Surgery For Final
Years!!!!
Dr. Nihal S Kiran
Surgery Resident
KIMSH
The Timeline..
– Discovery of anesthesia & asepsis (18th cent.)
– Development of stainless steel (19th cent.)
– Development of electrocautery, ultrasonic &
endoscopic device (20th cent.)
– Newer materials: titanium, vitallium, vanadium,
carbides & polymers
– Advances in remote tele-surgery, robotics and
image guided systems
What is It Made Of???
• Majority of surgical instruments- stainless steel
– Alloy: carbon, iron, chromium and other metals
– Resistant to wear & corrosion
– Strong
– 3 types of finishes: mirror, satine/matte, ebony
– Gold plating: tungsten carbide (hard metal)
The Separations
• Basic standard design:
– Handles/Finger rings
– Ratchets
– Shanks
– Joints
– Jaws/blades
– Tips
Mayo Scissors and kocher forceps
The Separations
• Basic standard design:
– Handles
– Ratchets
– Shanks
– Joints
– Jaws/blades
– Tips
Plain tissue forceps
The Separations
• Basic standard design:
– Handles
– Ratchets
– Shanks
– Joints
– Jaws/blades
– Tips
Richardson-Eastman double ended retractor
Purpose
1. Accessory
2. Clamping & Occluding
3. Cutting & Dissecting
4. Grasping & Holding
5. Probing & Dilating
6. Retracting & Exposing
7. Suctioning & Aspirating
8. Suturing & Stapling
9. Viewing
Surgical Needles: used for stitching.
either straight or curved
They are of different sizes.
Straight Needle
Round shaft curved needle
Triangular shaft curved needle Flat shaft curved needle
RAMPLEY’S SWAB HOLDING FORCEPS
⚫ Used for cleansing the skin
with swab
⚫ It is used for removing
laminated membrane and
daughter cysts from Hydatid
cyst.
⚫ Used to hold fundus and
Hartman’s pouch during
cholecystectomy.
Towel Clips
⚫ Used to fix draping towels.
Doyen's type
⚫ Used for fixing
diathermy
cables, suction tubes etc.
⚫ May be used to hold ribs
while elevating
flail segment of chest.
Backhaus type
Grey's type
BARD PARKER HANDLE
• #3 & 7 handle holds blades 10, 11, 12, and 15
• #4 handle holds blades 20, 21,22, 23,24 and 25
#3 #3 long
#4 #7
Haemostatic Forceps
⚫ Used to hold bleeding
vessels.
⚫ Used to split internal
oblique and transverse
abdominisduring
appendectomy.
⚫ Used
Rochester
to do blunt
(Horizontal Serration) Carmalt (Vertical serration)
dissection.
Kocher’sHaemostatic Forceps
⚫ Used to crush the base
of the appendix during
appendectomy.
⚫ Used to hold meniscus
during menisectomy.
⚫ Used to do sub total
thyroidectomy.
Mosquito
Haemostatic Forceps
• Used to hold fine
bleeding vessels.
• Used to puncture the
mesoappendix at an avascular
site.
• Used in operations of infants.
Cheatle Forceps
• Used to transfer sterile
objects from one container
to another.
• Kept submerged in Gluteraldehyde
or Chlorxylenol.
Lister’s Sinus Forceps
⚫ Used to do I&D of
abscess by Hilton’s
method.
⚫ Used to hold gauze
swab to clean abscess
cavity.
Allis’ Tissue Forceps
⚫ Used to hold skin while
raising skin flaps.
⚫ Used to pick up a fold of
peritoneum during
laparotomy.
⚫ Used to hold linea alba while
closing midline incisions.
Babcock’s Tissue Forceps
⚫ Used to pick up
appendix during
appendectomy.
⚫ Used to hold delicate
visceral organs.
⚫ Used to hold cut
marginsof bladder
during open
prostatectomy.
Plain Dissecting Forceps
⚫ Used to hold delicate
visceral organs
⚫ Used to hold blood
vesselsand nerves
whiledissecting.
⚫ Used to hold the
hernial sac in hernia
repair.
Toothed Dissecting Forceps
⚫ Used to hold tough
structures like skin
whilesuturing.
⚫ Used to hold scalp
whilescalp suturing.
⚫ Used to hold rectus
sheath while closure of
abdomen.
DEBAKEY TISSUE FORCEPS
Needle Holders
⚫ Used to hold needles
while suturing.
Crile Wood (Fine) Mayo Hegar (Heavy)
Mayo’s Scissors
⚫ Used to tough structures
like linea alba,rectus sheath
during entry in to the
abdomen.
⚫ Used to cut delicate
structures like hollow
viscus, investing layer of
MAYO’S METZENBAUM’S
deep fascia of the neck in
thyroid surgery.
