surgical instruments basic

8/3/2019 Surgical Instruments Basic

http://slidepdf.com/reader/full/surgical-instruments-basic 1/11

Classification by type of points

All types of scissors can have blunt or sharp blades (A: Sharp:Sharp,

B: Blunt:Blunt).

All types can have either straight or curved blades.

Mayo and Metzenbaum

Mayo scissors (B) are used for cutting heavy

fascia and sutures.

Metzenbaum scissors (A) are more delicate than Mayoscissors.

Metzenbaum scissors are used to cut delicate tissues.

Metzenbaum scissors have a longer handle to blade

ratio.

Forceps: consist of two tines held together at one end with a spring device that holds

the tines open. Forceps can be either tissue or dressing forceps.

Dressing forceps have smooth or smoothly serrated tips.

Tissue forceps have teeth to grip tissue. Many forceps bear the name of the originator

of the design, such as Adson tissue forceps.



R at Tooth: A Tissue Forceps

Interdigitating teeth

hold tissue withoutslipping.

Used to holdskin/dense tissue.

Adson Tissue Forceps

Small serrated teeth on

edge of tips.

The Adsons tissue

forceps has delicateserrated tips designed for

light, careful handling of tissue.

Intestinal Tissue Forceps: Hinged (locking) forceps used for grasping and holding

tissue.



Allis: An Intestinal Tissue Forceps

Interdigitating short

teeth to grasp and hold bowel or tissue.

Slightly traumatic, use

to hold intestine, fasciaand skin.

Babcock: An Intestinal Tissue Forceps

More delicate thatAllis, less directly

traumatic.

Broad, flared ends with

smooth tips.

Used to atraumaticallyhold viscera (bowel and bladder).



Sponge Forceps

Sponge forceps can be

straight or curved.

Sponge forceps can

have smooth or serrated jaws.

Used to atraumaticallyhold viscera (bowel and

bladder).

Hemostatic forceps: Hinged (locking) Forceps. Many hemostatic forceps bear

the name of the designer (Kelly, Holstead, Crile). They are used to clamp and hold

blood vessels.

Classification by size and shape and size of tips

Hemostatic forceps and hemostats may be curved or straight.



K elly Hemostatic Forceps and Mosquito Hemostats

Both are transversely serrated.

Mosquito hemostats (A) are more delicate than

Kelly hemostatic forceps (B).

Comparison of K elly and Mosquito tips

Mosquito hemostats (A) have a smaller, finer tip.

Carmalt

Heavier than Kelly.

Preferred for clamping of

ovarian pedicals during anovariohysterectomy surgery

because the serrations runlongitudinally.



Doyen Intestinal Forceps

Doyen intestinal forceps are non-

crushing intestinal occluding forceps with

longitudinal serrations.

Used to temporarily occlude lumen of

bowel.

Payr Pylorus Clamps

Payr pylorus clamp is a crushing

intestinal instrument.

Used to occlude the end of bowel to

be resected.

Needle holder: Hinged (locking)

instrument used to hold the needle while

suturing tissue.

Good quality is ensured with tungsten carbide inserts at the tip of the needle holder.

Mayo-Hegar

Heavy, with mildly tapered jaws.

No cutting blades.



Olsen-Hegar

Includes both needle holding jaw and scissors blades.

The disadvantage to having blades within the needle

holder is the suture material may be accidentally cut.

Senn

Blades at each end.

Blades can be blunt

(delicate) or sharp (moretraumatic, used for

fascia).



Hohman

Levers tissue away

from bone duringorthopedic procedures.

Weitlaner

Ends can be blunt or sharp.

Has rake tips.

Ratchet to hold tissue apart.

Gelpi

Has single point tips.

Ratchet to hold tissue

apart.



Handles

#3 Handle

#4 Handle

Handles and Blades

Blades #10, 11, 12, 15 fit the #3 handle.

Blades #22, #23 fit the #4 handle and are commonly used for large animals.

Disposable Scalpel

Towel clamps secure drapes to a patient's skin. They may also be used to hold tissue.

Backhaus Towel Clamp

Locking forceps with curved, pointed tips.



Scissors and Hemostats:

The thumb and ring finger are inserted into the ringsof the scissors while the index and middle finger are

used to guide the instrument.

The instrument should remain at the tips of the fingerfor maximum control.

This is the wrong way to hold the scissors.The ring finger should be inserted into thering.

This is also the wrong way to hold the

scissors. The tips of the scissors should be

pointing upwards.

Thumb Forceps:



Thumb forceps are held like a pencil.

Thumb Forceps are not called 'tweezers'.

Thumb Forceps are not held like a knife.

Scalpels:

The scalpel is held with thumb, middle and ringfinger while the index finger is placed on the

upper edge to help guide the scalpel.

Long gentle cutting strokes are less traumatic totissue than short chopping motions.

The scalpel should never be used in a "stabbing" motion.

surgical instruments basic

Documents