Surgical Instruments Instruments Instruments are classified by - PowerPoint PPT Presentation

Surgical Instruments

Instruments  Instruments are classified by their function – Cutting & Dissecting – Grasping & Holding – Clamping & Occluding – Exposing & Retracting – Suturing & Stapling – Viewing – Suctioning

Instruments – Dilating & Probing – Measuring – Microinstruments – Powered instruments

Cutting & Dissecting

Cutting & Dissecting  Cutting instruments have sharp edges. They are used to dissect, incise, separate, or excise tissue.  Most instrument sets will include #3 and #7 knife handles & suture, curved mayo, metz and tenotomy scissors.

Knife Handles  Come in various #7 #4 #3 widths & lengths  Blades are attached by slipping the slit in the blade into the groove on the handle

Knife Blades  Blades with numeric prefix of “1” (e.g., 10, 11, 12, 15) fit #3 or #7 handles  Blades with the numeric prefix “2” (e.g., 20, 21, 22, 23, 24) fit #4 handles

Knife Blades  #10 are used for large skin incisions  #15 are used for short shallow incisions  #11 are used for initial skin puncture of tiny deep #15 #11 #10 incisions

Other Knife handles  Long handles are used inside deep incisions (e.g., open abdominal cases)  Beaver knifes are used for small delicate cases

Scissors  Blades of scissors may be straight, angled, or curved  Tips may be pointed or blunt, handles may be long or short  Should be used only for their intended purpose

Straight Mayo (Suture) Scissors

Bandage/Dressing Scissors

Tissue/Dissecting Scissors

Curved Mayo Scissors

Metzenbaum Scissors

Tenotomy scissors

Iris Scissors

Other cutting Instruments

Ronguer

Osteotome

Curette

Freer Elevator

Rasp

Grasping & Holding

Grasping & Holding  These instruments are used to grasp tissue and hold it in place without injuring surrounding tissues  Forceps can be ringed or the thumbed variety

Grasping & Holding  Most instrument sets will include kocher, allis, babcock, adson, tissue, debakey forceps, sponge sticks & towel clips.

Forceps

Kocher

Allis

Babcock

Sponge Stick

Towel Clip

Adsons

Tissue

Ferris Smith

DeBakey

Russians

Clamping & Occluding

Clamping & Occluding  These instruments are used to apply pressure  Some clamps are designed to crush the structure when applied  Others are noncrushing and are used to occlude or secure tissue

Clamping & Occluding  Most instrument sets will include mosquito, crile, kelly, tonsil, peon, and right angle clamps.

Anatomy of a Clamp

Mosquito

Crile

Kelly

Tonsil

Peon

mosquito crile kelly tonsil peon

Right Angle

Non-crushing Clamps

Bowel Clamp

Vascular Clamp

Bulldogs

Exposing and Retracting

Exposing and Retracting  Used to pull Soft tissue and muscle aside to expose surgical site  2 types: – Hand held – Self retaining

Exposing and Retracting  Most instrument sets will include small hand held , army-navy, malleable, weitlaner, and richardson retractors.

Hand Held Retractors

Skin Hooks

Senn

Cushing Vein Retractor

Volkman

Army-Navy

Malleable (Ribbon)

Richardson

Kelly

Harrington

Deaver

Self Retaining Retractors

Weitlaner

Cerebellar

Gelpi

Balfour

Bookwalter

Suturing and Stapling

Suturing and Stapling  Needle holder sizes vary according to type of needle used  Most instrument sets will have webster, crilewood, and mayo hegar type needle holders.

Suturing and Stapling  Clip appliers place individual staples, available in reusable and disposable  Disposable staplers

Needle Holders

Webster

Crilewood

Mayo Hegar

Castroviejo

Skin Stapler

Weck Hemoclip Applier

Ligaclip Applier

Staplers 

Viewing

Viewing  Surgeons can examine body cavities, hallow organs, or structures with viewing instruments  Procedures may be performed through them

Nasal Speculum

Vaginal Speculums

Rectal Speculums

Rigid Endoscope

Laparoscopic Trocars

Laparoscopic Instruments

Thorascopic Trocars

Arthroscopy Cannulas

Cystoscopy Sheath