal or chest incisions
Retracting and Exposing
Instruments
93Prof. Dr. RS Mehta, BPKIHS

94. Retracting and Exposing
Instruments
 An Army-Navy retractor (manual) is used to retract
shallow or superficial incisions. Other names: USA,
US Army.
94Prof. Dr. RS Mehta, BPKIHS

95. Retracting and Exposing
Instruments
 A goulet (manual) is used to retract shallow or
superficial incisions.
95Prof. Dr. RS Mehta, BPKIHS

96.  A malleable or ribbon retractor (manual) is used to
retract deep wounds. May be bent to various
shapes.
Retracting and Exposing
Instruments
96Prof. Dr. RS Mehta, BPKIHS

97.  A Weitlaner retractor (self-retaining) is used to
retract shallow incisions.
Retracting and Exposing
Instruments
97Prof. Dr. RS Mehta, BPKIHS

98.  A Balfour with bladder blade (self-retaining) is used
to retract wound edges during deep abdominal
procedures.
Retracting and Exposing
Instruments
98Prof. Dr. RS Mehta, BPKIHS

99. ELECTROSURGERY
•INITIAL Incision is
made by a SCALPEL
•Doubling the current
increases the heat
produced fourfold
•ARGON Enhanced
ESU Tip is held at 60
degree angle, causing
LESS Tissue Damage
•BUZZING – the
process of coagulating
the VESSELS
•BUZZ should not
exceed more than 3
SECONDS
Prof. Dr. RS Mehta, BPKIHS 99

100. Powered Surgical Instruments
DRILL
BURR
BLADE
REAMER
ABRADER
AIR-POWERED
ELECTRICALLY POWERED
Prof. Dr. RS Mehta, BPKIHS 100

101. VIEWING
•Speculums
•Endoscopes
•Hollow Endoscopes
•Lensed Endoscopes
Prof. Dr. RS Mehta, BPKIHS 101

102. LASER SURGERY
•Light amplification by stimulated emission of radiation (LASER)
•Types of LASES = ARGON, CARBON DIOXIDE, HOLMIUM,
KRYPTON, NEODYMIUM, PHOSPHATE, RUBY/XENON
Prof. Dr. RS Mehta, BPKIHS 102

103. Prof. Dr. RS Mehta, BPKIHS
WWW.SMSO.NET
103

104. Thank you
104Prof. Dr. RS Mehta, BPKIHS

105. Drains Tubes Catheters
105Prof. Dr. RS Mehta, BPKIHS

106. 106Prof. Dr. RS Mehta, BPKIHS

107. Catheters
 Are used for evacuating or injecting fluids.

 Catheters are sized on a french scale according to the
diameter of the lumen .
107Prof. Dr. RS Mehta, BPKIHS

108. Drains and tubes
Are devices used to
drain fluid from the body
when excessive drainage
is expected .
108Prof. Dr. RS Mehta, BPKIHS

