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‫َ‬
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‫َ‬
‫"‬
‫يَْرفَِع الل ّ ُ‬

‫صدق الله العظيم‬

‫سورة المجادلة آية رقم ‪11‬‬

 ‫قال رسول الله صلى الله عليه وسلم‬

‫إذا مات ابن آدم انقطع عمله إل من ثلث صدقة جاريه أو علم ينتفع به أو ولد‬
‫صالح يدعو له‬

‫صدق رسول الله صلى الله علية وسلم‬

REVIEW OF SURGICAL
INSTRUMENTS
 ‫إعدا د‬

‫جمال ابراهيم موسى‬ ‫ا‪.‬د‪/.‬‬

‫أستاذ جراحة الجهاز الهضمى والمناظير‬
‫كلية الطب جامعة طنطا‬
I Articulating instruments
-

instruments with
A Instruments with joint and
- lock
 Straight Curved

1- Mosqui to
for ceps :
Us ed for :

Ha emo st asis, in
ca tchi ng of smal l v essel
Blade
as, subcutaneous or sub- Joint
Shaft
Lock
Handle
 Straight Curved

2- Ar ter y for ce ps:

•*U se d for.
•# Ha emo st asis,
In catching of medium
sized vessels as
subcutaneous or epiploic Blade
vessels during
spleenectomy before its
Shaft
ligation.
•# Parie tal
perito neum elevation Handle

before its opening in

abdominal operations.
 Straight Curved

Blade
3- Cl amp
for ceps:
•Us ed for
Shaft
Ha emo st asis in
catching of large size
vessels as,
•spleenic during Handle
spleenectomy
& renal during
nephrectomy before
their ligation.
W ha t is the dif fer ence betw een thi s
Mosquito Artery Clamp

Small Medium Large

 Teeth

4-Koc her Blade

for ceps: Joint

*U se d for Shaft

*Grasping tough
Handle
structures as
tendon, sheath or
muscle. Lock

*Crushing the base

of the appendix in
appendectomy.
 Blade

Joint

Shaft

5- Needle hol der : Lock

*Grasp the needle Handle

for stitching
 Artery Needle
holder

W ha t ar e the
di f fer ences
betw een
ar ter y and
needl e hol der :
•1- le ngth o f th e
bla de in rela tion
to shaft.
•2- Cor r ugatio n
Artery Needle holder
 Curved artery Moynihan
Obtuse Right
6- Moynihan

( Ch olec ystectomy
ar ter y):
•Use d i n Blade

Joint
Grasping the cystic vessels
& cystic duct before their Shaft
ligation during
cholecystectomy operation.
Lock Handle
•W hat is the
dif ference b etween
Mo ynih an a nd ar te r y
 Blade. Flat-Thin-Non crushing

7- Intesti nal Blade

clamps:
Grasp the intestinal
loop in resection
Shaft
anastomosis. Joint

A- Non crushing
intestinal type (flat thin Lock Handle
blade)
•Differ from artery in
blade length in relation
to shaft & Corrugation
of shaft
B- Cr ush ing

inte st in al cla mp
C-Gastr ic
cla mp:

Blade

Joint
D-D ouble
Ga st ric cla mp
 Blade
8- All is Toothed
Blade

for ceps:
*U se d for Closed at the tip only

- Catching the skin Shaft

as in scalp incision,
thyroid surgery
-Meso-appendix in Handle
appendectomy
-Edge of bowel in
W hat are t he d if ferences betw een
ar ter y & A llis b la de?
Artery Allis
1- Space after closure.
2- Teeth on tip of Allis
Blade ( short, shallow
Blade
Depression in between).
 Blade
Blade

9- Ba bcoc k
for ceps:
•En cir clin g
str uctu res a s Joint

Shaft
vas a nd u rete r. Lock

•Catc h str uctures

as

appendix and Handle

W hat are the dif ferences
between A ll is and

Babcock

bla de?
 Pin pointed end of the blade

10- Towel
clips:
* F or
Blade
graspin g
the edge of
the to wel Shaft

over the
patient Handle
* Another
type of towel
clips
 Blade
11 - Tongue
g r asper .
Used for traction of
the tongue
outwards Blade Joint Shaft Lock Handle
B- Instruments without lock
 Scope

