Basic Instruments Clamping and Occluding Instruments
Surgical instrument - are used to compress blood vessels or hollow
- is a tool or device for performing specific organs for hemostasis or to prevent spillage of
actions or carrying out desired effects during a contents.
surgery or operation, such as modifying
biological tissue, or to provide access for Mosquito
viewing it. - is used to clamp small blood vessels. Its jaws
may be straight or curved.
Classifications:
A. Cutting and Dissecting Kelly
- used to dissect, incise, separate, or excise - is used to clamp larger vessels and tissue.
tissues - Available in short and long sizes.
- Other names: Rochester Pean.
Cutting and Dissecting Instruments
Blade Handle/ Scalpel Right angle
- A metal handle with a range of single use - is used to clamp hard-to-reach vessels and
sterile blade for incising the skin and for sharp to place sutures behind or around a vessel.
dissection. - A right angle with a suture attached is called
a "tie on a passer."
Blade holder # 7 with 15 blade (deep knife) - Other names: Mixter.
- Used to cut deep, delicate tissue.
c. Grasping and Holding Instruments
Blade holder # 3 with 10 blade (inside knife) - are used to hold tissue, drapes or sponges.
– Used to cut superficial tissue.
Allis
Blade holder # 4 with 20 blade (skin knife) - is used to grasp tissue.
- Used to cut skin. - Available in short and long sizes.
- A "Judd-Allis" holds intestinal tissue; a "heavy
Scissors allis" holds breast tissue
- the blades of scissors may be straight, angled,
or curved, as well as either pointed or blunt at Bobcock
the tips. - is used to grasp delicate tissue (intestine,
fallopian tube, ovary). Available in short and
Straight Mayo Scissors long sizes.
– Used to cut sutures, also known as suture
scissors. Kocher
- is used to grasp heavy tissue. May also be
Curved Mayo scissors used as a clamp. The jaws may be straight or
- Used to cut heavy tissue (fascia, muscle, curved.
uterus, breast). - Other names: Ochsner.
- Available in regular and long sizes.
Backhaus towel clip
Metzenbaum scissors - is used to hold towels and drapes in place.
- Used to cut delicate tissue. •Other name: towel clip.
- Available in regular and long sizes.
Thumb forceps
Suture Scissors - Non-toothed forceps used for fine handling of
- Used to remove sutures tissue and traction during dissection.
- Blade has beak or hook to slide under sutures
Tissue forceps
Bandage Scissors - Used for grasping and holding tissue, muscle
- Used to remove bandages and dressings or skin surrounding a wound for suturing.
- Probe tip is blunt; inserted under bandages
with relative safety Adson pick ups are either smooth
- used to grasp delicate tissue; or with teeth:
used to grasp the skin.
- Other names: Dura forceps
Sponge Forceps Passing and Care of Instruments
- Used to hold gauze squares or sponge to 1. The SN should know the various steps of the
“mop up” the surgical site different operations.
- Jaws are serrated 2. She must be familiar with the characteristics
of each surgeon’s technique.
Needle Holder 4. When passing the instrument, it should be
- Used to hold and pass a suturing needle held at the shank between the cushions of the
through tissue thumb and first two fingers, with the tip visible
- Has groove to hold needle within jaws and the handle is free for the surgeon’s palm.
5. The curve of the instrument goes with the
Retracting and Exposing Instruments curves of the surgeon’s palm
- used to hold back or retract organs or tissue 6. By a slight turn of the wrist, the rings of the
to gain exposure to the operative site. instruments’ handle are gently rung over the
- They are either "self-retaining" (stay open on surgeon’s finger.
their own) or "manual" (held by hand). 7. Tissue and thumb forceps are held with the
- When identifying retractors, look at the blade, tip down.
not the handle. 8. Instruments should be wiped off with a wet
sponge to remove all free fatty substances and
Deaver Retractor (Manual) blood. They should then be returned to proper
- is used to retract deep abdominal or chest position.
incisions. 9. Instrument tables should never be in
- Available in various widths. disorderly state during an operation so that the
SN can work smoothly and with speed
Richardson retractor (manual) 9. Impaired instruments should never be
- is used to retract deep abdominal or chest passed to the surgeon.
incisions
Passing and Care of Instruments
Army-Navy retractor (manual) • Any instrument that have come in contact
- is used to retract shallow or superficial with contaminated areas should be discarded.
incisions. Other names: USA, US Army. • They should Be lifted from the field with pick
up forceps or received by the kidney basin
Malleable or ribbon retractor (manual) and should never be touched with the gloved
- is used to retract deep wounds. May be bent hand
to various shapes • The SN should be familiar with the surgical
hand signals.
Weitlaner retractor (self-retaining)
- is used to retract shallow incisions. Notes:
> Pass instruments in a decisive manner
Gelpi retractor (self-retaining) > With the tip of the instrument visible and
- is used to retract shallow incisions. hand is free, the handle is placed in the
surgeon’s waiting hand
Balfour with bladder blade (self-retaining) > The instrument should be slapped firmly into
- is used to retract wound edges during deep the palm of the surgeon in proper position for
abdominal procedures. use.
• Self-retaining > If the surgeon is in the same side of the table
• Bladder retractor and on the left side, use your right hand to
pass the instrument
Bladder retractor > If the surgeon is on the same side and on the
- Is used for retracting bladder during right side, use your left hand to pass the instrument.
abdominal operations like LSCS, abdominal > Don’t reach behind a member of a sterile team
hysterectomy.
Senn retractor
- is a small, relatively delicate retractor that is
used extensively in hand surgery, vascular
surgery, plastic surgery and other procedures
involving the skin and soft tissue.