Surgical Instruments Dr.Faisal Alsobyani Classification by usage • to cut or incise:Instruments used for this purpose are frequently referred to as “sharps”. They include scissors, knives, scalpels, chisels and osteotomes, among others. • to retract:Hand-held and self-retaining retractors serve this purpose, as well as instruments such as skin and bone hooks • to grasp, hold or occlude:These include the many types of forceps, including hemostats, dressing and tissue forceps, as well as bone holding forceps. Also included in this group are needle holders • to dilate or probe:These instruments are used to dilate or enlarge openings or to find an area or foreign object. • to cannulate or drain:These instrumentsincluding catheters, drains and cannulas, are generally used to drain a wound. • to aspirate, inject or infuse:These instruments serve to remove unwanted fluids as well as to inject needed fluids into a patient. Among these instrumentssyringes, some needles, trocars and cannulas. • to suture or ligate:Suture or ligation is used to close or rejoin a wound or an area of operation, e.g., a vessel, a nerve or tissue. There are a variety of sutures and clips, as well as suture needles and ligating instruments. • Cutting & Dissecting Instruments - including scalpels, scissors, and saws. • Grasping & Holding Instruments - predominantly includes forceps and clamps. • Hemostatic Instruments - instruments utilized for the cessation of bleeding. • Retractors - to aid in exposing the bodies cavities accessed during surgery. • Tissue Unifying Instruments - instruments that aid in tissue unification, such as needle holders. Cutting & Dissecting • BP handle(Bard & Parker) / scalpel handle Surgical Knife – (The Surgical Instruments) Different types of surgical blades/knives with their number for cutting incision and excision. Suture cutting scissors Surgical scissor’s - 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 deep fascia of the neck in thyroid surgery. - Used to raise skin flaps by sharp dissection. Iris scissors Heamostatic 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 -Used to pick up appendix during appendectomy. -Used to hold delicate visceral organs. -Used to hold cut margins of bladder during open prostatectomy. Dunhills Forceps • Dunhill forceps are small forceps with curved serrated ends, often used to grasp vessels prior to ligation -Used to fix draping towels. -Used for fixing diathermy cables, suction tubes etc. -May be used to hold ribs while elevating flail segment of chest. - Used to crush the base of the appendix during appendectomy. -Used to hold meniscus during menisectomy. -Used to do sub total thyroidectomy. - 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. Needle Holder Desjardin’s Choledocholithotomy Forceps • Used to remove stones from common bile duct. • Used to remove stone from kidney, bladder stone. Intestinal clamp
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