Instruments

NEET PG Image Guide

Retracting and Exposing Instruments
Doyen Retractor

Used for retracting Bladder

 Deaver Retractor

Deaver Retractor (Manual)

Used to retract deep abdominal or Chest Incisions

Available in various widths
 Richardson Retractor

Richardson Retractor (Manual)

Used to retract deep abdominal or Chest Incisions
 Army-Navy Retractor

Army-Navy Retractor (Manual)

Used to retract Shallow or Superficial incisions
 Goulet Retractor

Goulet Retractor (Manual)

Used to retract Shallow or Superficial incisions
 Ribbon / Malleable Retractor

Malleable or Ribbon Retractor (Manual)

Used to retract Deep incisions

May be bent to various shapes
 Weitlaner Retractor

Weitlaner Retractor (Self Retaining)

Used to retract Shallow incisions
 Gelpi Retractor

Gelpi Retractor (Self Retaining)

Used to retract Shallow incisions
 Balfour with Bladder Blade Retractor

Balfour with Bladder Blade (Self Retaining)

Used to retract edges in deep abdominal procedures
Cutting and Dissecting Instruments
 Knife Handle & Blade

For Deep / Superficial Incisions

Comes in Different Sizes

Handle Size 7 with Blade Size 15 Used for Deep Tissue

Handle size 3 with Blade Size 10 Used for Superficial tissue

Handle size 4 with Blade size 20 to cut skin
Straight Mayo Scissors

To cut sutures and supplies

 Curved Mayo Scissors

To cut heavy tissue (Fascia / Muscle / Uterus / Breast)

Available in various sizes
 Metzenbaum Scissors

To cut delicate tissue

Have longer handle to blade ratio than Mayo ( Handles are longer)

Blunt Ends
Clamping and Occluding Instruments
Curved Mosquito Hemostat

Used to hold delicate tissue Used to compress bleeding vessels

Jaws are fully serrated
 Kelly Hemostat

•.Used to clamp smallvessels or hold tissue

•Jaws are partially serrated .
•Curved or straight
Hemostat, Mosquito and Kelly
 Burlisher

•A burlisher is used to clamp deep blood vessels.

•Burlishers have two closed finger rings.
•Burlishers with an open finger ring are called tonsil hemostats.
•Other names: Schnidt tonsil forcep, Adson forcep
 Right Angle Clamp

• A right angle is used to clamp hard-to-reach vessels and to place sutures behind or
around a vessel.
• A right angle with a suture attached is called a "tie on a passer."
• Other names: Mixter.
 Hemoclip Applier with Hemoclips

A hemoclip applier with hemoclips applies metal clips onto blood vessels and ducts
which will remain occluded.
Grasping and Holding Instruments
 Allis Tissue Forceps

•Allis is used to grasp tissue.

•Available in short and long sizes.
•A Judd-Allis holds intestinal tissue
•A heavy Allis holds breast tissue.
 Babcock Forceps

Used to grasp delicate tissue (intestine, fallopian tube, ovary).

Available in short and long sizes.
 Kocher Forceps

•Kocher Forceps used to grasp heavy tissue.

• May also be used as a clamp
• The jaws may be straight or curved.
•Other names: Ochsner
Foerster Sponge Forceps

Used to Grab Sponge

Backhaus Towel Clip

Used to hold towels and drapes in place

Russian Tissue Forceps

Are used to grasp tissue

 Adsons Pick up Forceps

•Are either smooth: used to grasp dericate tissue;

• With teeth: used to grasp the skin.
•Other names: Dura forceps.
Dressing Forceps

Long and Smooth Pick Ups

 De Bakey Forceps

Used to pickup delicate tissue especially in cardiovascular surgery

 Thumb Forceps

•Are used to grasp tough tissue (fascia, breast).

•Forceps may either have many teeth or a single tooth,
•Single tooth forceps are also called "rat tooth forceps."
Mayo Hegar Needle Holder

Used to hold needles when suturing.

 Transfer Forceps Holder

•When sterile, transfer forceps;

•Arrange items on sterile tray
•Transfer items to sterile field
Splinter Forceps

Fine tip for foreign object retrieval

Walter Splinter Forceps

Very Fine tip (Spearhead Design)

 Toothed Forceps

•Used for grasping and holding tissue, muscle or skin surrounding a wound
•Single toothed on one side; fits between two teeth on the other side
•Available as 1x2 or 2x3 or 3x4
 Plain Thumbs Forceps

•Used to hold tissue in place when applying sutures

•Used to gently move tissues out of the way during exploratory surgery
•Used to insert packing into or remove objects from deep cavities
 Skin Hook

•Flat end is a blunt retractor

•Three-prong end may be sharp to dull
•Used to retract small incisions or secure a skin edge for suturing
 Iris Suture Scissors

•Used to remove sutures

•Blade has beak or hook to slide under sutures
 Lister Bandage Scissors

•Used to remove bandages and dressings

•Probe tip is blunt and inserted under bandages with relative safety
 Sim’s Speculum

•Also called Duck Bill Speculum

• Used to retract vaginal wall (Usually Post wall)
• Double / Single ended (Blades atraumatic and rounded)
• Handles slightly concave to collect drained blood and secretion
 Cusco’s Bi-valved Speculum

