Co111rnon SLJrgical lnstJruments

1
features
the operation theatre, there are two types
111: surgical instruments. Some are general • Tv. o ring hand)
0
in5trurnents required for every surgery and • Two long shank'-
some are for specific surgical procedures. • Two locking ratchet:
• Two serrated jaw'-
Common surgk ~1 , 1struments are as follows:
• Bo·dock
,r Artery forcer .
, Dissecting f
• Towel clip
• Scissors
, Needle hok1er
• Scalpels
Fig. 40.l : curvea orterv torcePS
• Allis tissue forceps
, Sponge holding forceps
• Cheatle's forceps
~ Kocher' s forceps
• Sinus forceps
' Needles
• Scoop / curette
' Retractors

ARTERY FORCEPS .
}so know n as he1nos l,ll tc
Artery fo rceps, a tia l in stn111u•nl s in ,di
f0 rcep s, are dessen
es LO' control blL•t>din g.
surgical proce ur
DISSECTING FORCEPS
Di ....... l'\. ting l(,rct:-p s ,1 Is,, knn,, 11 ,1"- 1hrnnh
fl,r~c-rs ,111? um1mnnl\ ll'-('d inslt lllllt'lll~ f nt
,111 ~urgi\.al ~'l\"'\.Cdnn" lo h,,td snll liss11eR
including ~kin.

Features Fig 40 3 Tow 11,.__ , p

It C\."'1'!5bts \."'t l" ,.1 '-\.'lTated wings connl~cled ill
one \."'nd. Usec:

Types (Fig. 40.2) • 1o _f 1x the d rn pc•s with the body of th

pc1t1cnl.
~ Toothed dissecting forceps: The hps of the
• To fix lhc diathermy cord or suction tu
"in~::- ha\ e the tooth
or any olhc1 cimilar items with the drap
w No~-toothed dissecting forceps: The tips nca1 lhc operative field .
ot the ,nngs are plain
• To hold a small piece of bone or tough ciof
tissue.

SCISSORS
It is a cutting instrument used in the operative
procedure (Fig. 40.4).

Features
Fig. 40.~ Toothed and non-toothed thumb forceps • Two ring handles
• Two cutting blades /serrated jaws
Uses
.., T W(l shafts/ shanks
• To hold tough tissue of the body like skin,
: 1P ,. t ,ck (ioint)
deep fascia, muscle, capsule, ligament and
foreign body with toothed forceps.
• To hold delicate structures like nerve,
peritoneum, and synovium.

TOWEL CLIP
If is an instrument used to secure drape and
towels in an operative field. Different types
of towel clips are available for different
functions (Fig. 40.3).

J:eatures of Typical Towel Clip

It consists of:
• Two ring handles
• Two long shanks
• Two locking ratchets
,. Two pointed curved tips of the blades Fig. 40.4· Small and largf' scissors
 Common Surglca1 lnstru;rn~e
;n~t~s___________ _______ J]
\pes ·tl 1 · l
1
<ssors
~Lh ~ w1 1 a 011);!;
'- straig 1t and c urvnd
~
t,l,1dcs.
scissors with short straigh t and curved
t,l,1des.
, scissors ,!\Tith _short curved/ straight and
t,lnnt / sharp-tipped blades.
Ag. 40.5: t leedle holder
Scissors '"rith specially designed shor t
straight / curved blades. .. Curved
.. Straight
Specially designed stitch cutting scissors
with curved s1nall serrated blades. .. Angled
, Heavy-duty scissors Uses
uses To grasp needles of different stzes for suturino-
tough to delicate tissue like skm and come_;,
, Straight long scissor~ t. cut superficial respectively.
tough structures.
r Curved long scisson' r;'_ <.'-. 1, t tough structures SCALPEL
at a deeper plane.
• Straight short scissc;ff1 l :3 cut s1nall delicate It is a cutting instrument with a reusable
handle and a disposable blade.
tissues in the surfa_ce.
• Curved short scissors to cut s1nall delicate Features of Handle (Fig 40.6)
tissues in a deeper plane. • Metallic handle
• Curved or straight scissors with blunt- • Grooved narrow end to accomrnoda re
tipped blades to dissect vessels and nerves. disposable blades of different series
• Scissors with small curved serrated blades • Embossed with a number l-4 3 .:md ; most
to cut stitches. d co1nmonlyused)
• Heavy-duty scissor_s to cut gauze, ban age
Features of Blade
and draping matenals.
• Sharp cutting edge
• Straight or cun ed in sh,1rt'
NEEDLE HOLDERS • A different sh,1pt.' for ,, diftt.'rt.:'nt sur~k-11
h 0 ld needles of different proced ttrt.' ._
It is an instrument to
sizes (Fig. 40.5).

