MAJOR AND MINOR INSTRUMENTS

Objectives
At the end of the lesson the students will be
able to:
1. Describe surgical instruments and the different
classifications
2. Know the different Instruments used in Obstetric and
Gynecologic procedures
3. Identify major and minor instruments and their uses

 SURGICAL INSTRUMENT
• Surgical instruments are specially designed tools that assist
health care professionals carry out specific actions during an
operation

• Most instruments crafted from the early 19th century on are

made from durable stainless steel.

• Some are designed for general use, and others for specific
procedures.

 4 MAJOR SURGICAL INSTRUMENT

CLASSIFICATIONS

1. Cutting and Dissecting

2. Clamping and Occluding
3. Retracting and Exposing
4. Grasping and Holding

 1. Cutting and Dissecting

• These instruments usually have

sharp edges or tips to cut
through skin, tissue and suture
material
• These instruments have single or
double razor-sharp edges or
blades.

2. Clamping and
Occluding

• Are used in many surgical

procedures for compressing blood
vessels or hollow organs, to prevent
their contents from leaking.
• They are either straight, curved or
angled, and have a variety of inner
jaw patterns..

3. Retracting and
Exposing

• These surgical instruments are

used to hold back, or retract organs
and tissue so the surgeon has
access to the operative area.

• They spread open the skin, ribs and

other tissue; and are also used
separate the edges of a surgical
incision.

4. Grasping and
Holding

• These instruments, as their name

suggests, are used to grasp and
hold tissue or blood vessels that
may be in the way during a surgical
procedure.

• Forceps are a very good example of

these types of instruments.

INSTRUMENTS USED IN
GYNECOLOGY AND
OBSTETRICS
• are instruments used for
uterine and caesarian birthing,
hysterectomy and
other obstetrics and
gynecology surgery.

 1. KNIFE AND HANDLE BLADE

• Used with the rounded portion of the blade
rather than the point. To cut the tissue very
little pressure is required
• Surgical scalpels consist of two parts, a
blade and a handle.
• The handles are reusable, with the blades
being replaceable.

• Size of the blade does not change

the technique of its use
• Double-edged scalpels are referred
to as lancets
• Scalpels may be single-use
disposable or re-usable.

• #7 knife handle with 15 blade

(deep knife) - Used to cut deep,
delicate tissue.
• #3 Knife handle with 10 blade
(inside knife) - Used to cut
superficial tissue.
• #4 handle with 20 blade (skin
knife) - Used to cut skin.

KNIFE AND HANDLE BLADE

 2. STRAIGHT MAYO SCISSOR

• Straight Mayo scissors are generally used near the surface of
a surgical wound to cut fascia and muscle layers.

 3. CURVE MAYO
SCISSOR
• allow deeper penetration into
the wound and often used in
the cutting of fascia.
• Used to cut heavy tissue .
• Available in regular and long
sizes.

 4. METZENBAUM
SCISSOR
• The most common scissors used
for cutting tissue. Used to cut
delicate tissue, more delicate
than Mayo scissors. Available in
regular and long sizes, curved or
straight.
• have a longer handle to blade
ratio.

4. EPISIOTOMY SCISSOR
• This is used for giving
episiotomy.

 5. ARTERY FORCEPS

• This is a hemostat used for

clamping bleeding vessels.
• It is also used for grasping tissue
at the time of operation( opening
and closing peritoneum) .
• It is also used to hold stay
sutures.

 6. ALLIS' FORCEPS
• This instrument is used
for grasping tough
structures like Rectus
sheath or fascia in
operations like
tubectomy, LSCS and
abdominal
hysterectomy.

 7. AYRE'S SPATULA
• Used for taking Pap
Smear for screening of
carcinoma cervix.

• Made of wood so that

cells can adhere to its
porous surface.

 8. BABCOCK’S FORCEP
• Used for grasping tubular
structure like fallopian tube in
tubectomy.
• The tip is atraumatic as there are
no sharp tooth

 9. BAND APPLICATOR FOR

LAP TL
• This instrument is used for grasping
tubular structures like fallopian tube
in tubectomy in modified Pomeroy's
operation , ureter ,appendix etc.
• The tip is atraumatic as there are no
sharp tooth.

 10. CUSCO SPECULUM

• Used in OPD for routine
examination.
• Because of limited opening
only few procedures like taking
of Pap smear , insertion and
removal of Copper T can be
done.

CUSCO SPECULUM

11. DOYENS RETRACTOR

• This instrument is used for
retracting bladder during
abdominal operations like LSCS ,
abdominal hysterectomy ,
laparotomy.

DOYENS RETRACTOR
12. DEAVER RETRACTOR
• A Deaver retractor (manual)
is used to retract deep
abdominal or chest incisions.
• retraction of deep structures

DEAVER RETRACTOR

 13. GREEN ARMYTAGE

FORCEP
• It has a bulb below the tip. This
can be inflated by normal saline.