1- Stone Blade on
blade

for ceps

( Ur eter ic, Shaft

Shaft
bi liar y and Handle
Bl ad der ): Handle

•Us ed for
Stone extraction
from the ureter,
common bile duct
and urinary Ureteric & Billiary Bladder
 Tissue Stitches

2-
Sci ssor s: Blade

Us ed for. Joint

*Tissue
dissection. Shaft

*Tissue cutting Handle

*Opening
peritoneum.
*Stitch removal
 Blade
3- Bo ne cutti ng
for ceps. Joint

Us ed for.
Spring
1- Cutting ribs.
2-Cutting small bones. Handle

3-Circumcision.
 Blade
4- Cr ocdyle
for ceps

Joint
 Blade
5- Pr oc to-
scope

(Ano- scope)

Used for. Handle

*In spectio n o f
the a nal canal &
lower r ectum
Joint
II- NON ARTICULATING

without joint
1-
Retr actor es :
*Retraction of the
abdominal wall.
*Liver retractors.
*Retraction of
viscera.
To open surgical
A- Non-self

retaining retractors
B- Self Lock

r etai nin g
r etr act or s

Blades
2- Tip

Di lator s:
Shaft
A- U reth ral
Rounded blunt tip

- Ur eteric

Base
B-He gar , s
dil ator.

W ith double
 Base

C- He gar
(F enton) d il ator.
With one size end.

Tip
 Non toothed

3- Ti ssue
Toothed
for ceps:
A- Non toothed for
catching fine structure
as intestine, bladder or
tube.
B- Toothed for catching
tough structure as skin,
tendon or muscle.
Non toothed Toothed
 Tip
4- Fistul ae
di r ector :
In ser tio n i nsid e
Shaft
•fistulae tracts before (grove)
fistulotomy.
•Inside constricting
hernia ring. Base
•Its handle (base) may
used in tie tongue
5- Scal pel
handl e.

For scalpel insertion

 Encircling the
rib

6- Rib di ssector :
*For separation of the rib
from its bed
Handle
 Sharp edge

7- Peri ost eal

el eva tor :
* For elevation of
periosteum as in amputation
Handle
 Opening for thread insertion

8- An eur ysm
needl e:
* For encircling vessel or
tubular structure with a

Handle
 Spoon

9- Cur ette
Handle
spoon (Bo ne
cur ett e).
*Curettage for chronic
ulcer, sinus or chronic

Spoon
9- Circumcision
device
III- RUBER INSTRUMENTS.
1- Cor r uga ted
r ub be r dr ai n:
*Advantages.
Simple, Not expensive .
*Disadvantages.
Introduce infection and we
can not measure the
amount of discharge.
2- Vacuum drain
(Negative pressure):
*Closed system,
not introduce infection from
outside
* measure the amount of
discharge.
*But may lead to
visceral injury if present
intra-peritoneal by negative
suction and expensive.
*O th er
typ es o f
drain :
--Sump
drain
-- T ube
drain
-*
In dic ations
3- Flui d
inf usio n
set: Needle Lock Bulb

•For intravenous
infusion of any
fluid as glucose
and saline.
•*Another type
for blood with
large needle and
filter inside its
4-Blood infusion set
5- Selo ce t (infusi on set for
neona tes & chil dr en)
6-Ca thet er s: Tip

A- Foley (self
retaining). For balloon
inflation
With double or triple
ways. Balloon
Distal end

Left inside the

bladder for
Tip
time.
Tip
B- Nelaton.
Removed after
evacuation of the
bladder.
Nelaton
C- Depezer catheter.

head
7- Rayel Distal end
tube: Rayel

•For gastric
aspiration.
•- After laparotomy Catheter
•- Intestinal
obstruction
•- After anastomosis

•* Difference between
it and Nelaton
catheter?
•*Importance of
aspiration?
8- T - tub e

Horizontal limb
Vertical limb
8- Collecting bag.
Are you know this instruments?