109. A- Respiratory Tubes
109Prof. Dr. RS Mehta, BPKIHS

110. A-1- Airway
110Prof. Dr. RS Mehta, BPKIHS

111. A-2- Laryngeal tube
111Prof. Dr. RS Mehta, BPKIHS

112. A-3-Endotracheal intubation
112Prof. Dr. RS Mehta, BPKIHS

113. A-4- Cricothyroidotomy
113Prof. Dr. RS Mehta, BPKIHS

114. Cricothyroidotomy
114Prof. Dr. RS Mehta, BPKIHS

115. A-5- Tracheostomy tube
115Prof. Dr. RS Mehta, BPKIHS

116. A-5- Tracheostomy tube
116Prof. Dr. RS Mehta, BPKIHS

117. A-6- Chest Tube
117Prof. Dr. RS Mehta, BPKIHS

118. Collection
Unit
118Prof. Dr. RS Mehta, BPKIHS

119. Thoracic catheters
119Prof. Dr. RS Mehta, BPKIHS

120. The Trocar Catheter
With a large trocar needle is
used for a closed thoracostomy .
120Prof. Dr. RS Mehta, BPKIHS

121. A-7- Thoracentesis needle
121Prof. Dr. RS Mehta, BPKIHS

122. 122Prof. Dr. RS Mehta, BPKIHS

123. B-
Gastrointestinal
Tubes
123Prof. Dr. RS Mehta, BPKIHS

124. B-1- Nasogastric Tube
124Prof. Dr. RS Mehta, BPKIHS

125. Ryle’s Tube
125Prof. Dr. RS Mehta, BPKIHS

126. B-2- P.E.G. (Percutaneous
Endoscopic Gastrostomy)
126Prof. Dr. RS Mehta, BPKIHS

127. B-3- Nasogastric and
nasojejunal feeding tube
127Prof. Dr. RS Mehta, BPKIHS

128. Feeding NGT
128Prof. Dr. RS Mehta, BPKIHS

129. B-4- Rectal Tube
129Prof. Dr. RS Mehta, BPKIHS

130. A Rectal Tube
130Prof. Dr. RS Mehta, BPKIHS

131. B-5- T Tube- Kehr's T-tube
131Prof. Dr. RS Mehta, BPKIHS

132. 132Prof. Dr. RS Mehta, BPKIHS

133. B-6- Blackemore Sengstaken
Tube
133Prof. Dr. RS Mehta, BPKIHS

134. C- Genitourinary
Tubes &Catheter
134Prof. Dr. RS Mehta, BPKIHS

135. C-1- Catheters
135Prof. Dr. RS Mehta, BPKIHS

136. -Rubber
-Plastic
-Silicone
2-ways foley
3-ways foley
136Prof. Dr. RS Mehta, BPKIHS

137. 137Prof. Dr. RS Mehta, BPKIHS

138. 2Way Foley Catheters
To drain the bladder
An inflatable balloon near the tip
which holds the catheter in place
2way Foley
138Prof. Dr. RS Mehta, BPKIHS

139. 3 Way Foley
Has an inlet for irrigation .
139Prof. Dr. RS Mehta, BPKIHS

140. Robinson Catheter
Straight Drainage Of
The Bladder.
140Prof. Dr. RS Mehta, BPKIHS

141. Nilatone (straight) catheter
141Prof. Dr. RS Mehta, BPKIHS

142. Silicone Catheter
142Prof. Dr. RS Mehta, BPKIHS

143. suprapubic catheter
143Prof. Dr. RS Mehta, BPKIHS

144. C-2- Condom Catheter
144Prof. Dr. RS Mehta, BPKIHS

145. C-3 Double J Catheter
145Prof. Dr. RS Mehta, BPKIHS

146. C-4- Nephrostomy Tubes
Malecot
Pigtail
146Prof. Dr. RS Mehta, BPKIHS

147. D-vascular Tube
147Prof. Dr. RS Mehta, BPKIHS

148. D-1- Butterfly Needle
148Prof. Dr. RS Mehta, BPKIHS

149. D-2- IV Cannula
149Prof. Dr. RS Mehta, BPKIHS

150. D-3- Venous Catheter
150Prof. Dr. RS Mehta, BPKIHS

151. D-4- IV set (venoset)
151Prof. Dr. RS Mehta, BPKIHS

152. D-5- BT (blood transfusion) set
152Prof. Dr. RS Mehta, BPKIHS

153. D-6- Fogarty Catheter
Arterial embolectomy catheter is used to
remove blood clots from an artery .
153Prof. Dr. RS Mehta, BPKIHS

154. Differentiate vascular tubes from;
-spinal needle or catheter
-peritoneal catheter
154Prof. Dr. RS Mehta, BPKIHS

155. Spinal Needle
155Prof. Dr. RS Mehta, BPKIHS

156. Peritoneal Catheter
156Prof. Dr. RS Mehta, BPKIHS

157. Peritoneal Catheter
157Prof. Dr. RS Mehta, BPKIHS

158. Thank you
158Prof. Dr. RS Mehta, BPKIHS

159. IMPORTANT TERMS
 Atraumatic
 Dilation
 Dissection
 Grasping
 Retraction
 Sharp
 Traumatic
 Trocar
Prof. Dr. RS Mehta, BPKIHS 159

160. CLASSIFICATION OF
INSTRUMENTS
 Cutting and
Dissecting
 Grasping and Holding
 Clamping and
Occluding
 Exposing and
Retracting
 Suturing and Stapling
 Viewing
 Suctioning and
Aspirating
 Dilating and Probing
 Measuring
 Accessory
Instruments
 Microinstrumentation
Prof. Dr. RS Mehta, BPKIHS 160