Features
. handles
• Two nng d jaws
• Two short serrate
hanks
• Two shafts / s ls
. ratcbe
• Two lock111-g -
·oint)
• Box lock (J

Types
Ag. 40 o Sco1Pe1 handle
• Long
• Medium
• Short
 174 Textbook of Operation Theatre Technology
-------.::...:..________---.,
Types SPONGE~HOLDING FORCEPS
• Small
• Large It is a holding instrument basically desi
e
to hold a spo'.nge or swab about 9 inch~ _d
• Concave cutting edge length. 111
• Convex cutting edge
• Straight cutting edge Features
• Two ring handles
Uses • Two jaws
• To incise soft tissue like skin, fascia, • Two shafts
membrane, muscle, tendon, capsule,
• Two locking ratchets
ligament, etc.
• Box lock (joint)
• To incise an abscess cavity

ALLIS FORCEPS
It is a grasping and holding instrument.

Features
• Two ring handles
• Two jaws Fig. 40.8: Sponge-holding forceps
• Multiple teeth at the tip of the jaws in row
• Two shafts Types
Two locking ratchets • Straight
• Box lock (joint) • Curved

Uses
ttTo hold sponge for cleaning/painting the
, kin before surgery
" r o toilet the abdominal cavity after surgery
(o hold fundus of the gallbladder

CHEATLE'S FORCEPS
Fig. 40.7: Allis forceps It is a heavy metallic forceps designed to hold
and move sterilized instruments and materials
Types from one place to another.
• Long The instrument is kept in a wide mouth jar
• Short filled with an antiseptic lotion. One must be
careful that the tip of the forceps does not
• Curved sometimes
touch unsterile area (Fig. 40.9).
Uses Features
.:; To grasp the tough structure • Two ring handles
$ To hold soft tissue for dissection • Two angled shafts
 Common Surgical Instruments 175 7/,

Uses
• To catch bleeding vessels in tough tissues
I
11' I
(like palm, sole of the foot)
• To hold any tough structure firmly during
surgical dissection.
p-..rl(JLI::- rs.r-£)
Fig. 40.9: Cheatle's forceps SINUS FORCEPS

, Two serrated jaws ~t has almost all the features of the grasping
~trument except the lock mechanism. The
, No locking device
Jaws are long and serrated.
, Joint in midshaft region
It is used to explore any sinus tract or
abscess cavity. As there is no lock, it cannot
uses catch any important soft tissue during its
To hold sterile instruments or drape or any
manoeuvre.
other item from a sterile drum usually.
SCOOP/CURff!t
K0CHER'S HAEMOSTATIC FoqcfPS
It is a spoon-~ ~ , -... r:Tt~:twith a handle
This forcep s h as almoc ' teatures - r> •1 ,~ '>poon is
of various s1
of haemostatic forcer -r
1 forceps sharp. It is u
(Fig. 40.10). tissue durir
of a foreigr
features
• Two ring handles
• Two long shanks
• Two locking ratchets
• Two serrated jaws
• Box lock 4
• Tip of the jaws are toothed (Fig. 0.lO)

