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