161. CUTTING AND DISSECTING
•SCALPELS
• Insert Blade using a HEAVY HEMOSTAT of KELLY CLAMP
•No.
•No. 11 Blade
•No. 12 Blade
•No. 15 Blade
•No. 23 Blade
•KNIVES
•SCISSORS
•BONE Cutters and Debulking Tools
•Biopsy Forceps and Punches
•Curettes
•Snares
•Blunt Dissectors
Prof. Dr. RS Mehta, BPKIHS 161

162. CUTTING AND DISSECTING
•Bone Curette
Prof. Dr. RS Mehta, BPKIHS 162

163. CUTTING AND DISSECTING
•Mayo Scissors
•Metzenbaum Scissors
Prof. Dr. RS Mehta, BPKIHS 163

164. CUTTING AND DISSECTING
•Suture Scissors
(Blunt /Blunt)
Prof. Dr. RS Mehta, BPKIHS 164

165. GRASPING & HOLDING
•Tissue Forceps
•Smooth Forceps
•Toothed Forceps
•Allis Forceps
•Babcock Forceps
•Stone Forceps
•Tenaculums
•Bone Holders
Prof. Dr. RS Mehta, BPKIHS 165

166. GRASPING & HOLDING
•Rat-Toothed Tissue Forceps
Prof. Dr. RS Mehta, BPKIHS 166

167. GRASPING & HOLDING
•Allis Tissue Forceps
Prof. Dr. RS Mehta, BPKIHS 167

168. GRASPING & HOLDING
•Babcock Intestinal Forceps
Prof. Dr. RS Mehta, BPKIHS 168

169. GRASPING & HOLDING
•Backhaus Towel Clamps
Prof. Dr. RS Mehta, BPKIHS 169

170. CLAMPING & OCCLUDING
•Hemostatic Forceps
•Hemostats
•Crushing Clamps
•Noncrushing Vascular ClampsProf. Dr. RS Mehta, BPKIHS 170

171. CLAMPING & OCCLUDING
•Hemostatic Forceps
•Hemostats
•Crushing Clamps
•Noncrushing Vascular Clamps- used to occlude peripheral or
major blood vessels
Prof. Dr. RS Mehta, BPKIHS 171

172. CLAMPING & OCCLUDING
•Pean Intestinal forceps
Prof. Dr. RS Mehta, BPKIHS 172

173. CLAMPING & OCCLUDING
•Hemostatic Forceps
•Hemostats
•Crushing Clamps
•Noncrushing Vascular ClampsProf. Dr. RS Mehta, BPKIHS 173

174. CLAMPING & OCCLUDING
•Hemostatic Forceps
•Hemostats
•Crushing Clamps
•Noncrushing Vascular ClampsProf. Dr. RS Mehta, BPKIHS 174

175. EXPOSING & RETRACTING
•BALFOUR ABDOMINAL RETRACTOR
Prof. Dr. RS Mehta, BPKIHS 175

176. EXPOSING & RETRACTING
•ARMY NAVY
FARABEUF Retractor
Prof. Dr. RS Mehta, BPKIHS 176

177. EXPOSING & RETRACTING
•GELPI Perineal Retractor
Prof. Dr. RS Mehta, BPKIHS 177

178. EXPOSING & RETRACTING
•Weitlaner Retractor
Prof. Dr. RS Mehta, BPKIHS 178

179. EXPOSING & RETRACTING
•Spay Hook
Prof. Dr. RS Mehta, BPKIHS 179

180. EXPOSING & RETRACTING
•Senn Retractors
Prof. Dr. RS Mehta, BPKIHS 180

181. EXPOSING & RETRACTING
•Finochietto Retractor
Prof. Dr. RS Mehta, BPKIHS 181

182. EXPOSING & RETRACTING
•Ribbon Retractor
Prof. Dr. RS Mehta, BPKIHS 182

183. SUTURING & STAPLING
•Needle Holders
•Tungsten Carbide Jaws
•Crosshatched Serrations
•Smooth Jaws
•Staplers
Prof. Dr. RS Mehta, BPKIHS 183

184. SUTURING & STAPLING
•Terminal End Staplers
•Internal Anastomosis Staplers
•End-to-End Circular Staplers
Prof. Dr. RS Mehta, BPKIHS 184

