Surgerical Instruments (important compiled).pdf
- 4. Rampleys sponge holder • It has fenestrated ends with transverse serrations • It has rachet and a box joint USES • Used for cleaning/preparing parts , to hold gallbladder and cervix during surgeries, for blunt dissections, as ovum forceps
- 5. Towel clip • 2 types - • Mayo towel clip: has ratchet for locking the box joint -used to fix suction tubes, diathermy wires, laproscopy cables, fix ribs in flail chest • Doyen towel clip: has pinch lock action
- 6. Bard-Parker handle • Used to mount surgical blades • Pen/paint brush grip, palmar grip
- 7. Vicryl suture • Polyglactin braided suture • Synthetic absorbable suture • Undergoes hydrolyses in 60-90days • Tensile strength is 60% at end of 1st week and 30% at the end of 3rd week USES • Bowel (3-0 round body needle), bladder (3-0 round body needle), CBD (5-0 round body needle) • It can also be used to approximate subcutaneous tissues together.
- 8. Surgical blades No. 11- Pointed/Stab blade : for incision and drainage, also used for arteriotomy No.12- Curved blade: for suture removal No. 10,15,20,21,22,23: these have a belly (sharpest portion) which is curved used to make in incision
- 9. I. V Cannula
- 10. Yankauer Suction • suction of blood/secretions • suction of saliva in oral surgery
- 12. RETRACTORS NON SELF RETAINING RETRACTORS SELF RETAINING RETRACTORS SKIN HOOK CAT’S PAW RETRACTOR CZERNEY’S RETRACTOR LANGENBECK RETRACTOR MORRIS RETRACTOR DOYEN RETRACTOR DEAVER RETRACTOR MALLEABLE RETRACTOR VOLKMANN’S RETRACTOR MASTOID RETRACTOR BALFOUR SELF-RETAINING RETRACTOR BOOK-WALTER SYSTEM
- 13. Skin hook (single/double) retractor • used for raising skin flaps
- 14. Czerney’s retractor • It has a hook at 1 end (at 90 degrees) to hook tissue • has fenestrations to make instrument lighter and bettre grip • at other end space for taking bites from rectus sheath • used for superficial tissues and abdominal wall retraction, hernia and laprotomy closures • prevents slipping of tissues
- 15. Langenbeck retractor • long handle + small solid blade • hernia/superficial injuries to retract skin, fascia, aponeurosis • narrow blade to retract liver edge
- 17. Doyen’s retractor • convexity of the blade is more • used to retract bladder
- 18. Deaver’s retractor • ?-shape, retractor with broad gentle curved blade • comes in different lengths of the blade • retract liver, spleen, abdominal viscera • atraumatic and gives adequate exposure
- 19. Mastoid retractor • Mollison self retaining homeostatic mastoid retractor
- 20. Volkmann’s retractor • used to retract fascia in soles and palms
- 21. Balfour self-retaining retractor • used for abdominal surgeries • one blade is fixed while other is mobile • helps in adjusting the amount of retraction required • bladder retractor can be attached to it
- 22. Book-Walter system • Its a bulky retractor with a semi-circular ring fixed to OT table with multiple instruments • used to retract multiple structures at same time
- 23. Joll’s thyroid retractor • self retaining retractor • for thyroid surgeries
- 24. Needle holder • has criss-cross serrations with groove at the centre • helps in fixing/holding the needle • needle held at 1/3rd from the swaged end
- 26. Mayo Scissors • bulky and heavy • mainly for cutting sutures and tough structures like sheath and fascia • screw joint • can be straight/slightly curved
- 27. Metzenbaum scisssors • Lighter than Mayo scissors • curved and has a long handle • used for dissection and cutting fine tissues
- 28. McIndoe scissors • used for cutting delicate structures and dissecting tissue
- 29. Tissue scissors Tissue scissors are for cutting tissues only; avoid using them for tasks such as cutting suture material, as these activities blunt the sharp edge. Mayo can be straight or curved, and the points tapered or rounded. They are robust scissors and are used for dissecting and cutting strong tissues such as fascia. Metzenbaum are similar to Mayo scissors but they have shorter blades relative to the handles. They are used for precise, fine dissection around delicate tissues.