Types
• Straight and curved
• Long and short

i
s
Fig: 40.11: Curette

SURGICAL NEEDLE
e
It is a metallic device used to sutur .
or non-surgical wound It ea surgical
attached thread passes t~ou works ':"'hen an
wound and the thread is ti gh margins of the
help of a needle hold ghtened with the
er. The needles are

fig:
176 ______________ e_'T
Textbook of Operation Theatr::: ec
..~ :..::..n.:.:o::..::lo:. :g=~y-
: .:_h
..:,___ _ _ _ _ _ _ __

• The very small cur:ed nee~le is used for

available in different shapes and sizes for
s uturing delicate tissues like nerve and
suturing different types of tissues (Fig. 40.12).
cornea or similar s tructures.
Parts of the Needle
RETRACTOR
• An eye for attaclunent of tlu-ead
It is a basic instrument used to separate the
• Body
margins of a sur~ical ~ncision or wound.
• Tip
During surgical d1ssect10n, the orga_n~ ~~d
other tissues are separated for better v1S1b1hty
of the desired site. Depending upon the
surgical site and procedure, the ret_ractors are
designed in various shapes and sizes. Com-
monly Langenbeck 'L' shaped or Deaver
'C' shaped retractors are used in most of
the general and abdominal surgeries. The
retractors may be manual or self-retaining
(Fig. 40.13).
Parts of a Typical Retractor
• Handle for holding with the hands
• One blade or hook of different shape and
Fig. 40. 12: Surgical needle
sizes at one end of the shaft
Types
• Straight
• , Curved (the curvature may be 1/ 4, 3/8, 1/
2, or 5/8 circle and it is easy to manoeuvre
the needle in a small space with a more
curved needle)
• Cutting with sharp edges at the tip
• Round bodied needle which can pass
through delicate soft tissue like peritoneum.
• Atraumatic needle: In this needle, thread
~lends_ with the closed eye without
increasing its diameter so as to pass through
the tissue with less damage.
Uses
• Straight needles are used for suturin skin Fig. 40.13: Langenbeck and self-retaining retractors
usually. g
Uses
• Curv_ed cuttihng_ needles are used for
su tunng toug tissues like skin ca • It is a basic instrument and required for
and fascia. ' psu1e, every surgery for retraction of wound
margins
• The curved round-bodied needle is used f
. f 1 or • This is one of the essential items like artery
repair o muse e and other soft tissues.
or thumb forceps in any instrument trolley.
 C HAPT ER 41
rthopae~ic, Gynaecological and Obstetric,
oph~halm1c~ Otolaryngologic, Endoscopic,
cardtothorac,c and Neurosurgical Instruments

ORTHOPAEDIC INSTRUMENTS • Bradol (has one eye) for making a hole in

the bone.
common Instruments • Bone lever (different shapes and sizes) : 0 r
1
Periosteal elevator (different s i z es) to lifting the bone from its bed and retraction
remov e p eriosteum from the b one surface of soft tissue from the bone surface.
with muscle or other soft tissu e . • Hohmann retractor (different sizes) for
, Qsteotome (straight, curved and different retracting soft tissue from the bone.
sizes) for cutting bone. • Bone hook for manipulating the fragment
, Chisel (sloping edge, straight, curved and from its bed.
different sizes) f;,:r 1naking a window in a • Bone-holding forceps (differe1:1t co~fi-
bone. g ura tions) for holding and marupulating
, Gouge (stra igi,t , ._;,irved and different sizes) b one fragments.
for making a \ ·uxlow in the bone. • Seques t r um forceps (locking device) for
• Bone cutting r'....:r ....e ps (straight, curved and holding.
different sizes) tor cutting small bones or a • Hand drill for d r illing bone.
piece of bon e . • Screw driver fo r inserting a screw into the
• Bone nibbler (straight, curved and diff~rent bone.
sizes) for n ibbling a bone or tough tissue • Drill bit (different diameters) for m a king a
attached with the bone. hole in the b one for insertion of a s crew
• Bone cutting saw (diffe r ent sizes) for • Bon~·- ::a p (different diameters ) for 1naking
cutting bone end (amputation). . a tlFf•a d in the bone hole for easy insertion
• Gigli saw (handle with wire). fo:' cutting of a scr ew.
bone where working space is hrruted. "' Bone punch to strike on 1--oJu: ted bones
• Bone file or rasp for smoothening of rough and metallic substance , , , ' u1 t he desir ed
r
bone ends (usually after amputation surgery). place.
l
• Mallet or hammer to strike osteot_ome, • K-wire (different 0 mln ' , ) for provisiona l
y chisel, gouge, and intramedullary nail. or definitive fix..:1uon ,,l small bon e fr a g-
r. ' Bone awl for making a hole in the bone. ments .

