Surgical Instruments
Thumb forceps
➢ Instruments: Toothed Forceps.
➢ Uses: To hold tough structures during dissection.
➢ E.g.: Fascia Aponeurosis.
➢ Instruments: Non-toothed Forceps.
➢ Uses:
1. To hold delicate structures during dissection.
2. Dissection of delicate structures.
➢ E.g.:
1. Blood vessels, small intestine.
2. Hernial sac of small intestine/ Varicocele
➢ Instruments: Denis-Browne intestinal holding forceps
(Fenestrated Forceps).
➢ Uses: To hold delicate structures like the intestine.
➢ E.g.: Extraction of caecum during appendectomy.
Tissue forceps
➢ Instruments: Artery Forceps.
➢ Uses:
1. 1-Used in hemostasis to Catch bleeding points
2. Clamp a vessel between two artery forceps and
then dividing the vessel in between the two
3. Applied to peritoneal aponeurosis to perform
traction
4. Hold pieces of tissues
5. Facilitate taking ligatures in deep planes
6. During dissection
➢ E.g.: Larger Vessels.
➢ Instruments: Mosquito Forceps.
➢ Uses: As Artery Forceps.
➢ E.g.: Smaller Vessels (straight or curved).
➢ Instruments: Kocher’s Forceps.
➢ Uses:
1. To crush the base of the appendix before
ligation (prevent slippage of appendix contents
in the abdomen – strengthens the ligature)
2. To apply traction on tough structures.
➢ E.g.: Rectus sheath during closure of laparotomy.
➢ Instruments: Babcock’s Forceps.
➢ Uses: To hold intestine.
➢ E.g.:
1. appendix during appendectomy
2. resection and anastomosis of small and
large bowel (hold cut margins of the ends
of the intestine)
➢ Instruments: Allis’ Forceps.
➢ Uses: To hold subcutaneous tissue flaps for
retraction.
➢ E.g.:
1. during thyroidectomy
2. during modified radical mastectomy
➢ Instruments: Lane’s Forceps.
➢ Uses:
1. To hold muco-cutanous junction during
hemorrhoidectomy.
2. To hold tough structures like fascia
3. To hold spermatic cord during hernia repair.
➢ Instruments: Sponge (ovum) holding Forceps.
➢ Uses:
1. Scrubbing of skin before operation
2. Mopping of blood from the depth of operative field
3. Tongue holding forceps during oral surgeries.
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➢ Instruments: Choledocholithotomy (Desjardin).
➢ Uses: Used during Common Bile Duct (CBD)
exploration to extract stones (instrument is curved to
give more length) (NO LOCK: to get the stone out).
➢ Instruments: Ring Forceps.
➢ Uses: Holding spermatic cord during hernial repair.
➢ Instruments: Right Angle Forceps.
➢ Uses:
1. To dissect the pedicle of solid organs like spleen, kidney, thyroid
()بفصل\بسلك بيه الشريان من الوريد
2. Passing ligatures around deep structures
3. Uses of artery (differentiate between it and
curved artery, artery curve starts just after the
lock, right angle curve starts some distance
after the lock).
Clamps
➢ Instruments: Splenectomy Clamp.
➢ Uses: holding splenic hilum during splenectomy. (Vascular clamp
during splenectomy)
➢ Instruments: Non crushing intestinal clamp.
➢ Uses:
1. Holding the unresected part of
intestine to prevent leakage & spillage
of intestinal contents into the wound
2. Edge of the anastomosed part is
compressed so, prevent bleeding and
at the same time not cause ischemia,
so we use this instrument because it applies weak compression
3. To manipulate cut edges of the intestine
4. applied to the anastomosed not to the resected part.
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➢ Instruments: Payer’s clamp = (crushing intestinal
clamp).
➢ Uses: holding resected part of intestine during resection
& anastomosis surgeries to prevent spillage of intestinal
contents & soiling.
Retractors
➢ Instruments: Self-retaining Cecil-joll thyroid
retractor.
➢ Uses: Retraction of upper and lower skin & SC tissue
flaps during thyroidectomy.