185. VIEWING
•Speculums
•Endoscopes
•Hollow Endoscopes
•Lensed Endoscopes Prof. Dr. RS Mehta, BPKIHS 185

186. SUCTIONING & ASPIRATING
•Suction
•Poole Abdominal Tip
•Frazier Tip
•Yankeur Tip
•Autotransfusion
Prof. Dr. RS Mehta, BPKIHS 186

187. SUCTIONING & ASPIRATING
•Suction
•Poole Abdominal Tip
•Frazier Tip
•Yankeur Tip
•Trocar
Prof. Dr. RS Mehta, BPKIHS 187

188. DILATING & PROBING
Prof. Dr. RS Mehta, BPKIHS 188

189. MEASURING
Prof. Dr. RS Mehta, BPKIHS 189

190. ACCESSORY INSTRUMENTS
Prof. Dr. RS Mehta, BPKIHS 190

191. MICROINSTRUMENTATION
Prof. Dr. RS Mehta, BPKIHS 191

192. Powered Surgical Instruments
DRILL
BURR
BLADE
REAMER
ABRADER
AIR-POWERED
ELECTRICALLY POWERED
Prof. Dr. RS Mehta, BPKIHS 192

193. HANDLING INSTRUMENTS
•Standardized BASIC
sets
•Scrub Person
counts ALL
instruments, sharp
and sponges with
the CIRCULATOR
•Handle Loose
Instruments
SEPARATELY
•Sort by
CLASSIFICATION Prof. Dr. RS Mehta, BPKIHS 193

194. Handling INSTRUMENTS during
SURGERY
• Know the NAME and USE
• Handle INDIVIDUALLY
• Use for the INTENDED purpose
• Use of HAND SIGNALS
• Short INSTRUMENTS = Superficial
Work
• LONG Instruments = DEEP
• PASS instruments DECISIVELY
• FREE-HAND TECHNIQUE
• Watch the sterile field for
LOOSE instruments
• With a MOIST, SPONGE wipe
blood and organic debris from
instruments using a
DEMINERALIZED STERILE,
DISTILLED H20
Prof. Dr. RS Mehta, BPKIHS 194

195. ELECTROSURGERY
•INITIAL Incision is
made by a SCALPEL
•Doubling the current
increases the heat
produced fourfold
•ARGON Enhanced
ESU Tip is held at 60
degree angle, causing
LESS Tissue Damage
•BUZZING – the
process of coagulating
the VESSELS
•BUZZ should not
exceed more than 3
SECONDS
Prof. Dr. RS Mehta, BPKIHS 195

196. LASER SURGERY
•Light amplification by stimulated emission of radiation (LASER)
•Types of LASES = ARGON, CARBON DIOXIDE, HOLMIUM,
KRYPTON, NEODYMIUM, PHOSPHATE, RUBY/XENON
Prof. Dr. RS Mehta, BPKIHS 196

197. PATIENT SAFETY in LASERS
 Eyes and Eyelids
should be adequately
protected (aluminum
foil, moist pads)
 Antiseptics must be
NONFlammable
 Rectum should be
packed with a
MOISTENED sponge
to prevent escape of
METHANE gas
 Anesthetic Agents
should be
NONCombustible
 Flexible metallic or
insulated silicone
endotracheal tubes
 Wear high filtration
MASKS for CO2 laser
ablation such as
condylomata
(Venereal warts)
Prof. Dr. RS Mehta, BPKIHS 197

198. Advantages of LASERS
 Precise CONTROL =
ACCURATE incision
 Access to HARD to
REACH areas
(endoscopes, rhodium
reflector mirrors)
 Unobstructed view of
the surgical site
 Minimal TRAUMA to
tissues
 DRY, Bloodless
SURGICAL Field
 Minimal THERMAL
effect
 Reduced RISK for
INFECTION
 Prompt Healing
 Reduced
OPERATING Time
Prof. Dr. RS Mehta, BPKIHS 198

