‫بسم ال الرحمن الرحيم‬

‫يَرْفَعِ الُّ الّذِينَ آمَنُوا مِنْكُمْ وَالّذِينَ أُوتُوا‬

‫الْعِلْمَ َدرَجَاتٍ وَالُّ بِمَا تَعْمَلُونَ خَبِيرٌ"‬
‫صدق ال العظيم‬
‫سورة المجادلة آية رقم ‪11‬‬
 ‫قال رسول ال صلى ال عليه وسلم‬

‫إذا مات ابن آدم انقطع عمله إل من‬

‫ثلث صدقة جاريه أو علم ينتفع به‬
‫أو ولد صالح يدعو له‬
‫صدق رسول ال صلى ال علية وسلم‬
 ‫إعدا د‬
‫ا‪.‬د‪ /.‬جمال ابراهيم موسى‬
‫أستاذ جراحة الجهاز الهضمى والمناظير‬
‫كلية الطب جامعة طنطا‬
Mosqui to -1
:forceps Straight Curved

Us ed fo r:
Ha emo st asis, Blade

in cat chi ng of smal l Joint

vess el as, subcutaneous
or sub- mucosal vess el s
bef ore ligation or Shaft

cauteri zati on.

Lock

Handle
 Straight Curved
:Artery forceps -2
•*U se d fo r.
•# Ha emo st asis,
In catching of medium Blade

sized vessels as
subcutaneous or epiploic
vessels during
spleenectomy before its
ligation. Shaft

•# Pa rie tal
perito neum elevation
before its opening in
abdominal operations. Handle
What is the di fference between
the Mosqui to & Artery ?
 Blade

3- Clamp
forceps:
•Us ed fo r
Ha emo st asis in
catching of large size Straight Curved
vessels as,
• spleenic during Shaft
spleenectomy
& renal during
nephrectomy before
their ligation. Handle
What is the di fference bet ween thi s
?i ns trument s
Clamp Artery Mosquito

Lar ge Medi um
 Teeth
K ocher - 4
Blade
:f orceps
Use d fo r*
Grasping tough*
structures as
Joint
tendon, sheath or
.muscle
Lock
Shaft
Crushing the base*
of the appendix in
.appendectomy
Handle
What are the differences between Artery & Kocher?

1- Length
of blade.
2- Teeth.
3- Depth of
serration.
 Blade

:N eedl e hol der -5

Shaft
Grasp the needle*
for stitching

Handle
 Artery Needle holder

What are the

di fferences
between
arter y and
needl e hol der:
-1 le ngth o f th e •
bla de in rela tion
.t o shaft
-2 Corr ugatio n •
of t he blade
Artery Needle holder
Moyni han -6
Chol ecystectomy ( Blade

:)artery
•Used in
Grasping the cystic vessels
& cystic duct before their Shaft
ligation during
cholecystectomy operation.

Handle
What is the di fference between Moynihan
and arter y curve?

Curved artery Moynihan

Obtuse Right
 Blade. Flat-Thin-Non crushing

Intest inal -7 Blade

:cl amps
Grasp the intestinal
loop in resection
anastomosis.
A- Non crushing
intestinal type (flat thin
Shaft
blade)
• Differ from artery in
blade length in relation
to shaft & Corrugation Handle
of shaft
Straight or curved
B- Crushin g
in te st in al clamp
Intestinal clamps
C-Ga stric
cla mp:

Blade

Joint
D-D ouble
Ga st ric cla mp
Ga st ro intestinal c la mps
-8 All is
:f orceps Blade

Used fo r*
- Catching the skin
as in scalp incision,
thyroid surgery
Blade Toothed
-Meso-appendix in Closed at the tip only Shaft
appendectomy
-Edge of bowel in
bowel anastomosis

Handle
What are th e diffe rences betw een
?a rte ry & A ll is bla de
Artery Allis
.Space after closure -1
Teeth on tip of Allis -2
Blade ( short, shallow
Blade
.(Depression in between
 Blade

Blade

Babcock -9
:f orceps
•En circ lin g
str uctures as
vas a nd u re te r.
•Catch s tr uctures Shaft

as
appendix a nd
bowel wa ll
Handle
What are th e diffe rences
betwe en Alli s a nd
Babcock
bla de?
 Pin pointed end of the blade

Towel -10
:cl ips
For *
graspin g Blade
t he edge of
the to we l
over the
patie nt Shaft
aft er skin
ste rili za tio
.n
Handle
* Another
type of towel
clips
11 - Tongue Blade

grasper .
Used for traction of
the tongue
outwards
Blade Joint Shaft Lock Handle
1- St one Scope
on
forceps blade

