Definition

Operating rooms are the revenue generator of the hospital, and surgical instruments play a
large role in performing surgical procedures. Surgeons highly depend upon them to perform
as intended. How long should our surgical instruments last? That depends on many factors.
Surgical instruments are devices that are used to perform different tasks. There are thousands
of surgical instruments, so no wonder that many find it particularly daunting to what they are
and what they are used to do. But it gets much easier once you realize that surgical
instruments are essentially classified by the way the surgery and its use in that particular
surgical procedure.
The Common Surgical Instruments
SCALPEL
Used for incision and cutting tissue. Consists of a blade and handle. Surgeons often refer to
the instrument by its blade number.

 #10 Blade: Used primarily for making large skin incisions, e.g., in laparotomy.
 #11 Blade: Used for making precise or sharply angled incisions.
 #15 Blade: Smaller version of #10 blade used for making finer incisions.
SCISSORS
Used for cutting tissue, suture, or for dissection. Scissors can be straight or curved, and may
be used for cutting heavy or finer structures.

 Mayo Scissors: Heavy scissors available in multiple varieties. Straight scissors are used
for cutting suture, while curved scissors are used for cutting heavy tissue.
 Metzenbaum Scissors: Lighter scissors used for cutting delicate tissue, (e.g., heart)
and for blunt dissection. Also called “Metz” in practice.
 Pott’s scissors: Fine scissors used for creating incisions in blood vessels.
 Iris scissors: Used for fine dissection and cutting fine suture. Originally for ophthalmic
procedures, but now serves multipurpose role.
FORCEPS
Also known as non- locking forceps, grasping forceps, thumb forceps, or pick-ups. Used for
grasping tissue or objects. Can be toothed (serrated) or non-toothed at the tip.

 Tissue Forceps: Non-toothed forceps used for fine handling of tissue and traction
during dissection.
 Adson Forceps: Forceps toothed at the tip used for handling dense tissue, such as in
skin closures.
 Bonney Forceps: Heavy forceps used for holding thick tissue such as fascial closure.
 DeBakey Forceps: Used for atraumatic tissue grasping during dissection.
 Russion Forceps: Used for atraumatic tissue grasping during dissection.
CLAMPS
Also called as locking forceps, these are ratcheted instruments used to hold tissue or objects,
or provide hemostasis. Can be traumatic or atraumatic.

 Crile Hemostat: Also known as “snap”, atraumatic and non-toothed clamp used to
grasp tissue or vessels that will be tied off. Also used in blunt dissection.
 Kelly Clamp: Larger size variation of hemostat with similar function for grasping larger
tissue or vessels.
 Kocher Clamp: Traumatic toothed clamp used to hold tissue that will be removed.
 Allis and Babcock Clamps: Slightly rounded jaws, both are used for grasping intestine.
NEEDLES AND SUTURES
Needles come in many shapes and cutting edges for various applications. Suture can be
absorbable, non-absorbable, and is available in different sizes.

 Needle Types – Needles must dissect through tissue to pass suture. They come in
various sizes, types, and shapes depending on the application. Here are some
examples (though not all):
 Tapered Needle: Needle is round and tapers to a simple point. Most commonly
used in softer tissue such as intestine but may also be used in tougher tissue such
as muscle.
 Conventional Cutting Needle: Needle is triangular with sharp edges, and one edge
faces the inside of the curved needle. Used for tougher tissues such as skin.
 Needle Shape: The shape of the needle is also important. The curvature of the needle
allows for use in specialized applications. Curved needles are used in most general
surgical procedures, while straight needles are used for skin and subcuticular suturing.
 Skin Glue and Staplers: For skin closures, in particular, staplers and skin glue may be
used in lieu of suture. This is usually based on cosmetic outcome and surgeon
preference.
RETRACTORS
In varying forms, retractors are used to hold an incision open, hold back tissues or other
objects to maintain a clear surgical field, or reach other structures. They can either be
hand-held or self-retaining via a ratcheting mechanism.

 Deaver Retractor: Used to hold back the abdominal wall.

 Army-Navy Retractor: Used to gain exposure of skin layers.
 Weitlaner Retractor: Self-retaining for exposing deep or smaller surgical sites. Also
called “Wheaty.”
 Richardson Retractor: Used to hold back deep tissue structures. Also called “Rich.”
 Bookwalter Retractor: Self-retaining retractor system that is anchored to the
operating table.
 Rake Retractor: Hand-held retractor with sharp teeth used to hold back surface
structures.
  Malleable Retractor: Can be bent and customized. Also used to protect intestines
during abdominal closure
SUCTION

Suction tips, combined with a suction source, help to remove debris and fluid from the surgical field.
It can also be used to clear surgical smoke.

 Yankauer Suction Tube: Used primarily for surface suction and some intra-abdominal
suction.
 Poole Suction Tube: Used to remove large amounts of fluid from the surgical field, as
well as intra-abdominal suction.
 Frazier Suction Tip: Used primarily in ENT and neurosurgery. Usually angled.
STAPLERS AND CLIPS
Used for reanastomosis of viscera, vessel ligation, and excision of specimens. Can be one-time
use, reloadable, manual, or electronically powered. Staples come in multiple sizes.

 Linear Stapler: Creates a linear staple line; no cutting function. Used in ligation and
anastomosis. May be curved.
 Linear Cutter: Creates a linear cut and immediately staples both free edges. Used in
separation and anastomosis
 Circular Cutter: Performs circular cut and staple. Used in reanastomosis of hollow
viscera, e.g., large bowel.
 Clips: Used in the ligation of vessels, may be metal or absorbable material. Open and
lap applicators.
 Endostapler: Used in laparoscopic procedures, provides simultaneous cutting and
stapling. May be manual or electronic. Some feature articulating heads to accomplish
more difficult placement.
LAPAROSCOPIC INSTRUMENTS
Many instruments are similar to those used in open surgery, adapted to fit through narrow
ports placed through the skin. Laparoscopic work is then conducted via the ports.

 Insufflator: Injects carbon dioxide into the abdominal cavity to create a working space
for trocar placement and surgical procedures.
 Veress Needle: One method of achieving pneumoperitoneum. Consists of blind
placement of needle into abdomen and subsequent injection of gas.
 Trocars: Transabdominal working ports where laparoscopic instruments are inserted.
 Laparoscopic Instruments: Handheld and shafted implements used to work through
trocars. Can perform grasping, retracting, cutting, cauterizing, and other functions.