⚫ Used to raise skin flaps by
sharp dissection.
Heath’s Suture Cutting scissors
⚫ Used to cut sutures on
skin and mucous
membrane.
Lister Bandage Scissors
Langenbach’sRetractor
⚫ They are used to help
better visualization of
the operative
field, tissue handling
is minimized and
bleeding better seen
and controlled.
SENN RETRACTOR
– Other Names: Cat paw
ARMY-NAVY RETRACTOR
Doyen’s Retractor
⚫ Used while making
and closing abdominal
incisions for ease of
working in the deeper
layers.
⚫ Used to retract
Bladder in APR
resections.
Deaver’s Retractor
⚫ Used in
Cholecystectomy for
retraction of right lobe
of liver.
⚫ Used in Truncal
vagotomy for
retraction of left lobe
of liver.
⚫ Used in kidney
operations to retract
the anterior
abdominal wall.
RIBBON RETRACTOR
– Other Names: Malleable
SKIN HOOK
• Other Names: Joseph, Gilles
Joll’s Thyroid Retractor
⚫ It is a self retaining
retractor used in
thyroid surgeries to
retract the skin.
WEITLANER RETRACTOR
Lahey’s Right Angled
Forceps
• Used to dissect the cystic duct
and artery in cholecystectomy.
• Used in Vagotomies to dissect the
vagus nerve and pass ligatures
around them before division.
• Used in thyroid surgeries to dissect
and ligate middle thyroid
vein,superior thyroid pedicle,etc.
Doyen’s Intestinal
Clamps
• Used in gut resection and
anastomosis.
Foley’s Catheter
⚫ Diameter of the catheter in
mm is calculated by no. of
catheter in french scale/3.
⚫ Used to drain urine.
⚫ Used in suprapubic
cystostomy.
⚫ Used for urethral
catheterization following
prostatectomy.
Malaecot’s Catheter
⚫ Used in suprapubic
cystostomy.
⚫ Used to drain abscess
cavities.
⚫ Used as intercostal
tube drain.
Kelly’s rectal Speculum
⚫ Used to diagnose
haemorroids,anal
polyps, internal
opening of the
perianal fistula.
⚫ Used to take biopsy
from anal, rectal
growth.
⚫ Used in polypectomy.
Pratts Speculum
Flatus tube
⚫ Used to relieve
gaseous distension of
large gut due to
paralytic ileus.
⚫ Used to decompress
sigmoid volvulus non
operatively.
Fuller’s Metallic Tracheaostomy tube
⚫ Indications:
⚫ FB impacted in larynx.
⚫ B/L recurrent nerve palsy.
⚫ Acute laryngeal edema.
⚫ In respiratory paralysis
requiring mechanical
ventilation for longer
periods.
Corrugated Drain
⚫ Used as a drain to
drain pus ,blood,etc
Mayo’s Vein stripper
⚫ Used to do stripping of
varicose veins.
Giglie’s Saw
⚫ Used to cut bones in
amputations.
⚫ Used to do
craniotomies.
Bladderwash Syringe
(Asepto Syringe)
⚫ Used to give bladder
wash with antiseptic
solution.
⚫ Used to clear blocked
foley’scatheter.
Suprapubic Cystostomy Trocar and Cannula
⚫ Used to perform
suprapubiccystostomy
secondary urethral
rupture to relieve
urinary retention.
⚫ Used to perform
suprapubiccystostomy
secondary to distal
urethral obstruction.
FRAZIER SUCTION TIP
POOL SUCTION TIP
• Other Names: Abdominal sucker, Sump suction
YANKAUER SUCTION TIP
• Other Name: Tonsil suction tip
• Used for suctioning fluids
without harming the
underlying structures
• Has a blunt tip
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Genito-
Respiratory GI Tubes Vascular Sutures
Urinary
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Genito-
Respiratory GI Tubes Vascular Sutures
Urinary
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Genito-
Respiratory GI Tubes Vascular Sutures
Urinary
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Genito-
Respiratory GI Tubes Vascular Sutures
Urinary
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Genito-
Respiratory GI Tubes Vascular Sutures
Urinary
Respiratory Tubes
Guedels Airway
Laryngeal tube
Endotracheal intubation
Tracheostomy tube
Gastrointestinal
Tubes
Nasogastric Tube
Ryle’s Tube
Nasogastric and nasojejunal feeding tube
T Tube- Kehr's T-tube
Blackemore Sengstaken Tube
Genitourinary Tubes & Catheter
Foley’s Catheter
Types
◼ Rubber 2 ways foley
◼ Plastic 3 ways foley
◼ Silicone
Robinson Catheter
• Straight Drainage Of The
Bladder.
Condom Catheter
Double J Catheter
Vascular Tube
Butterfly Needle
IV Cannula
Venous Catheter
Fogarty Catheter
.