177
 Tex tb oo k of Op era on
17 8
.
t pl at e is a very srn
ire (d iff er en t ga uz e) - Mini -fra gmhen a11 I
• St ai nl es s st ee l w
ur c . 1en g t , t 1ck ness an d bread th P ate
h .
at io n of fra cl in
co m n1 on ly us ed fo r fix as lcn sio n fi xa lio n of fra ct ures of sm
all bu sed f0r
ol ec ra no n on es of
.fragments of pa te lla, ha nd an d fo ot.
ba nd wi rin g. tio n - Th e conto ured p la te is desjgn e for 0
d
fo r sk el et al tra c se
• Stein1na1u1 pi n us ed · pr ox1m
in
· aJ an d dista l Jo ng b
on es JjL
.b . us. 11.e
n1ainly. 1e m ur, ti ia, an d hu mer
c
(as so rte d siz es an d
• In tra in ed ul la ry K-n ail fra ct ur e - Th e Jo c~
l,
in g pl ate has th re ad s in ho e::1 for
lo ng bo ne
di am et er) for fixati on of sc re w flx a tio n.
an d hm ne ru s) .
(in fe m ur , tib ia,
(a ss or ted - Lo w co nt ac t dy nam ic compressJ on Plate
ck in g na il
• In tra med ul la ry in te rlo lo ng bo ne (LCDCP).
r) fo r fix ati on of
sizes an d diam ete us ) ha s - Bu ttres s pl at e
, tib ia, an d hu m er
fra ct ure (in fe m ur - Se m itu bu la r pl ate
ox im al an d di sta l ho le s fo r sc re w fix ati on
pr n dev·ice lii.
p re ve nt ro ta tio n at th e fra ct ur e site. • Dy na m ic hi p sc re w: Fi xa tio
to ur.
ed ul la ry En de r' s fle xi bl e na il tro ch an teric fra ctu re of th e fem
• In tr am
et er ) fo r fix ati on • Prosthesis: It is a device which replaces
(as so rte d siz es an d di am one
fe m ur, tibia, an d or bo th pa rts of a joint.
of lo ng bo ne .fracture (in
n Moore 's
hu m er us ) - Th omps on pr os th es is/Austi
es an d di am et er ) fo r in t (head and
• Ra sh ro d (as so rte d siz pr os thesis: Re pl ac es hi p jo
ctu re . It is ro un d- neck of fem u:
fixation of lo ng bo ne fra ne ck of fe m ur in fract ur e
ta tio n w he n th e in an el de rly pa tie nt).
sh ap ed an d pr ev en ts ro
d in to th e bo ne .
- · .K nee p ro st he si s:
Re pl ac es a pa rt o;
ho ok, in th e en d, is bu rie
es an d diarrieter) vi/ho le of the kn ee joint.
• Sq ua re na il (a ss or ted siz
fra ct ur e. I t is a
~~ f:.i'b cn,.v pros thesis:
Replaces elbow joint.
for fixation of lo ng bo ne 1