• This forceps is used as a hemostat

in caesarean operation.

 14. HEGAR’S DILATOR

• Its a long rod like instrument with
gentle curve and tapering tip. It is
used for dilatation of the cervix in
procedures like D&C , D& E ,
Fothergills operation ,
Hysteroscopy , Cervical Stenosis ,
Primary dysmenorrhoea.

HEGAR’S DILATOR

15. KOCHER’S FORCEPS

(CLAMP)
• This is used for holding pedicles in hysterectomy.
• Tips of the blades have teeth so that the tissue
does not slip.
• Blades can either be straight or curved.
• Used in hysterectomy to clamp pedicles which
are then transfixed.
• Used for salpingectomy in ectopic or
oophorectomy in ovarian mass.

KOCHER’S FORCEPS (CLAMP)

16. KARMAN’S
REGULATION
• This syringe is used for
menstrual regulation and
endometrial aspiration.

17. RUBINS CANNULA

• This cannula is used for tubal
patency test for infertility like HSG
(hysterosalpingo graphy ) or
Chromo perturbation in
laparoscopy.
• In HSG radio opaque iodine
• ( Urographin) is used ( it is colorless
to naked eye but on X Ray is seen
as opaque white)

18. LEECH
WILKINSON’S
CANNULA
• This cannula is also used for
tubal patency .

• It is straight instrument with

conical tip. This cone is
screwed into the cervix. Then
dye is injected.

 19. SPONGE HOLDING

FORCEPS
• This instrument is used for holding sponge
or a gauze piece for painting the area
before operation. This is also used for tissue
dissection when used as sponge or holder .

• This also used for grasping the cervix is

obstetrics in Os tightening operation. .

 20. SUCTION CURETTE

• This instrument is used for first trimester
MTP, suction of vesicular mole. It is
numbered as per outer diameter.

• The size of the cannula selected is equal

to no. of weeks of pregnancy.

• The tip is blunt ( to prevent perforation )

below the tip are two sharp openings for
suction and curetting the cavity.

SUCTION CURETTE

 21. CHROMIC CATGUT ( ONE

ZERO )
• This is an absorbable suture manufactured from
gut of large animals.
• The chromic catgut is brown in color and is
treated with chemicals to delay the absorption up
to 7 days.
• This suture material is used most commonly for
suturing of episiotomy, perineal tares, tubal
ligation with modified Pomeroy's Method, for
closing peritoneum in LSCS and hysterectomy.

 22. PLAIN CATGUT

• This is a rapidly absorbable suture
(absorbed in 7 days ) , yellow in
color , used sometimes for
approximation of sub cutaneous
fat

 23. VICRYL ( ONE ZERO ON

ROUND BODY)
• This is a synthetic delayed absorbable suture
colored violet. This get absorbed after 90 days.

• It causes less tissue reaction than catgut and

maintains strength for longer time than catgut.

• It is used for suturing uterus in LSCS and tying

pedicals in Hysterectomy. Ethilon (No One on
Curve cutting needle)

24. TROCAR AND CANNULA

TROCAR
• It is also called port ( port of entry to
telescope and other instruments.) It is
numbered as per outer diameter. 10
mm is used for operative telescope, 7
mm is used for Band Applicator and for
Tubal Ligation, 5mm is used for other
hand instruments like grasper etc.

 TROCAR AND CANNULA

TROCAR
 25. UMBILICAL CORD
CUTTING SCISSORS
• The tip is angled by about 15 degrees
for easy scraping.
• The tip comes in two shapes. Sharp
and Blunt. Sharp curate is used in
gynecology and blunt in pregnancy
check curettage. Diagnostic D&C is
done commonly for Menorrhagia,
Endometrial Carcinoma,
I n fe r t i l i t y ,Tu b e r c u l o s i s o f
endometrium .

 26. TENACULUM BLADDER

SOUND
• It is long instrument with gentle curve ( not angled like
uterine sound) and has no markings on it.
• It is used to define extension of bladder cystocele and
vaginal hysterectomy.
• This instrument is used for grasping the cervix ( Usually
anterior tip of the cervix is grasped) Its a long
instrument with gentle curve so that the line of vision is
not obstructed.

TENACULUM BLADDER SOUND

 27. WRIGLEY'S FORCEPS

OBSTETRIC FORCEPS
• Used for outlet forceps delivery. It has pelvic
curve. Parts of the forceps are blades ( which
has windows or fenestrate for firm grip of the
head) ,
• Other name: Shank , Lock( English lock for
Wriglys forceps) , Handle.

WRIGLEY'S FORCEPS OBSTETRIC FORCEPS

 28. BURLISHER
FORCEPS
• 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

 29. KELLY

• is used to clamp larger vessels and

tissue. Available in short and long
sizes.

• Other names: Rochester Pean

KELLY
 30. MOSQUITO
• is used to clamp small
blood vessels.

• Its jaws may be straight or

curved

MOSQUITO