Surgerical Instruments (important compiled).pdf

instruments used in surgery, compiled, forceps, scissors, retractors, biopsy, bone nibblers, vacuums, suction, tubes, catheters, laprascope, surgical instruments

1. SURGICAL
INSTRUMENTS
for
FINAL YEAR MBBS

4. Rampleys sponge holder
•It has fenestrated ends with transverse serrations
•It has rachet and a box joint
USES
•Used for cleaning/preparing parts , to hold
gallbladder and cervix during surgeries, for blunt
dissections, as ovum forceps

5. Towel clip
•2 types -
•Mayo towel clip: has ratchet for locking the box joint
-used to fix suction tubes, diathermy wires,
laproscopy cables, fix ribs in flail chest
•Doyen towel clip: has pinch lock action

6. Bard-Parker handle
•Used to mount surgical blades
•Pen/paint brush grip, palmar grip

7. Vicryl suture
•Polyglactin braided suture
•Synthetic absorbable suture
•Undergoes hydrolyses in 60-90days
•Tensile strength is 60% at end of 1st week and 30% at the end of
3rd week
USES
•Bowel (3-0 round body needle), bladder (3-0 round body needle),
CBD (5-0 round body needle)
•It can also be used to approximate subcutaneous tissues together.

8. Surgical blades
No. 11-Pointed/Stab blade : for incision and
drainage, also used for arteriotomy
No.12-Curved blade: for suture removal
No. 10,15,20,21,22,23: these have a belly
(sharpest portion) which is curved used to
make in incision

9. I. V Cannula

10. Yankauer Suction
•suction of blood/secretions
•suction of saliva in oral surgery

12. RETRACTORS
NON SELF RETAINING RETRACTORS SELF RETAINING RETRACTORS
SKIN HOOK
CAT’S PAW RETRACTOR
CZERNEY’S RETRACTOR
LANGENBECK RETRACTOR
MORRIS RETRACTOR
DOYEN RETRACTOR
DEAVER RETRACTOR
MALLEABLE RETRACTOR
VOLKMANN’S RETRACTOR
MASTOID RETRACTOR
BALFOUR SELF-RETAINING RETRACTOR
BOOK-WALTER SYSTEM

13. Skin hook (single/double) retractor
•used for raising skin flaps

14. Czerney’s retractor
•It has a hook at 1 end (at 90 degrees) to hook tissue
•has fenestrations to make instrument lighter and
bettre grip
•at other end space for taking bites from rectus sheath
•used for superficial tissues and abdominal wall
retraction, hernia and laprotomy closures
•prevents slipping of tissues

15. Langenbeck retractor
•long handle + small solid blade
•hernia/superficial injuries to retract
skin, fascia, aponeurosis
•narrow blade to retract liver edge

17. Doyen’s retractor
•convexity of the blade is more
•used to retract bladder

18. Deaver’s retractor
•?-shape, retractor with broad gentle curved blade
•comes in different lengths of the blade
•retract liver, spleen, abdominal viscera
•atraumatic and gives adequate exposure

19. Mastoid retractor
•Mollison self retaining homeostatic mastoid retractor

20. Volkmann’s retractor
•used to retract fascia in soles and palms

21. Balfour self-retaining retractor
•used for abdominal surgeries
•one blade is fixed while other is mobile
•helps in adjusting the amount of retraction required
•bladder retractor can be attached to it

22. Book-Walter system
•Its a bulky retractor with a semi-circular ring fixed to OT table with
multiple instruments
•used to retract multiple structures at same time

23. Joll’s thyroid retractor
•self retaining retractor
•for thyroid surgeries

24. Needle holder
•has criss-cross serrations with groove at the centre
•helps in fixing/holding the needle
•needle held at 1/3rd from the swaged end

26. Mayo Scissors
•bulky and heavy
•mainly for cutting sutures and tough structures like sheath and fascia
•screw joint
•can be straight/slightly curved

27. Metzenbaum scisssors
•Lighter than Mayo scissors
•curved and has a long handle
•used for dissection and cutting fine tissues

28. McIndoe scissors
•used for cutting delicate structures and dissecting tissue

29. Tissue scissors
Tissue scissors are for cutting tissues only; avoid using them for
tasks such as cutting suture material, as these activities blunt the
sharp edge.
Mayo can be straight or curved, and the points tapered or
rounded. They are robust scissors and are used for dissecting
and cutting strong tissues such as fascia.
Metzenbaum are similar to Mayo scissors but they have shorter
blades relative to the handles. They are used for precise, fine
dissection around delicate tissues.

