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8/3/2019 Surgical Instruments Basic
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Classification by type of points
All types of scissors can have blunt or sharp blades (A: Sharp:Sharp,
B: Blunt:Blunt).
All types can have either straight or curved blades.
Mayo and Metzenbaum
Mayo scissors (B) are used for cutting heavy
fascia and sutures.
Metzenbaum scissors (A) are more delicate than Mayoscissors.
Metzenbaum scissors are used to cut delicate tissues.
Metzenbaum scissors have a longer handle to blade
ratio.
Forceps: consist of two tines held together at one end with a spring device that holds
the tines open. Forceps can be either tissue or dressing forceps.
Dressing forceps have smooth or smoothly serrated tips.
Tissue forceps have teeth to grip tissue. Many forceps bear the name of the originator
of the design, such as Adson tissue forceps.
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R at Tooth: A Tissue Forceps
Interdigitating teeth
hold tissue withoutslipping.
Used to holdskin/dense tissue.
Adson Tissue Forceps
Small serrated teeth on
edge of tips.
The Adsons tissue
forceps has delicateserrated tips designed for
light, careful handling of tissue.
Intestinal Tissue Forceps: Hinged (locking) forceps used for grasping and holding
tissue.
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Allis: An Intestinal Tissue Forceps
Interdigitating short
teeth to grasp and hold bowel or tissue.
Slightly traumatic, use
to hold intestine, fasciaand skin.
Babcock: An Intestinal Tissue Forceps
More delicate thatAllis, less directly
traumatic.
Broad, flared ends with
smooth tips.
Used to atraumaticallyhold viscera (bowel and bladder).
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Sponge Forceps
Sponge forceps can be
straight or curved.
Sponge forceps can
have smooth or serrated jaws.
Used to atraumaticallyhold viscera (bowel and
bladder).
Hemostatic forceps: Hinged (locking) Forceps. Many hemostatic forceps bear
the name of the designer (Kelly, Holstead, Crile). They are used to clamp and hold
blood vessels.
Classification by size and shape and size of tips
Hemostatic forceps and hemostats may be curved or straight.
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K elly Hemostatic Forceps and Mosquito Hemostats
Both are transversely serrated.
Mosquito hemostats (A) are more delicate than
Kelly hemostatic forceps (B).
Comparison of K elly and Mosquito tips
Mosquito hemostats (A) have a smaller, finer tip.
Carmalt
Heavier than Kelly.
Preferred for clamping of
ovarian pedicals during anovariohysterectomy surgery
because the serrations runlongitudinally.
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Doyen Intestinal Forceps
Doyen intestinal forceps are non-
crushing intestinal occluding forceps with
longitudinal serrations.
Used to temporarily occlude lumen of
bowel.
Payr Pylorus Clamps
Payr pylorus clamp is a crushing
intestinal instrument.
Used to occlude the end of bowel to
be resected.
Needle holder: Hinged (locking)
instrument used to hold the needle while
suturing tissue.
Good quality is ensured with tungsten carbide inserts at the tip of the needle holder.
Mayo-Hegar
Heavy, with mildly tapered jaws.
No cutting blades.
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Olsen-Hegar
Includes both needle holding jaw and scissors blades.
The disadvantage to having blades within the needle
holder is the suture material may be accidentally cut.
Senn
Blades at each end.
Blades can be blunt
(delicate) or sharp (moretraumatic, used for
fascia).
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Hohman
Levers tissue away
from bone duringorthopedic procedures.
Weitlaner
Ends can be blunt or sharp.
Has rake tips.
Ratchet to hold tissue apart.
Gelpi
Has single point tips.
Ratchet to hold tissue
apart.
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Handles
#3 Handle
#4 Handle
Handles and Blades
Blades #10, 11, 12, 15 fit the #3 handle.
Blades #22, #23 fit the #4 handle and are commonly used for large animals.
Disposable Scalpel
Towel clamps secure drapes to a patient's skin. They may also be used to hold tissue.
Backhaus Towel Clamp
Locking forceps with curved, pointed tips.
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Scissors and Hemostats:
The thumb and ring finger are inserted into the ringsof the scissors while the index and middle finger are
used to guide the instrument.
The instrument should remain at the tips of the fingerfor maximum control.
This is the wrong way to hold the scissors.The ring finger should be inserted into thering.
This is also the wrong way to hold the
scissors. The tips of the scissors should be
pointing upwards.
Thumb Forceps:
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Thumb forceps are held like a pencil.
Thumb Forceps are not called 'tweezers'.
Thumb Forceps are not held like a knife.
Scalpels:
The scalpel is held with thumb, middle and ringfinger while the index finger is placed on the
upper edge to help guide the scalpel.
Long gentle cutting strokes are less traumatic totissue than short chopping motions.
The scalpel should never be used in a "stabbing" motion.