•Self retaining bi-valved speculum

• Cervical and vaginal inspection
• Used for pap smear , cervical Bx, Colposcopy
• Handles slightly concave to collect drained blood and secretion
Fergussons Tubular vaginal speculum
Auvard’s Weighted self retaining speculum
Soonawala’s self retaining Vaginal speculum
 Sim’s Anterior Vaginal wall retractor

•Spoon shaped ends with transverse serrations

• Loop makes an angle of 150 with the shaft
•Retraction of anteriorvaginalwall in conjunction with Sim's Speculum.
 Blake’s Uterine Curette

•Central shatt, one sharp end and one blunt end

• Used for Curetting Uterus in DUB
 Endometrial Biopsy Curette

•Diagnosis of DUB and Infertility

•Endometrial dating to diagnose anovulation/LPD
•Can also act as a uterine sound
Leesch Wilkonson’s Cannula

Used in HSG, Chromopertubation and Rubin’s Test

 Hegar Dilator

•3mm to 26mm
•Double ended with difference of 1 mm between the ends
• Used for D&C and other various Hysteroscopic procedures
Hawkin Ambler dilator

Markings indicate circumference in mm

 Purandare’s dilator

Cervical dilator has a guard and long tapering end

 Uterine Sound

•Blunt tip with bend of 30 degrees 5 cm from end

• Angle helps to negotiate the curvature of uterus
• Used for measuring uterocervical length
 Bladder Sound

• Gentle curve with no markings on it

• Used to define extension of bladder cystocele and vaginal hysterectomy
 Green Armytage Forceps

•Triangular tips with transverse serrations

•To hold cut edge ofthe lower segment after delivery of fetus
•Atraumatic and hemostatic
•Used in place of sponge holding forceps in for tracing cervicalt ears
 Haywood Smith’s Ovum Forceps

•Spoon shaped ends

•No lock, so no crushing action
•Uses
•1st trimester MTP: removalof POC aftercervical dilatation
•2nd trimester MTP: removal of retained bits of placenta
• Removal of pedunculated polyps
 Vulsellum

Hold the anterior lip of cervix

Cervical Punch Biopsy

To Take Punch Biopsy of Cervix

 Busch’s Episiotomy Scissors

•Length 16 cm Sterilized by glutaraldehyde (Cidex)

•Shape allows easy introduction into the vagina and prevents erratic cutting
•Angle prevents butting of the instrument against the patient's buttocks
 Umbilical Scissors

•10.5 cm
•Blades are so curved such that on closing they meet at the tip which prevents the
cord from slipping during cutting
Midcavity Forceps
Wrigley’s Outlet Forceps
Comparison of Various Forceps

Left – Outlet Forceps

Middle – Low or Midcavity Forceps
Right- Rotational Forceps
Ventouse Cup
 Obstetric Hook with Crochet

•Hook is used to apply groin traction in dead fetus

•Hook is also used to pull down the leg of a dead fetus in transverse lie
•Crochet is used to apply traction on fetal lower jaw, orbit, foramen magnum etc to
extract decapitated head.
•Crochet is also used to apply traction on fetal head after craniotomy
 Simpson Perforator

•28.5 cm long Blades with triangular tips and outer cutting edge
•Blades are locked with a locking system
•Flat spring is present between the handles for bringing the blades back into their
original place
• Used for Craniotomy and fetal evisceration of thorax/abdomen.
 Cranioclast

•42 cm long
•Used to crush the vault and base of dead fetal skull for extraction thereafter
Oldham’s Perforator
Willet’s Scalp Traction Forceps
 Copper T (Cu 380 A)

•42 cm long
•Used to crush the vault and base of dead fetal skull for extraction thereafter
 Heaney’s Hysterectomy Clamp

•Ridge on one blade and a notch on the other

•No teeth The curve is facing is facing the structure to be removed so that the ligature
can be passed around the clamp
 Uterine Polyp Forceps

Curved Grasping forceps having serrated rounded edges

 Dartigue Uterus Holding Forceps

•Blades curved in opposite direction in shape of question mark

• Blades usually covered by rubber cap
• Used to Hold and Steady uterus during various surgeries
 Cheatle Forceps

•Curved forceps with serrations

• No Lock
• Picking and transfering sterilized linen or instruments from one tray to another
Ayre’s Spatula

Used for PAP smear

Langenbeck Right angled Retractor

Used in tubectomy
 Karman’s Syringe

Used for menstrual regulation and endometrial aspiration

 Veress Needle

Used for creating a pneumoperitoneum

Karman’s Cannula

Used for Suction and Evacuation

Rubin’s Cannula

Test for tubal patency

Shirodkars Cerclage Needle

Putting stitch around cervix

Trocar and Cannula

Abdominal Laproscopy
IUCD Removing Hook
Doyen’s Myoma Screw
Bonney’s Myomectomy Clamp
Pinnard’s Fetal Stethoscope

Auscultation of fetal heart

Misc Instruments
 Ear Curette

•Can have sharp or blunt scraper ends

•Used to remove ear wax from ear canal
 Nasal Speculum

•Used to spread nostrils during examination

 Anoscope with Obturator

•Used to visualize the rectum and lumen of the sigmoid colon

•Used to examine anal canal and distal aspect of the rectum
•Consists of a stylus or removable plug (obturator) used during the
insertion of many tubular instruments (Anoscope).
Skin Stapler & Remover