- 30. tissue forceps and hemostatic forceps
- 31. Artery forceps • tranverse serrations • used to crush tissue • Small/medium/large • Straight/curved • Uses: to catch bleeding points, Open facial planes, pass ligatures, Hold fascia, peritoneum, aponeurosis, sutures, Darin abscess, hold guaze
- 32. Plain dissecting forceps • doesnt cause much trauma • transverse serrations for better grip on delicate structures like bowel and bladder • no teeth • can be used to crush vessels
- 33. Toothed dissecting forceps • has spring action • used to hold needles, tough structures (skin, fascia, sheath) • serrations on handle for better grip • are traumatic hence used for tough structures
- 34. Debakey vascular forceps • has longitudinal groove with two rows of teeth on side and single row on another side , provides interlocking effect • used for holding vessels during vascular anastomosis
- 35. Russian tissue forceps • end are club shaped with multiple transverse serrations and small teeth • used for holding lymph nodes and lymphatic tissues
- 36. Spencer wells straight artery forceps • it has 2 rings, ratchet, box joint, blades with tranverse serrations. • used for holding bleeding arteries • comes in different sizes
- 37. Adsons artery forceps • Lighter than Spencer artery forceps • Serrations at tip • Box joint smaller than Spencer • Used as a hemostat to control bleeding.
- 38. Curved Artery forceps • it has transverse serrations • used for holding tissues and epecially bleeders.
- 45. Morant-Baker’s Appendix holding forceps • its like Lane’s forceps but with opposing serrations proximal to the tooth. These serrations give a good grip in mesoappendix while holding appendix in appendicectomy • use replaced by babcock’s forceps
- 47. Right angle tissue forceps • blade is bent at the end alongwith transverse serrations • used for ligating pedicles
- 48. Kelly tissue forceps • its a long curved artery with more gradual curve of the blade • used for dissection and holding structures at depth
- 51. Babcock tissue forceps have a broad, blunt and flared tip that provides a delicate grasping action. They can be used with care on tissues remaining in the body. Doyen intestinal forceps are designed to hold the intestine without crushing. They have long, thin jaws with longitudinal, non-crushing serrations. They have a more delicate touch because they are bowed in shape, meaning the tips of the jaws only just meet when the ratchet engages. This provides a delicate, non-traumatic grip. Allis tissue forceps are a strong sturdy instrument with a number of teeth on the gripping surface. They may crush tissue and should be used with care, as they can be quite traumatic. They are used to firmly grasp tissues that are to be removed from the body, due to the damage that they can cause.
- 52. Haemostatic forceps should be held using the 'tripod' grip, as with scissors. The thumb and ring finger are inserted into the rings, while the index and middle finger are used to guide the instrument. The tips of the forceps are applied to a bleeding vessel. This controls haemorrhage with minimal trauma of the surrounding tissue. Curved haemostats can be used pointing downwards to clamp small bleeding vessels. They can also be used curving upwards, to grasp a bleeding stump. Kelly and Crile haemostats are more robust. The Kelly design has transverse grooves on the distal half of the jaws only whilst the Crile has grooves over the entire surface. Carmalt (Rochester-Carmalt) haemostats are sturdy instruments with their gripping surface containing longitudinal serrations with cross- hatching at the tip. These are large forceps suitable for clamping blood vessels and large tissues, and also for ligating pedicles. Halsted Mosquito haemostats are small delicate instruments.