) Ureter ic,
bi liar y and
Bl adder (:
•Us ed fo r Shaft

Stone extraction
from the ureter,
common bile duct Handle
and urinary
bladder.
Ureteric & Billiary Bladder
What ar e t he dif ferences between uret eri c
?& bl adder forceps
 Ti ssue
-2 Sti tches
:Sci ssors
Blade
.Us ed fo r
Tissue* Joint
.dissection
cutting Tissue*
Shaft
Opening*
.peritoneum
Stitchremoval*
Handle
3- Bone cutti ng Blade

forceps.
Us ed fo r. Joint

1- Cutting ribs.
2-Cutting small bones.
Spring
3-Circumcision.

Handle
 Blade
4- Cr ocd yle
forceps

Joint
 Blade
5- Pr octo-
scope
)Ano- scope(
Used for. Handle
*In sp ectio n o f
the a nal c anal &
lo we r rectu m
before o r durin g
anal o peratio ns Joint
-1
: Retra ctores
*Retraction of the
abdominal wall.
*Liver retractors.
*Retraction of
viscera.
To open surgical
A- Hand )Non-self
field.
Retaining(.
1- Skin retra cto rs
Mu sc le -2
:r etr actors
3- Abdominal wa ll
retr actors:
4- Liver o r v isceral re tracto rs :
B- Self Lock
retai ning
retrac tors

Blades
Ot her ty pes
Self
reta ining
retr actors
 Tip
2-
Di lat ors:
A- U re thral Rounded blunt tip

- Ur eteric
- B illia ry Shaft

Base
B-Hegar , s
dil ato r.
With d ouble
size end
C- He gar
)F ento n( d ila to r.
With one size end.

Ti p Bas e
-3 :Ti ssue f orceps
A - No n toothed
fo r c atching fine
stru cture a s
in te st in e, bladder o r
.t ube
B - To oth ed
fo r c atching tough
stru cture a s skin ,
.tendon or muscle

Toothed
4- Fistul ae Tip

di rect or:
In sertion in side
Shaft
•fistulae tracts before (grove)

fistulotomy.
• Inside constricting
hernia ring.
• Its handle (base) may
used in tie tongue
Base
Scal pel -5
.handl e

For scalpel
inserti on
 Encircling the
rib

:Ri b diss ector -6

For separation of the rib*
from its bed
Handle
 Sharp edge

-7 Per ios teal

:el evator
For elevation of *
periosteum as in amputation
.and skull surgery

Handle
 Opening for thread insertion

Aneurysm -8
:needl e
For encircling vessel or *
tubular structure with a
.thread
 Spoon

9- C ur ette
spoon )Bone
curett e(.
*Curettage for chronic Handle
ulcer, sinus or chronic
osteomyelitis

Spoon
9- Circumcision
device
 -1 Corr ugated
:rubber drai n
*Advantages.
Simple, Not expensive .
*Disadvantages.
Introduce infection and we
can not measure the
amount of discharge.
Vacuum drain -2
:))Negative pressure
,Closed system*
not introduce infection from
outside
measure the amount of *
.discharge
But may lead to*
visceral injury if present
intra-peritoneal by negative
.suction and expensive
*O th er
typ es of
drain :
--Sump
drain
-- T ube
drain
-*
In dic atio ns
of d rains?
-* Time of
drain
 -3 Fl ui d
inf usio n
:set
Needle
For intravenous•
infusion of any Bulb

fluid as glucose
.and saline
Another type*•
for blood with Lock
large needle and
filter inside its
. bulb
4- Blo od
inf usio n set

Needle

Bulb

Lock
 What are t he dif ferences between flui d &
bl ood inf us ion set ?

1-
Needl
e
2-
Fi lt er
5- Selo ce t )infusi on set for
neonates & chil dren(
:Catheter s- 6
A-Foley (self
.(retaining
With double or
.triple ways
Left inside the
bladder for
.time
B-Nelaton.
Removed after
evacuation of the
.bladder
C- Depezer catheter.

head
 Distal (inner) end
7- Rayel
tu be:
•For g astr ic
aspira tio n.
•Aft er
la parotomy
• In te st in al
Proximal (outer)
obst ru ction end

• Afte r
anasto mosi
s
Cat heter
Di ffer ence betw een Rayel and Nel aton
?catheter
8- T- tube
*In dicatio n
s.
*Time o f
remo val.

Ver ti cal Ho rizo nt

limb al limb
Inside
common
bile duct
?Are you know this instruments