30. tissue forceps and hemostatic forceps

31. Artery forceps
•tranverse serrations
•used to crush tissue
•Small/medium/large
•Straight/curved
•Uses: to catch bleeding points,
Open facial planes, pass ligatures,
Hold fascia, peritoneum, aponeurosis,
sutures, Darin abscess, hold guaze

32. Plain dissecting forceps
•doesnt cause much trauma
•transverse serrations for better grip on delicate structures like bowel
and bladder
•no teeth
•can be used to crush vessels

33. Toothed dissecting forceps
•has spring action
•used to hold needles, tough structures (skin, fascia, sheath)
•serrations on handle for better grip
•are traumatic hence used for tough structures

34. Debakey vascular forceps
•has longitudinal groove with two rows of teeth on side and single row
on another side , provides interlocking effect
•used for holding vessels during vascular anastomosis

35. Russian tissue forceps
•end are club shaped with multiple transverse serrations and small
teeth
•used for holding lymph nodes and lymphatic tissues

36. Spencer wells straight artery forceps
•it has 2 rings, ratchet, box joint, blades with tranverse serrations.
•used for holding bleeding arteries
•comes in different sizes

37. Adsons artery forceps
•Lighter than Spencer artery forceps
•Serrations at tip
•Box joint smaller than Spencer
•Used as a hemostat to control bleeding.

38. Curved Artery forceps
•it has transverse serrations
•used for holding tissues and epecially
bleeders.

45. Morant-Baker’s Appendix holding forceps
•its like Lane’s forceps but with opposing serrations proximal to the
tooth. These serrations give a good grip in mesoappendix while
holding appendix in appendicectomy
•use replaced by babcock’s forceps

47. Right angle tissue forceps
•blade is bent at the end alongwith
transverse serrations
•used for ligating pedicles

48. Kelly tissue forceps
•its a long curved artery with more
gradual curve of the blade
•used for dissection and holding
structures at depth

51. Babcock tissue forceps have a broad, blunt and flared tip that provides
a delicate grasping action. They can be used with care on tissues
remaining in the body.
Doyen intestinal forceps are designed to hold the intestine without
crushing. They have long, thin jaws with longitudinal, non-crushing
serrations. They have a more delicate touch because they are bowed in
shape, meaning the tips of the jaws only just meet when the ratchet
engages. This provides a delicate, non-traumatic grip.
Allis tissue forceps are a strong sturdy instrument with a number of
teeth on the gripping surface. They may crush tissue and should be
used with care, as they can be quite traumatic. They are used to firmly
grasp tissues that are to be removed from the body, due to the damage
that they can cause.

52. Haemostatic forceps should be held using the 'tripod' grip, as with
scissors. The thumb and ring finger are inserted into the rings, while
the index and middle finger are used to guide the instrument.
The tips of the forceps are applied to a bleeding vessel. This controls
haemorrhage with minimal trauma of the surrounding tissue. Curved
haemostats can be used pointing downwards to clamp small bleeding
vessels. They can also be used curving upwards, to grasp a bleeding
stump.
Kelly and Crile haemostats are more robust. The Kelly design has
transverse grooves on the distal half of the jaws only whilst the Crile
has grooves over the entire surface.
Carmalt (Rochester-Carmalt) haemostats are sturdy instruments with
their gripping surface containing longitudinal serrations with cross-
hatching at the tip. These are large forceps suitable for clamping
blood vessels and large tissues, and also for ligating pedicles.
Halsted Mosquito haemostats are small delicate instruments.

