Surgical Instruments: Types, Uses, and Care

Posted on Jan 6, 2025 in Medicine & Health

Surgical Instruments: Types, Uses, and Care

1. Introduction

Surgical instruments have different uses: cutting, producing hemostasis, holding tissue, and exposing tissues. Knowing the usefulness of each piece will help you prepare your care cart and care packages for instrumental or interventions. The auxiliary is responsible for collecting and cleaning the instruments.

2. Surgical Instruments

Surgical instruments are the set of instruments used in all types of surgical procedures and examinations.

2.1. Cutting and Dissection Instruments

These are pieces that are used to cut or section tissue:

  • Manual Bistouries: The most important cutting instrument.
  • Surgical Knives: Made of stainless steel, they are numbered 3 or 4 according to their shape and size.
  • Scalpel Blades: Made of stainless steel or carbon, they come in various sizes and shapes.
  • Fulfilled Scalpel: Consists of a handle and blade in one piece.
  • Disposable Knife: Made of plastic with a stainless steel blade.
  • Scissors: Divided according to the type of tips and the shape of their branches.
    • Lister Bandage Scissors: Used for cutting bandages and clothes, usually ending with angled buttons to prevent skin injury.
    • Littauer Scissors: Used for cutting stitches and other hard materials.
    • Mayo Scissors: Straight or curved, the most used, with wider blades, for cutting large thicknesses of tissue.
    • Metzenbaum Scissors: Used for isolating or dissecting the finest vessels or ducts.
    • Plaster Shears: Very strong, with a long handle, used for cutting thin layers of bandaging.
  • Costotome: Very powerful pliers used in thoracic surgery for rib sectioning.
  • Electric Scalpel: Uses electrical current to cut tissue.
  • Ultrasonic Scalpel: Used for cutting and coagulation of tissue using ultrasound.
  • Plaster Pliers: Short, wide branches, with a long and powerful handle.
  • Saws: Used for carving hard tissues without injuring soft tissues, or for cutting thick bones.
  • Drills: Electric, used to pierce bone to introduce material.

2.2. Tissue Clamps

Used to hold and control tissue during care and surgery, most commonly dissection.

  • Dissection Clamps: Hold tissues while they are subjected to exposure, cutting, or wounding. They have two flat metal branches joined at one end, and the ends may be smooth or have teeth. The most used are dissection clamps with and without teeth.
  • Adson Dissection Forceps: Same size but without teeth.
  • Claws: Have more holding capacity than their predecessors.
  • Duval and Lovelace Clamps: Used to hold lung tissue, with a triangle-shaped lace to minimize trauma.

2.3. Hemostasis Instruments

Used to close the lumen of blood vessels, preventing hemorrhage. The most used are mosquito clamps.

  • Mosquito Clamps: Curved or straight, used to clamp small vessels.
  • Pean and Kocher Clamps: Larger clamps.

2.4. Separators

Instruments used to facilitate exposure of tissues during surgery. They can be held by hand or kept open by means of a zipper. The most used are:

  • Roux
  • Farabeuf
  • Adson

2.5. Field Clamps

Sharp and conflicting, they firmly hold the drapes used to cover the surgical field.

  • Backhaus
  • Jones
  • Doyen

2.6. Suture Material and Instruments

  • Needle Holders: Designed to hold suture needles and make knots. There are three types:
    • Hegar: Held with the middle finger and thumb.
    • Mathieu: More expensive, more traumatic, break more easily, but are easier to use.
    • Gillies: Combined with scissors when there is no help.
  • Sutures: Any material used to tie blood vessels or approximate tissues.
    • Features: High resistance, smooth surface, free of chemicals, less hydrophilic, sterile.
    • Types:
      • Absorbable: Used for internal organs and subcutaneous tissue.
      • Non-absorbable: Not hydrolyzed by organic enzymes, remaining indefinitely in the body.
        • Natural: Silk
        • Synthetic: Nylon
  • Staplers: Mechanical suture instruments for applying staples to sterile vessels. They are usually reloadable.
  • Staple Removers: Devices for removing staples that exert pressure on the midpoint, allowing the staple to come out easily.

2.7. Wound Dressing

  • Pean or Kocher Clamps: Used for wound dressing.

2.8. Suture Kits

Consist of a dissection clamp with teeth, scissors, and a needle holder.

2.9. Tendon Set

Includes two Adson dissection forceps (without teeth), a needle holder, a set of Senn-Miller retractors (2), two mosquito forceps (straight and curved), Mayo scissors, and Metzenbaum scissors.