Surgery
INSTRUMENTS
CREATED BY -
Ananya Kumar Sahoo
MKCG, MCH
2018-23
Surgery
INSTRUMENTS
KELLY'S PROCTOSCOPE
DIAGNOSTIC THERAPEUTIC
1. Piles 1. Injection
2. Rectal polyps sclerotherapy for Piles
3. Carcinoma of anal 2. Polypectomy
canal or rectum 3. Biopsy
4. Ulcerative colitis
Done in left lateral position
DRE done before proctoscopy to rule out painful
conditions like anal abscess or fissure
Proctoscope lubricated with 2% xylocaine jelly
Surgery
INSTRUMENTS
RYLE'S TUBE
1-meter long made of transparent plastic tubing.
There are a few lead shots near the tip.
(These lead shots are radiopaque and make the tip
heavier for easy introduction)
There are number of side holes near the tip.
Tube is lubricated with 2% xylocaine jelly
USES
Decompression of the stomach during upper
abdominal surgery
To empty stomach in intestinal obstruction
To decompress the stomach postoperatively
For feeding.
MARKINGS (Tip of tube at)
1. One line (40cm from tip) - GE junction
2. Two lines (50cm from tip) - Body of stomach
3. Three lines (60cm from tip) - Pylorus of stomach
4. Fourth lines (70cm from tip) - Duodenum
Surgery
INSTRUMENTS
FOLEY'S BALOON CATHETER
USES
Relief of acute or chronic urinary retention
(obstructive uropathy)
Intermittent catheterization of a neurogenic bladder.
Instillation of contrast agent fory cstourethrography.
Bladder irrigation.
Instillation of a drug.
Surgery
INSTRUMENTS
BARD PARKER HANDLES
Flat stainless steel instrument with the narrower end
having slots to attach the scalpel blade.
Used to make skin incisions for any operation.
Number
1. Number 3
2. Number 5 Narrow slot for scalpel
3. Number 7
4. Number 4 → Wider slot for scalpel
Surgery
INSTRUMENTS
RAMPLEY'S SWAB HOLDING FORCEPS
Long instrument
The shaft has a ratchet
The blades are oval and fenestrated
Serrations present on inner aspect of blade
USES
1. Cleansing the skin with antiseptic
2. Cleaning the blood during procedures
3. As ovum forceps
4. As tongue holding forceps
Surgery
INSTRUMENTS
DOYEN'S INTESTINAL FORCEPS
Long instrument
The shaft has a ratchet
The blades are straight and long
Serrations present on inner aspect of blade
USES
Gut resection and anastomosis (Grasping on large
organs such as intestines)
Surgery
INSTRUMENTS
DESJARDIN'S CHOLEDOCHOLITHOTOMY
FORCEPS
Long instrument
The shaft has no ratchet and is curved
The blades are fenestrated
No serration on the blades
USES
Used during laparoscopic cholecystectomy
May also be used during removal of kidney, ureteric or
bladder stone
Surgery
INSTRUMENTS
METZENBAUM SCISSORS
Longer and finer than Mayo scissors
The blades are sharp and shorter than shaft
There is no ratchet lock
Blades have no serrations
USES
Used for dissection at depth
Surgery
INSTRUMENTS
MAYO SCISSORS
Shorter but heavy scissors
The blades are blunt and thick
There is no ratchet lock
Straight or curved type
USES
Used for dissection and cutting thick structures
Surgery
INSTRUMENTS
RIGHT ANGLED FORCEPS
aka Lahey's forceps
The terminal part of blades is bent at right angles.
There is a ratchet lock
The blades have transverse serrations like hemostatic
forceps
USES
This is usually used to dissect pedicles of important organs
Used to pass ligatures around dissected vessels.