sh ap e pr ev errtSJ es shoulder
flexible na il an d its sq ua re ~D tu:rulder pros th es is: Repl ac
to th e m ed uH.]fl'
:<;:;»

ro tation when in se rte d in · J«'in t

kle joint.
canal. - An kl e pr os th es is: Re places an
t ba sic im pl an t fo r l he ad pros thes is: Replace
s head
• Screw: It is an imp or tan - .R ad ia
en ts or a pl a te
fixation of fra ct ur e fra gm nt of th e ra di us
to p re ve m en ts are
wi th the bo ne . It is also
us ed
of Co rn .m an or th op ae di c in st ru
lo ck in g ho le s
:o tation wh en p lac ed in an d tip sh ow n in Fi gs 41.1 an d 41
.2.
ad , sh af t,
mtram~dulla ry nails . Its he
se rv e di ffe re nt
have different de sig ns to ope
d av ail ab le in as so rte d siz e an d Arthrosc ic h a su rg eo n c.m
func tio ns an Th is is a m ach in e by wh a joint.
diameter.
e, an d vi s ua liz e th e in te rn al st ru ct ur es of
• Pla!e: It has a di ffe re
nt sh ap e, siz in ts w he re it is us ed ar
e knee .
gm en ts Co m m on jo
desi?11 used for fixation of
bo ne fra wrist. The
ca tio ns ). sh ou ld er , hi p, elb ow , an kl e, an d
nt lo d treat many
(availab le for us e in differe ar th ro sc op e h el ps to di ag no se an
are:
Co m m on ly us ed pl at es jo in t di se as es an d in ju rie
s.
ut co m pr es sio n de vi ce
- Plate w~tho "e
co mp res sio n dev ice· (h av in . g Parts of Arfhroscona M ac h',,,
- Pl ate wi th ,..,
1 te holes) called dy na . len s sys tem
, ov a1 pa
co n:i - • Sc op e- a rig id tu be w ith a
press.ion pl ate (DCP). Na
rro :~
an CP
18 en te ring th e join t
us ed for radius , ul na , fib ula
d • Optica~ fib~e -- su rro un di ng th e lens
which
tib . d br oa
OCP for femur , ia, an d hu m er us . t fro m th e source
tra ns m its hg ht to th e jo in
 ~§mlwiEui1

.t ✓ rri )