199. Prof. Dr. RS Mehta, BPKIHS
WWW.SMSO.NET
199

200. THANK YOU
Free Nursing Lectures
http://nursinglectures.blogspot.com
200Prof. Dr. RS Mehta, BPKIHS

201. BASIC SURGICAL
INSTRUMENTS
Fundamentals of Primary Health Care
B
201Prof. Dr. RS Mehta, BPKIHS

202. BASIC SURGICAL
INSTRUMENTS
 Basic laparotomy instruments are essential to
accomplish most types of general surgery. Each
instrument can be placed into one of the four
following basic categories:
 Retracting and Occluding Instruments
 Cutting and Dissecting Instruments
 Clamping and Occluding Instruments
 Grasping and Holding Instruments
202Prof. Dr. RS Mehta, BPKIHS

203. Retracting and Exposing
Instruments
 used to hold back or retract organs or tissue to gain
exposure to the operative site. They are either "self-
retaining" (stay open on their own) or "manual" (held by
hand). When identifying retractors, look at the blade, not
the handle.
203Prof. Dr. RS Mehta, BPKIHS

204. Retracting and Exposing
Instruments
 A Deaver retractor (manual) is used to retract deep
abdominal or chest incisions. Available in various
widths.
204Prof. Dr. RS Mehta, BPKIHS

205.  A Richardson retractor (manual) is used to retract
deep abdominal or chest incisions
Retracting and Exposing
Instruments
205Prof. Dr. RS Mehta, BPKIHS

206. Retracting and Exposing
Instruments
 An Army-Navy retractor (manual) is used to retract
shallow or superficial incisions. Other names: USA,
US Army.
206Prof. Dr. RS Mehta, BPKIHS

207. Retracting and Exposing
Instruments
 A goulet (manual) is used to retract shallow or
superficial incisions.
207Prof. Dr. RS Mehta, BPKIHS

208.  A malleable or ribbon retractor (manual) is used to
retract deep wounds. May be bent to various
shapes.
Retracting and Exposing
Instruments
208Prof. Dr. RS Mehta, BPKIHS

209.  A Weitlaner retractor (self-retaining) is used to
retract shallow incisions.
Retracting and Exposing
Instruments
209Prof. Dr. RS Mehta, BPKIHS

210.  A Gelpi retractor (self-retaining) is used to retract
shallow incisions.
Retracting and Exposing
Instruments
210Prof. Dr. RS Mehta, BPKIHS

211.  A Balfour with bladder blade (self-retaining) is used
to retract wound edges during deep abdominal
procedures.
Retracting and Exposing
Instruments
211Prof. Dr. RS Mehta, BPKIHS

212. Cutting and Dissecting
Instruments
 are sharp and are used to cut body tissue or surgical
supplies.
Knife Handle, Scissors
(left to right)
212Prof. Dr. RS Mehta, BPKIHS

213. Cutting and Dissecting
Instruments
 7 handle with 15 blade (deep knife) - Used to cut
deep, delicate tissue.
 3 handle with 10 blade (inside knife) – Used to cut
superficial tissue.
 4 handle with 20 blade (skin knife) - Used to cut
skin.
#7, #3, #4
(left to right) 213Prof. Dr. RS Mehta, BPKIHS

214.  Straight Mayo scissors - Used to cut suture and
supplies. Also known as: Suture scissors.
EX: Straight Mayo scissors being used to cut suture.
Cutting and Dissecting
Instruments
214Prof. Dr. RS Mehta, BPKIHS

215.  Curved Mayo scissors - Used to cut heavy tissue
(fascia, muscle, uterus, breast). Available in regular
and long sizes.
Cutting and Dissecting
Instruments
215Prof. Dr. RS Mehta, BPKIHS

216.  Metzenbaum scissors - Used to cut delicate
tissue. Available in regular and long sizes.
Cutting and Dissecting
Instruments
216Prof. Dr. RS Mehta, BPKIHS

217.  are used to compress blood vessels or hollow organs
for hemostasis or to prevent spillage of contents.
Clamping and Occluding
Instruments
217Prof. Dr. RS Mehta, BPKIHS

218.  A hemostat is used to clamp blood vessels or tag
sutures. Its jaws may be straight or curved. Other
names: crile, snap or stat.
Clamping and Occluding
Instruments
218Prof. Dr. RS Mehta, BPKIHS

219. Clamping and Occluding
Instruments
 A mosquito is used to clamp small blood
vessels. Its jaws may be straight or curved.
hemostat, mosquito (left to right)
219Prof. Dr. RS Mehta, BPKIHS