53. Farabeuf periosteal elevator
it has slightly curved , sharp blade
used for elevating periosteum

54. Doyen rib raspatory
•to cut rib attachments
•to determine side-handle laterally,
convexity upwards. tip downwards

55. Rib cutter
•Geirtz: 2 levers to magnify the cutting
effect
•Dolphin: sharp tip (above) and blunt tip
(placed below the rib)

56. Bone nibbler
•used for nibbling the sharp edges of the
rib

57. Lung holding forceps
•its a triangular forceps used for
stabilising the lung

58. Joll’s Thyroid retractor
•used to raise, fix and retract the flaps
during thyroid durgery

59. Kocher’s thyroid dissector
•used for dissecting the superior pole of thyroid

60. Aneurysm needle
•Used for passing sutures
•also used during venesection

61. Suprapubic cystolithotomy forceps
•no lock
•closed ring is for the thumb and the open ring is for 4 fingers

62. Pyelolithotomy forceps
•come in different angulations for different calyxes
•has no lock, has transverse serrations

63. Desjardin’s choledocholithotomy forceps
•long distal blades with smooth
serrations and fenestra in tip
•used for extracting stones from CBD
•no ratchet, lock or serrations

64. Ovum forceps
•used in gynaecological procedures
•used for removing placental
fragments
•sometimes stones removal from GB

66. Sinus forceps ( Lister’s)
•straight, long blades with serrations in tip
•no lock, no serrations, broad tip, blunt
•drain pus ( Hilton’s method )

67. Cheatle’s forceps
•kept in dressing trolley dipped in antiseptic solution
•used to pick guaze pieces and other instruments
•no lock

68. Bulldog clamp
•used for temporary occlusion of peripheral vessels
•has spring loaded action, vertical grrove , and fine transverse
serrations

69. Satinksy vascular clamp
•has curved needle with longitudinal groove and transverse serrations
•has ratchet

70. Doyen’s intestinal clamp
•Non-toothed , non-crushing clamp
•longitudinal serrations and ratchet

71. Moynihan’s occlusion clamp
•long distal blade with longitudinal serrations
•stright/curved
•non-traumatic, non-crushing type
•occludes lumen of bowel/stomach and prevents spillage
•occludes vessels & prevents bleed
•used during anastomosis

72. Payr crushing clamp
•stout and heavy with double lever in
handle
•has toothed ends and longitudinal
serrations
•spring loaded action
•crushes bowel, used in gastrectomy,
resection&anastomosis

73. Punch biopsy instrument
•used for incisional biopsy

74. Trucut biopsy gun
•8-18G
•breast lesions, soft tissue sarcomas -Inv. of choice

75. Humby knife
•used for raising skin grafts manually

76. Underwater Seal bag
•connected with intercostal tube
•marking for water column
•one end of the tube is always submerged

77. Urobag
•connected with foleys catheter/drain
•no pipe running in between
•no water column

78. Foley’s catheter
•3 way: Balloon, drainage for urine
to come out, irrigation to prevent
clot formation
•French= outer circumference

79. Bake’s Dilator
•long metallic malleable instrument with club at terminal end
•used to assess CBD, duodenal papilla for patency or block

80. Lister’s urethral dilator
•olive tip
•to dilate stricture urethra

81. Ryle’s tube
•one metre long -rubber/plastic
•3 lead shots in tip -radioopaque
•markings at different levels
•40cm-GEJ
•50cm-body of stomach
•60cm-pylorus
•65cm-duodenum

83. Volkmann’s scoop
•To scoop cavities, ulcer bed, granulation tissue
•on either side, different sized scoops are present

84. Romovac suction Drain
•suction is created by pressing suction
corrugation
•sharp metallic introducer to pass the
tube into the required area after
puncturing the skin
•used in thyroidectomy, mastectomy,
radical dissection, wide excision, flap
surgeries

85. Abdominal Drain
•Fixed to the skin either via a silk
or nylon on a cutting needle

89. Flatus tube
•Indian rubber, 45cm
•one opening in tip and another
proximal to tip on the side
•used in sigmoid volvulus, paralytic
ileus, subacute intestinal obstruction