'iZt

,t:·s :S:::~ ?~,-~~

~ml~~

~~ I

Fig. 41 . l: common orthopaedic instruments

yo~1op~
~
'
. --:: -r•
0

ccuiog:c0<0~1(
. •
c\1ep1ece-f1 tted "Hh a ~
i;. • l
0
:n~d~O;b~s~te;t~·~~~~i;~;~;~;=~;: :~~----=====
1.: a. m. er .1
nc, Oohthalmic.
, h.
Otolorvngologlc I
· · nstrurn nts 18 ,
captures a p 1otograph of . • '' 1ch • SJ ..
"'" of joint 1ntern,1l sh·\ ~ lttodknr's utc•, .
tun.:~ . • tC• lo hold 11 us holdmg forccp<;-u<;cd
· ht source--whi 1 h' llll'ruc; 111 .
• 1,.1g ~ c 1 transmits 1' gcctu1n ' hk(' .1lpm
opt•r,,1101\<;
~cL1pe through ..1 cable. . tght lo the • F J ) nnd lP1v1ct.1l ,11nputc1t1on
· · .nuonwtri 11 h'
• \'ideo mon1tor-showin,, tl cndom ·t . •, I' '?Psy 1.;llfl'ltc for ~.,mplmg
ictures .of the joint on th~ ~. ,c c,1111era • F ..... l 11d filing.
P ~ ~l:1 cen ~p 1s1otorny sd
• · 111 l . ~ ~sors, nun-r,1tchL ted blunt
~rthroscoptc system means: \ g_ cd ~c1sson.. - 10 P'-'rform ('nJ ; 0 l Y
· Ltll1'!Jh-. l ll10 r um
, Arthroscope o ' ur ,ind dell\ cry.
• Bladder so .J I
, Light source ,. ~ unca- to ocatc ,my ~tone m thP
1
o adder.
, Lio-ht cable
0 • Anterior , . . . ~·111 1 I
, Camera system th e p_o s
0
8 • wa 11 retr.ictor placed on
lerior w,111 ,md to examine the
, Video recorder monitor ~ntenor wall of the vagina to check c1ny
, Arthroscopic instruments mflammatoq lc~ion~ of the pelvis.
, Irrigation system • Polypu~ forceps-used to remove a polyp
, Suction pump from the uterus.
• Special hand instruments • yterine dressing forceps multifunctional
instrument for packing uterine cavitv or
COMMON INSTRUMENTS FOR removal of tissues after the D&C procedure.
GYNAECOLOGICAL AND OBSTETRICAL • Cranioclast-to crush and then extract the
OPERATION skull of a fetus to facilitate delivery in
obstructed labour.
• Sim_s vaginal speculum-to inspect the • Green Armytage uterine forceps-uc:;ed to
vagma and cervix. grasp and clamp tissues in the uterus
• Cusco' s vaginal speculum-to inspect the • Flushing curette (blunt type)-used to
vagina and cervix. collect a sample from uterus or rectum.
• Cervical dilator (Hegar's)-to dilate the • Endometrial biopsy curette--used to collt:'(:t
opening of the cervix for D&C and D&E endometrial tissue fron1 the uterus.
operations. • Auvard weighted speculum is a single end
' Vulsellum forceps-to hold the lip of cervix vaginal speculum. Used in Y,1gin,1l h, ste-
• Ovum forceps- to remove placental frag- rectomy.
ments and products of conception in • Hawkins Ambler's uterine di.l,1h.w~-sin~lt.-...
incomplete or inevitable abortion from the ended uterine dilators of, .ui1..1us \\ 1dtl~s.
uterine cavity. • Obstetrical forceps for dl'l1, l.'r\ l.,t t(,t,ll h(','\d
• Sim's uterine sound-to measure the length having two large j.1\\ s for hokhn~ u::-l.'l.1 1n
and direction of the cervix and uterus. vaginal deli,·en of th0 b,,b) .
• Uterine curette (double-ended)-for removing
tissues from the inner lining of the uterus. COMMON INSTRUMENTS FOR ENT SURGERY
• Myomectomy clam~ (B_onney)-used to • Tons~l holding for--:·l'ps ~l.h'~ li~l.' sp\,n~l.'
remove the uterine fibr01d. h.oldmg forcep~. L :--l'd H\ h,n:--llll.'\'t\,n\\
• Cervical biopsy forceps-used to take a operation.
biopsy from the cervix. • D,n is Boyle mouth ~.1~ usl.'d in h.'tbill\.'\'•
• Punch biopsy forceps-used to take a small tom) and .1dl.'n1..-,kkch,n1\ \'l'L'r,lti\Hb.
amount of tissue from a selected area of the • Ton-..11lar ,ut...-n fl)l'l.'l..'ps l,tr,1i~ht ,lnd
cervix. cun ed)-- u~l.'d m l\H\~i\ll.'\ l\,l\l\ \)l'\'\\\ti\)n.
 TextboOk of Operation Theatre Technology
182
• /\ntr,11 burr-used for intranac;al inf,l!r1, ir
• 'l\msill,,r !--dSSl)1·-u~cd in lonsilkctomy
,rntroslomy.
opt'ratilm • Ethmo1d lllf<'tte--used in intranasal el},,rn,n..
• Ton~il J1ssl'dor- used in tonsilll!Cforny .
clcctomy opl rJl1on.
1