220.  A Kelly is used to clamp larger vessels and
tissue. Available in short and long sizes. Other
names: Rochester Pean.
Kelly, hemostat, mosquito (left to right)
Clamping and Occluding
Instruments
220Prof. Dr. RS Mehta, BPKIHS

221.  A burlisher is used to clamp deep blood
vessels. Burlishers have two closed finger
rings. Burlishers with an open finger ring are called
tonsil hemostats. Other names: Schnidt tonsil forcep,
Adson forcep.
Clamping and Occluding
Instruments
221Prof. Dr. RS Mehta, BPKIHS

222.  A right angle is used to clamp hard-to-reach vessels
and to place sutures behind or around a vessel. A
right angle with a suture attached is called a "tie on a
passer." Other names: Mixter.
Clamping and Occluding
Instruments
222Prof. Dr. RS Mehta, BPKIHS

223.  A hemoclip applier with hemoclips applies metal
clips onto blood vessels and ducts which will remain
occluded.
hemoclip applier with hemoclips
Clamping and Occluding
Instruments
223Prof. Dr. RS Mehta, BPKIHS

224. Grasping and Holding
Instruments
 are used to hold tissue, drapes or sponges.
224Prof. Dr. RS Mehta, BPKIHS

225.  An Allis is used to grasp tissue. Available in short
and long sizes. A "Judd-Allis" holds intestinal tissue;
a "heavy allis" holds breast tissue.
Grasping and Holding
Instruments
225Prof. Dr. RS Mehta, BPKIHS

226. Grasping and Holding
Instruments
 A Babcock is used to grasp delicate tissue (intestine,
fallopian tube, ovary). Available in short and long
sizes.
226Prof. Dr. RS Mehta, BPKIHS

227.  A Kocher is used to grasp heavy tissue. May also
be used as a clamp. The jaws may be straight or
curved. Other names: Ochsner.
Grasping and Holding
Instruments
227Prof. Dr. RS Mehta, BPKIHS

228.  A Foerster sponge stick is used to grasp
sponges. Other names: sponge forcep.
Foerster sponge stick EX: Sponge sticks holding a 4 X 4
and probang.
Grasping and Holding
Instruments
228Prof. Dr. RS Mehta, BPKIHS

229.  A dissector is used to hold a peanut.
Grasping and Holding
Instruments
dissector
EX: Dissector holding a peanut.
229Prof. Dr. RS Mehta, BPKIHS

230.  A Backhaus towel clip is used to hold towels and
drapes in place. Other name: towel clip.
Backhaus towel clip Large & small towel clips
Grasping and Holding
Instruments
230Prof. Dr. RS Mehta, BPKIHS

231.  Pick ups, thumb forceps and tissue forceps are
available in various lengths, with or without teeth, and
smooth or serrated jaws.
Grasping and Holding
Instruments
231Prof. Dr. RS Mehta, BPKIHS

232.  Russian tissue forceps are used to grasp tissue.
Grasping and Holding
Instruments
232Prof. Dr. RS Mehta, BPKIHS

233.  Adson pick ups are either smooth: used to grasp
delicate tissue; or with teeth: used to grasp the
skin. Other names: Dura forceps.
Grasping and Holding
Instruments
233Prof. Dr. RS Mehta, BPKIHS

234. Grasping and Holding
Instruments
 Long smooth pick-ups are called dressing
forceps. Short smooth pick-ups are used to grasp
delicate tissue.
234Prof. Dr. RS Mehta, BPKIHS

235.  DeBakey forceps are used to grasp delicate tissue,
particularly in cardiovascular surgery.
Grasping and Holding
Instruments
235Prof. Dr. RS Mehta, BPKIHS

236. Grasping and Holding
Instruments
 Thumb forceps are used to grasp tough tissue
(fascia, breast). Forceps may either have many
teeth or a single tooth. Single tooth forceps are also
called "rat tooth forceps."
single tooth forceps, many teeth forceps
(top to bottom)
236Prof. Dr. RS Mehta, BPKIHS

237.  Mayo-Hegar needle holders are used to hold
needles when suturing. They may also be placed in
the sewing category.
Grasping and Holding
Instruments
short, medium & long
(top to bottom)
EX: Needle holder with suture.
237Prof. Dr. RS Mehta, BPKIHS