Surgical Instruments Manual

- Prepared by

Operation Room guide

- Scissors

All types of scissors have either sharp or blunt edges:

• (A: Sharp-Sharp)
• (B: Blunt-Blunt)

Additionally, all types have blades that are either straight or curved.

Mayo and Metzenbaum

• Mayo Scissors (B): Used for cutting thick fascia and sutures.
• Metzenbaum Scissors (A): Thinner than Mayo scissors and used for cutting delicate tissues.

- Dressing and Tissue Forceps

Forceps consist of two gripping tips held together at the end and equipped with a spring mechanism that allows them to open.

• Forceps can be classified as either dressing or tissue forceps:
• Dressing Forceps: Have smooth tips for handling dressings.
• Tissue Forceps: Have serrated tips for gripping tissues.

Most forceps are named after their designer, such as Adson forceps.

• Rat Tooth Tissue Forceps:
• Feature interlocking teeth that provide a firm grip on tissues without slipping.
• Used for holding skin and dense tissues.

Figure (2)

Adson Tissue Forceps

A fine-toothed instrument with small serrations at the tip. Adson tissue forceps have thin, precisely serrated tips, designed for carefully grasping tissues.

Figure (3)

Intestinal Tissue Forceps

• Allis Forceps: Designed to lock when used to grasp tissues.
• Intestinal Tissue Forceps: Used for holding the intestines, tissues, omentum, and skin.

Figure (4)

 Babcock Intestinal Tissue Forceps

• Babcock forceps have finer serrations than Allis forceps.
• Features a wide, outward-curving tip with a smooth gripping surface.
• Used for holding delicate, traumatized organs such as the intestines and bladder.

Figure (5)

- Sponge Forceps

• Sponge forceps can be straight or curved.
• The tips may be serrated or smooth.
• Used for grasping delicate, traumatized organs such as the intestines and bladder.

Figure (6)

- Hemostats (Hemostatic Forceps)

• Hemostatic forceps are locking clamps used to grasp and constrict blood vessels.
• Most hemostats are named after their designers (Kelly, Halsted, Crile).
• Classified based on size, shape, and tip dimensions.
• Available in curved or straight forms.

Figure (7)

Kelly Hemostatic Forceps & Mosquito Hemostats

• Kelly Hemostatic Forceps (B): Used for clamping medium to large blood vessels.
• Mosquito Hemostats (A): Thinner than Kelly forceps, designed for smaller blood vessels.
• Both have transversely serrated tips.

Comparison of Kelly vs. Mosquito Hemostat Tips:

• (A) Mosquito Hemostat: Has a smaller tip for delicate procedures.

Figure (8)

Carmalt Hemostatic Forceps

• Preferred for clamping ovarian vessels during ovariectomy due to its longitudinal serrations.

Figure (9)

- Intestinal Forceps

• Doyen Intestinal Forceps:
• Feature longitudinal serrations.
• Used to grasp the intestines and temporarily occlude their lumen.

 Figure (10)

- Payr Pylorus Clamps

• A crushing intestinal clamp used to close the bowel end during resection.

Figure (11)

- Needle Holders

• A locking instrument used to hold surgical needles during suturing.
• High-quality types have tungsten carbide inserts at the tips for enhanced grip.

Figure (12)

- Mayo–Hegar Needle Holder

• Heavy-duty with moderate, grooved jaws.
• No cutting edge.

- Olsen–Hegar Needle Holder

• Combines the functions of a needle holder and scissors.
• Disadvantage: The sharp cutting edge may accidentally cut sutures transversely.

 Figure (13)

- Hand-Held Retractors

• Senn Retractor:
• Features dual-ended tips, which can be blunt (fine) or sharp.
• Used for retracting the peritoneum.

Figure (14)

Hohmann Retractor

• Used to elevate tissues away from the bone during fracture reduction and orthopedic procedures.

Figure (15)

Self-Retaining Retractors

• Weitlaner Retractor:
• Features sharp or blunt prongs.
• Has a rake-like design.
• Equipped with a locking mechanism to hold tissues apart.

 Figure (16)

Gelpi Retractor

• Features a single, pointed tip.
• Equipped with a locking mechanism to hold tissues apart.

Figure (17)

- Scalpels and Blades

• Handles:
• Size 3 Handle
• Size 4 Handle

Figure (18)

Handles and Blades:

• Blades (Sizes 10, 11, 12, 15) fit Handle Size 3.
• Blades (Sizes 22, 23) fit Handle Size 4 and are mainly used for large animals.

Figure (19)

Disposable Scalpel :

Figure (20)

- Towel Clamps

• Towel clamps are used to secure a sterile drape onto the patient’s skin and can also be used to grasp tissues.
• Backhaus Towel Clamp:
• Curved design
• Locks during use

Figure (21)

Scalpels

• The scalpel is held using the thumb, middle, and ring fingers, while the index finger rests on the upper edge for guidance.
• A smooth, continuous incision causes less tissue trauma compared to an interrupted cutting motion.

Figure (22)

The scalpel should not be used in stabbing movements.

Figure (24)