- 53. Farabeuf periosteal elevator it has slightly curved , sharp blade used for elevating periosteum
- 54. Doyen rib raspatory • to cut rib attachments • to determine side- handle laterally, convexity upwards. tip downwards
- 55. Rib cutter • Geirtz: 2 levers to magnify the cutting effect • Dolphin: sharp tip (above) and blunt tip (placed below the rib)
- 56. Bone nibbler • used for nibbling the sharp edges of the rib
- 57. Lung holding forceps • its a triangular forceps used for stabilising the lung
- 58. Joll’s Thyroid retractor • used to raise, fix and retract the flaps during thyroid durgery
- 59. Kocher’s thyroid dissector • used for dissecting the superior pole of thyroid
- 60. Aneurysm needle • Used for passing sutures • also used during venesection
- 61. Suprapubic cystolithotomy forceps • no lock • closed ring is for the thumb and the open ring is for 4 fingers
- 62. Pyelolithotomy forceps • come in different angulations for different calyxes • has no lock, has transverse serrations
- 63. Desjardin’s choledocholithotomy forceps • long distal blades with smooth serrations and fenestra in tip • used for extracting stones from CBD • no ratchet, lock or serrations
- 64. Ovum forceps • used in gynaecological procedures • used for removing placental fragments • sometimes stones removal from GB
- 66. Sinus forceps ( Lister’s) • straight, long blades with serrations in tip • no lock, no serrations, broad tip, blunt • drain pus ( Hilton’s method )
- 67. Cheatle’s forceps • kept in dressing trolley dipped in antiseptic solution • used to pick guaze pieces and other instruments • no lock
- 68. Bulldog clamp • used for temporary occlusion of peripheral vessels • has spring loaded action, vertical grrove , and fine transverse serrations
- 69. Satinksy vascular clamp • has curved needle with longitudinal groove and transverse serrations • has ratchet
- 70. Doyen’s intestinal clamp • Non-toothed , non-crushing clamp • longitudinal serrations and ratchet
- 71. Moynihan’s occlusion clamp • long distal blade with longitudinal serrations • stright/curved • non-traumatic, non-crushing type • occludes lumen of bowel/stomach and prevents spillage • occludes vessels & prevents bleed • used during anastomosis
- 72. Payr crushing clamp • stout and heavy with double lever in handle • has toothed ends and longitudinal serrations • spring loaded action • crushes bowel, used in gastrectomy, resection&anastomosis
- 73. Punch biopsy instrument • used for incisional biopsy
- 74. Trucut biopsy gun • 8-18G • breast lesions, soft tissue sarcomas - Inv. of choice
- 75. Humby knife • used for raising skin grafts manually
- 76. Underwater Seal bag • connected with intercostal tube • marking for water column • one end of the tube is always submerged
- 77. Urobag • connected with foleys catheter/drain • no pipe running in between • no water column
- 78. Foley’s catheter • 3 way: Balloon, drainage for urine to come out, irrigation to prevent clot formation • French= outer circumference
- 79. Bake’s Dilator • long metallic malleable instrument with club at terminal end • used to assess CBD, duodenal papilla for patency or block
- 80. Lister’s urethral dilator • olive tip • to dilate stricture urethra
- 81. Ryle’s tube • one metre long - rubber/plastic • 3 lead shots in tip - radioopaque • markings at different levels • 40cm- GEJ • 50cm- body of stomach • 60cm- pylorus • 65cm- duodenum
- 83. Volkmann’s scoop • To scoop cavities, ulcer bed, granulation tissue • on either side, different sized scoops are present
- 84. Romovac suction Drain • suction is created by pressing suction corrugation • sharp metallic introducer to pass the tube into the required area after puncturing the skin • used in thyroidectomy, mastectomy, radical dissection, wide excision, flap surgeries
- 85. Abdominal Drain • Fixed to the skin either via a silk or nylon on a cutting needle
- 89. Flatus tube • Indian rubber, 45cm • one opening in tip and another proximal to tip on the side • used in sigmoid volvulus, paralytic ileus, subacute intestinal obstruction