opcr,lth.m
• Tl)tl::-il dissl'rhw ,md rl'tr,Kl<lt combined. • Pl'rioslec1I clcv,1tor used in mastoidc•cl
. • ()fll\t
,ind Cc1ldwcll Luc operations. ,
USl'd in hmsilkdomy oper,1lton.
• Tlw tonsill,\r ~n.1n' 1s used in tuns1lleclomy • Swivd_knifc-uscd in SMR and septoplast
o~wr.1twns. opera lions. Y
• Adenoid curcltt' used in adenoidectomy. , Metallic sucker (suction tip) us,,d in SMp
• 'Dlc head mirror bused in the ENT exami- turbinectomy and other na~i:ll ope-rations. '
nation. • Walsham's forceps-used in the reductfon
• The .mral speculum is used in the exami- of fractured nasal bones.
nation of the ear. • Anterior nasal pack-used in the mana.
• Siegle speculum (pneumatic speculum)- gement of anterior epistaxis.
used in the examination of the ear.
• Posterior nasal pack-used in the mana-
• Nasal speculum (long-bladed)-used in gement of p osterior epistaxis.
SMR and turbinectomy.
• Nasal speculum (short-bladed)-used in • Myringotomy knife-used for myringotomy
the examination of the nose (anterior operation.
rhinoscopy). • Masto~d curette-used in mastoidectomy
• Metallic tongue depressor straight and operation.
curved used in the examination of the oral • Gland forceps-used in thyroidectomy and
cavity and oropharynx. submandibular sialadenectomy.
• Wooden tongue depressor used in the • Alice forceps-used in tracheostomy and
examination of the oral cavity and oro- neck operations.
pharynx. • Tracheal dilator-used in tracheostomy
• The laryngeal mirror is used in the exami- operation.
nation of the larynx (indirect laryngoscopy).
• Tracheostomy tube (single lumen, silicon,
• The post-nasal mirror used in the examination cuffed)-used in tracheostomy operation.
of the posterior part of the nasal cavity and
Common ENT instruments are shown in
nasopharynx (posterior rhinoscopy).
Fig. 41.3.
• Dressing forceps-used for dressing of the
ear or nose. Laser Instrument
• Probe (cotton applicator)-used for
cleaning the ear canal. Laser surgery is a surgical procedure where
special light beams are used instead of surgical
• Tuning fork. Diagnostic instrument.
instruments while performing the surgeries.
• Self-retaining nasal speculum-used for
SMR and septoplasty operations. Full form of 'LASER' is "light amplification
• Luc' s forceps-used for SMR and turbirt _ by stimulated emission of radiation". Laser
tomy. ec device produces light which has no existence
• Septal dissector-used for SMR and in nature. It has three characteristics:
toplasty operations. sep- • One colour or wavelength (so-called mono-
• A na sal. snare-used for poly pee t omy chroma tic).
operation. • Wavelengths are in phases (calJed coherent).
• Chisel-:--used for SMR and Caldwell-L • Light bea ms arc verv narrow and con-
operations. uc
centrated on one point (called collimated).
 Fig. 41.3: Common ENT Instruments

Basically, the uses of lasers in soft tissue

in . I ophth ..1\mk FN l d: I.--nt ' ,l , 1\1,\'\.I l,O-
. m,1ny
, tu 111 lHl r neu n )~ \t t \' 1..' n
hl c 1,1 \'\ i 1..)t ,\1...'r
surgery are to cut, abl~te: vapouri~e, and • " • ' 1..

coagulate. With this pnnc1ple, laser 1s used surgenes no\'\' .,11.."l.l\ ~ -

 l84
luxll'll.ll)k lll Uf'l tllhon 11\t nhl 1t c lmoloqy

• J\1l1 •1y l11n1' p s (l1 ,1c•in11s t,1I)

