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SURGICAL INSTRUMENTS

I. CUTTING AND DISSECTING


~ Cutting and dissecting instruments are sharp and are used to cut body tissue or
surgicalsupplies.
A. KNIFE HANDLESdeep knife7 handle with 15blade
Used to cut deep,delicate tissue.
inside knife3 handle with 10blade
Used to cutsuperficial tissue.
skin knife4 handle with 20blade
Used to cut skin.
InstrumentsFunctionsB. SCISSORSStraight Mayo Scissors
Used to cut suture and supplies.Also known as: Suture scissors.
Curved Mayo Scissors
Used to cut heavy tissue (fascia, muscle, uterus,breast).
Metzenbaum Scissors
Used to cut delicate tissue.
II. CLAMPING and OCCLUDING
~ Clamping and occluding instruments are used to compress blood vessels or
hollow organs forhemostasis or to prevent spillage of contents.

InstrumentsFunctionsHemostatOther names: crile, snap or stat.


A
hemostat
is used to clamp blood vessels or tagsutures. Its jaws may be straight or curved.

Hemostat, Mosquito (left to right


)A
mosquito
is used to clamp small blood vessels. Itsjaws may be straight or curved.
Kelly, Hemostat, Mosquito (left to right)Other names: Rochester Pean
A
Kelly
is used to clamp larger vessels and tissue
BurlisherOther names: Schnidt tonsil forcep, Adsonforcep.
A
burlisher
is used to clamp deep blood vessels.Burlishers have two closed finger rings.
Burlisherswith an open finger ring are calledtonsil hemostats.

Right AngleOther names: Mixter.


A
right angle
is used to clamp hard-to-reach vesselsand to place sutures behind or around a
vessel. Aright angle with a suture attached is called a "tie ona passer."
Hemoclip applier with hemoclips
A
hemoclip applier with hemoclips
applies metalclips onto blood vessels and ducts which will remainoccluded.
Carmalt Clamp
Larger than a kelly clamp and often confusedwith the Peon Clamp of the same size;
Carmaltclamps have the characteristic jaw structure pictured.

Debakey Vascular Clamp


The most standard of vascular clamps, the jaw of the clamp is designed to clamp
veins and arterieswithout causing damage.
III. GRASPING and HOLDING
~ Grasping and holding instruments are used to hold tissue, drapes or sponges.
InstrumentsFunctions

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Description: a #7 knife handle holds blades 10, 11, 12, and 15.

CAUTION: never retrieve the scalpel from the surgeon after it is used; allow the
surgeon to place it in the "neutral zone."

CAUTION: use a needle holder to load and unload a scalpel blade; never use fingers.

Backhaus towel clamp (penetrating) Category: grasping and holding

Other names: Roeder towel clip, Jones.

Use(s): is used for holding towels in place when draping, when grasping tough
tissue, and during reduction of small bone fractures.

Description: a ratcheted instrument with curved, sharp, tinelike jaws.

Instrument Insight: used in all disciplines. Never use penetrating clips to attach the
electrosurgical unit (ESU), suction, or any other item to the drapes. This will
perforate the drapes and compromise the sterile field.

CAUTION: when clipping towels together, be careful not to penetrate the patient's
skin.

CAUTION: exercise care when handling penetrating forceps. The sharp tips can
easily compromise the integrity of oyur gloves or those of the surgeon.

Crile forceps/clamps, curved or straight Category: clamping and occluding

Other names: hemostat, snap, clamp, Kelly

Use(s): is used to occlude bleeders before cauterization or ligation.

Description: a curved or straight clamp w/horizontal serrations that run the


complete length of the jaws.

Instrument Insights: the curved Crile is the most widely used clamp in all specialty
areas.


halstead mosquito forceps/clamps Category: clamping and occluding

Other names: Mosquito, Hartman

Use(s): is used to occlude bleeders in small or superficial wounds before


cauterization or ligation. Used often for delicate or small confined procedures. Some
examples are plastics, pediatrics, thyroid, and hand procedures.

Description: a curved or straight clamp w/fine tips and horizontal serrations that run
the length of the jaws.

Allis intestinal forceps Category: grasping and holding

Use(s): is used for lifting, holding, and retracting slippery dense tissue that is being
removed. Commonly used for tonsils; for vaginal, breast, and thyroid tisse; or for
grasping bowel during resection.

Description: curved or straight w/multiple, interlocking fine teeth at the tip that
reduce injury to the tissue.

Babcock intestinal forcep Category: grasping and holding

Use(s): is used for grasping and encircling delicate structures such as ureters,
fallopian tubes, bowel, ovaries, and appendix.

Description: an atraumatic forceps w/a flared, rounded, hollow end w/smooth,


flattened tips.

Schnidt tonsil forceps/clamps Category: clamping and occluding

Other Names: Adson, Schnidt

Use(s): is used for clamping small vessels in a deep wound or holding tonsil
sponges.

Description: the jaws may be curved or straight; they have horizontal serrations
running half of their length, ending in fine, blunt tips. The shanks are longer than
those of a Crile or a Kelly.