This may also be used as a hemostatic forceps to hold a
bleeding vessel at a depth
Surgery
INSTRUMENTS
HEMOSTATIC ARTERY FORECEPS
Light instrument
The blades are half the length of shaft
There is a ratchet lock
The blades have transverse serrations
USES
Used to hold bleeding vessels while cutting through
different layers of tissues
Surgery
INSTRUMENTS
MOSQUITO ARTERY FORECEPS
Very light instrument
The blades are a lot smaller than shaft
There is a ratchet lock
The blades have transverse serrations
USES
Used to hold fine bleeding vessels during delicate
procedures like cleft lip.
Used as hemostatic forceps in infants and children
where the vessels are delicate.
Surgery
INSTRUMENTS
Mosquito forceps Hemostatic forceps
Surgery
INSTRUMENTS
NEEDLE HOLDER
Light instrument
The shaft is longer than blades
There is a ratchet lock
The blades have criss-cross serrations and a groove in
central part
USES
Used to hold the needle for suturing
Surgery
INSTRUMENTS
ALLIS TISSUE FORCEPS
The blades when opposed have space between them
to hold some tissue.
There is a ratchet lock
The blades have toothed tips
USES
During laparotomy through midline incision, to hold
the skin margins and lift the Linea Alba.
Used to hold the skin flaps while excising a lipoma,
sebaceous cyst or lymph node
Surgery
INSTRUMENTS
PLAIN DISSECTING FORCEPS
Light instrument
Transverse serrations on the blades
No tooth at the tip of blades
USES
Used during various procedures to hold the vessels,
muscles and nerves.
It is used in pediatric patient to hold the delicate
structures during suturing.
Used to insert packing into or remove objects from
deep cavities
Surgery
INSTRUMENTS
TOOTHED DISSECTING FORCEPS
Light instrument
Transverse serrations on the blades
Single toothed on one blade that fits between two
teeth on the other blade
USES
Used for grasping and holding tissue, muscle or skin
surrounding a wound
Surgery
INSTRUMENTS
LANGENBACH'S RETRACTOR
Has a handle, a long shaft and a flat solid blade.
The blade is curved at right angle to the shaft.
The tip of the blade is also curved at right angle for
better retraction of the tissues
USES
Retractors help in better visualization of the operative
field.
The tissue handling is also minimized.
Bleeding is better seen and controlled with placement of
retractors
Surgery
INSTRUMENTS
HUMBY'S SKIN GRAFTING KNIFE
Humby - Braithwaite dermatome is used to collect a slice
of healthy skin from donor site to perform a skin graft on
a site with tissue loss.
Surgery
INSTRUMENTS
URETHRAL DILATORS
Used for treating urethral strictures
Dilatation of meatus for catheterization
Surgery
INSTRUMENTS
FISTULA PROBE
The Fistula Probe allows easy access into a small and
curved fistula tract for the permanent occlusion of
complete fistulae-in-ano
Surgery
INSTRUMENTS
SURGICAL SUTURES
ABSORBABLE NON ABSORBABLE
It is degraded via It is not degradable and
inflammatory response in permanent
10 days - 8 weeks Often used externally
Often used internally Ex. Nylon, Prolene,
Ex. Vicryl, monocryl, PDS, Stainless steel & Silk*
Chromic Catgut
ADVANTAGE ADVANTAGE
Broken down by body Permanent Wound Support
No Foreign body left Causes less scarring
DISADVANTAGE DISADVANTAGE
Less period of wound Foreign body left
support Suture Sinus
Can cause inflammation Must be removed
*Silk is not truly permanent as it can break down over many years
Surgery
INSTRUMENTS
(Dexon) (Vicryl) (Maxon) (PDS)
(Prolene) (Dacron)
(calcified tissue) (noncutting)
tendon subcutaneous
tissue
fascia
Skin
Skin
Curved hemost.
Surgery
Lahey's forc.
INSTRUMENTS
Straight hemost.
Mayo Scissor
Needle holder
Metzenbaum
Desjardin's
Intestinal clamp
Surgery
INSTRUMENTS
All
the
best
For your exams
To begin, begin.
-William Wordsworth