Ilado RN
Classification of Instruments: A. Cutting and Dissecting cutting instruments have sharp edges. used to dissect, incise, separate or excise tissues
1. Scalpels
has reusable handle with a disposable blade a heavy hemostat or Kelly clamp is used to attach and detach, the blade
has rounded cutting edge along one side fits on nos. 3, 7, and 9 handles
No. 12 blade shape like a hook, with the cutting edge on the inside curvature
No. 15 blade has a smaller and shorter curved cutting edge than a 10 blade
Nos. 20, 21, & 22 blades are the same shape but are larger, they
No. 23 blade/No. 24 blade has a curved cutting edge that comes to more of a point than nos. 20, 21 and 22 blades
2. Scissors
blades are straight, angled or curved, as well as either pointed or blunt at the tips handles may be long or short used to cut or dissect tissues and also to cut other materials
Classifications:
A. Tissue scissors has a sharp blades
1.
2. Curved Mayo scissors - Used to cut heavy tissue (fascia, muscle, uterus, breast). Available in regular and long sizes.
3. Metzenbaum scissors - Used to cut delicate tissue. Available in regular and long sizes.
2. Suture Scissor has blunt points to prevent structures close to the suture from being cut used to cut sutures
2. Wire scissors has short, heavy blades used to cut stainless steel sutures
3.Dressings/Bandage scissors used to cut drains and dressings and to open items such as plastic packets
4. Bone Cutters and Debulking Tools used for cutting into or through bone and cartilage
a. Chisels b. Osteotomes, c. Curette has a sharp edge at the loop and scoop on the end, used to scrape tissue or bone
Types:
a. Smooth Forceps also referred to as pick-ups
has serrations or grooved at the tip that does not injure delicate structures
b. Toothed/Thumb Forceps referred to as rat-toothed forceps has single tooth on one side that fits between two teeth on the opposing side provides a firm hold no tough tissues, including skin, fascia
Adson pick-ups either smooth: used to grasp delicate tissue with teeth: used to grasp the skin other names: Dura forceps
2. Allis Forceps
has scissor action, each jaw curves slightly inward and there is a row of teeth at the end holds tissue gently but securely
3. Babcock Forceps
the end of each jaw is rounded to fit around a structure or to grasp tissue without injury used to grasp delicate tissue (intestine, fallopian tube, ovary).
4. Kocher
used to grasp heavy tissue and also used as clamp jaws either straight or curve other name: Oschner
5. Tenaculums
a curved or angled points on the ends of the jaws used to penetrate tissue to grasp firmly, such as when a uterine tenaculum is used to manipulate the uterus
C. Clamping or Occluding
1. Hemostatic Forceps clamps used for occluding blood vessels which has two opposing serrated jaws that are stabilized by a box lock and controlled by ringed handles Parts of hemostatic forceps includes: 1. Serrated jaws 2. Box lock 3. Shank 4. Ratchets 5. Ring Handle
a. Hemostat
used to clamp blood vessels either straight or curved that taper to a fine point serrations go across the jaws aka. Crile clamp
b. Mosquito clamp
used to clamp small blood vessels or skin jaws may be straight or curved
c. Kelly clamp
used to clamp larger blood vessels and tissue Available in short and long sizes Other names: Rochester Pean
d. Right Angle
used to clamp hard-to-reach vessels and to place sutures behind or around a vessel. Other names: Mixter.
used to hold back or retract organs or tissue to gain exposure to the operative site
1. Handheld Retractors (manual) most retractors have blade on a handle. These blades are usually dull, but some are sharp used in pairs and they are held by the first or second assistant
Types
a. Malleable Retractors may be bent to the desired angle and depth for retraction is used to retract deep wounds - aka. Ribbon retractor
b. Deaver retractor
c. Richardson
d. Army Navy
used to retract shallow or superficial incisions aka US army
e. Goulet
f. Volkmann Rake
g. Vaginal speculum
Types
1. Weitlaner used to retract shallow incisions
2. Gelpi retractor
used to retract wound edges during deep abdominal procedure used during laparotomy
E. Suturing
1. Needle Holders used to grasp and hold curved surgical needles most needle holders resemble hemostatic forceps but the basic difference is the jaws. the size of the needle holder should match the size of the needle (i.e. heavy jaws for large needles and slim jaws for small needles)
6. With a moist sponge, wipe blood and organic debris from instrument after use 7. Placed used instrument into a tray at the end of the surgical procedure