',,~.,, •I•~.
• l ' l ,1111 tl1 s!;1'1 l111>', l1 ) 11l1 p s lo hold
li:;s111·H wi ll1011I d t 11li.)g1·. l>oft
• L\1lih1•i l1ll1'1'11•., lnr holding c:«11ne,il fl
• ,,.,·... Inn 1•ps to I Hl Il I .ll'I' S, np
Use~ ot laser
• [)l''l'tn 1t \ • S 11 pc1 ,or n•cl 11 s holding 11,rceps--t() h
. ' u ,,~~' ,ind pl.1:-;tk ::- ul'~\'''' In 0 1d
I l'lllll\ \ l
n ·ct w, nH1 sch·.
• '- l I\\\ ,1nll'd ~l• ,11·, \ ' ,\Sl' Ul.11 .,nd
pagnwnkct ll'sil,n • c.,p~tilotrnny lorceps-usl'd in cat
surg,•ry .
arac 1
• I~\ l' su 1. '"' ' .
., ~ ~U\ lllnltTl'Clthl•n•tr.\dl\l'l't't'lll'
.ind h, r l ,I)(.)\, l' llH"IW,\l llp,ll il\'
• Md 'lwn,on's forceps - for holding parts
0
· . , , .\ •h1 l'l't'\\ll\ <.' ,1tlwnnn.1 .111
• V,'l::--cu l,ll · :-.uq.:,l:t lhl' lens. f
. . • Ch,11,lzion forceps (clamp)- used in ch
th<..~ ~rkrv • ,1 nc:i \,h~r-,b~t:--hxl ,1ngt0pl.1sl}. . a~
1
• Fnot 111 j , z1on surgery.
1
• '- ani-- '-' sur).!.t.'r\ tn n .• mo,e ,,
turnour frl,m t,,lus ,1nd c.1k,11wum ,,nd to • Epilalion forceps (Cilia forccps)-for rern.
tre,1t ing1·owing n~il. tlVing eyelashes.
• Gastroinh~stin,1\ surgcn to treat oeso- • Diamond knife- used for microincision on
phagca l varices and duodenal ulcers the cornea.
(photoablation), haemorrhoids, coloreclal • Ncttleship's punctum dilator-used fo
and liver cancer. dilating the lacrimal punctum. r
• s . • Wire Vectis-for lens extraction
pme surgery such as discectomy operation
• Used ~n dental, gynecological, urogenital, • Lacrimal cannula-for introducing druos
thoracic, neurosurgery, otolaryngological and fluids into the nasolacrimal duct. "
surgeries. • Evisceration spoon or scoop-for removino
contents of the eyeball during eYisceratio;,
COMMON INSTRUMENTS FOR • Tookes' knife has semi-circular cuttino-edoe
OPHTHALMIC SURGERY .
used 1n cataract operation and also for
b O

• Speculum used for keeping the eye open splitting layers of the sclera.
during operation. • Elliot's trephine with handle-for corne,1:
• Guarded eye speculum (left and right) surgery.
keeps eyelashes away from the operative • Rougine-for dissection of the lacnmal
field. duct
• Universal eye speculum can be used in both • Strabismus hook, muscle hook. or ~quint
eyes for keeping the eye open during hook-used for squint surgef).
operation. This is used in a squint, ptery- • Elsching's intra.capsular forceps
gium, foreign body removal from cornea • Keratome both straight and angll' bl,,lkd
operations. knife-used for incising cornea.
• Needle holders (light weight)-for holding • Disc holding forceps.
needles. • Lens expressor- used in c,,tarad ::-urgcn
• Arruga's needle holder with a catch (lock) • Lens spatula-used in c,1t.1ract surgrr~ ·
for heavy-duty. • Castroviejo corneal spring scissors h.1"
r's needle holder without a catch .
. used in opl'rahon:-
d oubl e ~prmg f ·,mw,1
• Barraqu e ll l

for light duty. and iris.