➢ Instruments: Mastoid Retractor.
➢ Uses:
1. ENT surgery
2. Mastoidectomy
3. Tympanoplasty
4. Tracheostomy
5. Neurosurgical operation
6. Hernia Surgery.
➢ Instruments: Non-self-retaining abdominal retractors
(Deaver).
➢ Uses: Hold and retract deep soft abdominal visceral
organs during laparotomy.
➢ Instruments: Non-self-retaining abdominal
retractors (Morris).
➢ Uses: Hold and retract strong abdominal wall
muscles especially large wound.
~4~
➢ Instruments: Non-self-retaining abdominal retractors
(Lagenbeck Retractor).
➢ Uses: Used in surgeries with a lot of dissection.
➢ E.g.: Hernioplasty - Thyroidectomy.
Miscellaneous
➢ Instruments: Towel clips.
➢ Uses:
1. Fix towels in position
around the operative field.
2. Holding sterile bowels after
sterilization (drape).
➢ Instruments: Needle Holder.
➢ Uses: Holding the needle during suturing.
➢ Instruments: Clip Applier.
➢ Uses: Made from titanium (inert) closes arteries and
can be left in the abdomen.
➢ Instruments: scissors.
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➢ Instruments: Scalpel.
➢ Uses: For incision at the beginning of surgery.
➢ Instruments: Scalpel handle.
➢ Uses: To hold the scalpel.
➢ Instruments: Curette.
➢ Uses: for curette sinuses and cavities.
Drains
They are surgical tools to drain excess body fluid, blood or pus from a wound.
Indications:
1. To remove existing fluids, blood, bile or pus.
2. To prevent potential fluid collection.
3. To decrease risk of infection.
Types:
1. Open drain such as corrugated rubber drain.
2. Closed tube drain connected to sterile bag.
3. Closed suction drain with negative pressure
application.
4. Special type e.g., t-tube, chest tube.
➢ Instruments: Rubber corrugated drain.
➢ Uses: From depth of the wound to the
outside.
➢ Instruments: Tube Drain.
~6~
➢ Instruments: Closed drain (Jackson Pratt).
➢ Uses: Negative pressure from the bulb sucks fluid out
of the abdomen (difference between it and Redi-vac,
Redi-vac cannot be used in abdominal wounds as the
tube is so tough and can lead to complications and
perforations SO, Redi-vac is used in wounds elsewhere
than the abdomen
➢ e.g., Arm lipoma and closed tube is used in abdominal
wounds).
➢ Instruments: Closed suction drain (Redi-Vac).
➢ Uses: To avoid collection of Bl. Or seroma in
narrow areas & compression on vital structures.
Laparoscopic Surgeries
➢ Instruments: Tower.
➢ Instruments: Telescope (Laparoscope).
➢ Uses: بينقل الصورة للشاشة
➢ Instruments: Veress needle.
➢ Uses: Insufflation (to create pneumoperitoneum) during
laparoscopy.
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➢ Instruments: Trocars.
➢ Uses: بدخل من خالله اآللت
➢ Instruments: Maryland Laparoscopic forceps.
➢ Uses: Artery of laparoscope/ Used for dissection.
➢ Instruments: Laparoscopic Hook.
➢ Uses: Used for fine dissection and hemostasis.
➢ Instruments: Laparoscopic spatula.
➢ Uses: For hemostasis during laparoscopy
➢ E.g.) assuring liver bed hemostasis during
cholecystectomy.
➢ Instruments: Laparoscopic scissors.
➢ Uses: بقص بيه غرزة أو أي حاجة.
➢ Instruments: Non-toothed laparoscopic grasper.
➢ Uses: Forceps of laparoscope/ Used to hold
delicate structures during laparoscopy (two
types: toothed and nontoothed)
➢ Toothed is called endo clinch.
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➢ Instruments: Laparoscopic needle holder.
➢ Instruments: Laparoscopic clip applier.
➢ Uses: Used to apply clips to occlude a vessel
or a duct during laparoscopy.
➢ Instruments: Laparoscopic Babcock.
➢ Uses: Same as open Babcock.
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