Foerster sponge forcep Category: grasping and holding

Other Names: Fletcher, sponge stick, ring forceps

Use(s): is used to create a sponge stick, for grasping tissues such as the lungs, or
for removing uterine contents.

Description: can be curved or straight and has two round tips w/horizontal
serrations.

Instrument Insight: to assemble a sponge stick, fold a 4x4 Raytex in thirds and then
in half and attac it to the ring forceps. A sponge stick can be used for the surgical
prep (painting), to absorb blood, or for blunt dissection in deep wounds.


Mayo-Hegar needle holder Category: suturing and stapling

Use(s): is used for holding heavy needles when suturing.

Description: has a broader jaw that is rounded at the tip w/crisscross pattern on the
inner jaw.

DeBakey tissue forceps Category: grasping and holding

Other Names: DeBakey's, DeBakes

Use(s): grasps numerous types of tissue; commonly used in cardiac and vascular
surgery

Description: an atraumatic tissue forceps w/an elongated, narrowed blunt tip. A set
of parallel fine serrations runs the length of one jaw w/a center row of serrations on
the oppostie side that interlocks to grip when closed.

Instrument Insight: is considered a vascular tissue forceps, but it is commonly used


in all specialty areas because of its ability to securely grip w/out causing damage to
the tissues.

Russian tissue forceps Category: grasping and holding

Other Names: Star, Russian star

Use(s): grasps dense tisses and used during wound closer.

Description: rounded tips w/starburst pattern serrations.

plain Adson tissue forceps Category: grasping and holding

Other Names: Adson dressing forceps

Use(s): grasps delicate tissue

Description: fine tips w/horizontal serrations

Instrument Insight: all of the Adson tissue forceps are the same size and shape.
They are differentiated by the inner tips.

toothed Adson tissue forceps Category: grasping and holding

Other Names: Adson w/teeth

Use(s): aligns the edges of the wound during stapling of the skin; grasps superficial
tissues so that Steri-Strips can be placed.

Description: the fine tips have two small teeth on one side and one small tooth on
the other side that fit together when closed. All of the Adson tissue forceps are the
same size and shape. They are differentiated by the inner tips.

Instrument Insight: exercise care when handling forceps w/teeth. The sharp teeth
can easily compromise the integrity of your gloves or those of the surgeon.

straight Mayo scissors Category: cutting and dissecting

Other Names: suture scissors

Use(s): are used to cut suture

Description: heavy scissors w/straight blades

Instrument Insight: when cutting suture, use the tips of the scissors. Slightly rotate
the scissors to visualize the knot or the appropriate length of the suture tail that will
remain.

curved Mayo scissors Category: cutting and dissecting

Other Names: heavy tissue scissors

Use(s): dissect or undermine heany fibrous tissues

Description: heavy scissors w/curved blades and blunt or sharp tips.

Instrument Insight: tissue scissors are intended to cut tissue only and should never
be used to cut other items. Inappropriate use of the scissors will cause the blades to
become dull and not function properly.

curved Metzenbaum scissors Category: cutting and dissecting

Other Names: Metz, tissue scissors

Use(s): dissect and undermine delicate tissue

Description: a longer, thinner scissors w/curved or straightblades that can have


blunt or sharp tips

Instrument Insight: tissue scissors are intended to cut tissue only and should never
be used to but suture or other items. Inappropriate use of the scissors will cause the
blades to become dull and not function properly.

Yankauer suction tip Category: suctioning and aspirating

Other Names: tonsil suction tip, oral

Use(s): is used for suctioning in all types of wounds. Allows effective suction w/out
aspiration damage to the surrounding tissue.

Description: a hollow plastic tube w/a grip handle and a slightly bent shaft that
terminates w/a bulbous tip and large opening.

Instrument Insight: the disposable Yankauer is the most widely used suction tip.

Poole suction tip Category: suctioning and aspirating

Other Names: abdominal sucker

Use(s): suctioning large amounts of blood and/or fluids from a body cavity. The inner
cannula of this suction tip can be used to suction down the shaft of the femur during
a total hip replacement procedure.

Description: can be disposable or reusable. Has two components: an outer sheath


and an inner cannula.

Instrument Insight: multiple fenestrations (holes) on the outer sheath allow for more
suction. If less suction power is desired, the surgeon may use the inner cannula
only.

Weitlaner retractor Category: retracting and exposing

Use(s): holds wound edges open

Description: self-retaining finger-ringed instrument w/a ratchet/release device on


the shanks, which holds them open in the wound. the tip has three outward-curved
prongs on one side and four on the other side that may be sharp or dull.

Instrument Insight: always hand this retractor to the surgeon w/the prongs down.

CAUTION: the prongs may be very sharp. Exercise care when handling sharp
instruments to avoid puncture to gloves and/or skin.

gelpi retractor

richardson-eastman retractor

richardson retractor

ribbon retractor

army-navy retractor

deaver retractor

Harrington sweetheart retractor

Balfour w/bladder blade & wing nut