SURGICAL INSTRUMENTS Surgery Trans Peeps

TERMINOLOGIES
Atraumatic Use of instrument with built-in suture
Traumatic Use of conventional needle
Dilation Enlarging an opening in a progressive manner
Process of separating tissues through anatomic planes by using
Dissection
sharp or blunt instrumentation
Grasping Holding in a traumatic or atraumatic manner
Retraction Stabilizing a tissue layer in a safe position for exposure of a part
Instrument with a cutting edge or pointed tip(s) that is used to cut
Sharp
or dissect tissue
A device used for penetration of tissue layers
Commonly used for percutaneous endoscopy
Trocar Used as a temporary pathway for gases, other instrumentation or
the removal of an organ or substance
CLASSIFICATION OF INSTRUMENTS
Cutting & Dissecting Suctioning & Aspirating
Grasping & Holding Dilating & Probing
Clamping & Occluding Measuring
Exposing & Retracting Accessory Instruments
Suturing & Stapling Microinstrumentation
Viewing
 CUTTING AND DISSECTING
 Always look at the tip between #3
and #4, mas maliit ang tip ng #3,
1. SCALPEL (Blade Holder and Blade) and obviously, iba ang over-all
structure ng #7

 Goes with
blade #3/#7
(pero mostly
#3)

 Goes with
blade #4

Blade Blade Blade

holder #3 holder #4 holder #7
CUTTING AND DISSECTING
1. SCALPEL (Blade Holder and Blade)

When identifying scalpels, ganito isusulat

mo: Blade holder #__ with blade #__ (or the
other way around) 

You don’t identify it using its nickname e.g.

Stab knife, unless stated otherwise (BIG NO,
NO! LAGOT KA KAY DOC MATA HAHA  )

Memorize this!!!
CUTTING AND DISSECTING
1. SCALPEL (Blade Holder and Blade)

ACTUAL INSTRUMENT. LOOK AT THE TIP!

CUTTING AND DISSECTING
2. SCISSORS
Either curved or straight Bandage Scissor Stitch Scissor

Dalawang scissor lang ang hindi curved: Bandage and

Stitch

Ganito pag-identify ng scissors: Curved/Straight

_________ Scissors (wag mong kalimutan yung
“SCISSORS” na term)

Di mo na kailangan lagyan ng word na “Straight” yung

sa bandage and stitch 

During the exam, you have to look closely talaga to

know if the instrument is straight or curved WITHOUT
TOUCHING IT!
ACTUAL INSTRUMENTS
CUTTING AND DISSECTING
2. SCISSORS
MAYO
 Used for tough tissue &
heavy fascia (Curve)
 Used to cut sutures
(Straight)
 Used by Ob-gyn to cute
ligaments
 Remember: Mas mataba to  Straight  Straight
 Mukhang mayo to,
so mas malaking tissues
Curved hindi iris
ACTUAL INSTRUMENTS
CUTTING AND DISSECTING
2. SCISSORS
METZENBAUM/ METZ
 Used for delicate tissues; more
delicate than Mayo
 Plastic Surgery
 Longer handle to blade ratio
 Handle is thinner than that of Mayo
 Not used for cutting sutures
(merong intended for that hehe  )
 Remember: Mas mapayat to so mas Curved
delicate/maliliit tissues Straight

ACTUAL INSTRUMENTS
CUTTING AND DISSECTING
2. SCISSORS
TENOTOMY/ STEVENS
 Can be curved or straight
 Used for Plastic Surgery or
for Optha
IRIS
 Mainly used in ophthalmic  Straight  Curved
 Straight  Curved (ACTUAL)
surgery
 Parang sa blade holder
lang, look at the tip! Iris
Tenotomy
Para madifferentiate. 
CUTTING AND DISSECTING
3. BONE CURETTE
Used in orthopedic
and neurosurgery for
laminectomy
May be straight or
angulated (for spine
surgery)
Laminectomy -
removal of
intervertebral disk to
remove tissues and
debris
ACTUAL INSTRUMENT
CLAMPING AND OCCLUDING
Used to compress blood vessels or hollow organs for hemostasis or for
preventing spillage of contents
A.k.a. hemostat
Also used to tag sutures
Straight or curved
Many hemostatic forceps bear the name of the designer (Kelly, Halsted,
Crile)
Each are classified by size, shape, and size of tip
CLAMPING AND OCCLUDING
1. MOSQUITO FORCEP
Used to clamp small blood vessels e.g. small arteries
Its jaws may be straight or curved
More delicate and has a smaller and finer tip than Kelly
Pag sasagutin sa exam eh ganito: Straight/Curved
Mosquito Forcep (same goes with the other forceps )
Jaw-handle ratio: almost 1/3 ng handle yung jaw

Curved Straight

ACTUAL INSTRUMENTS

 Remember: Fully serrated ang mosquito than

Kelly. 
 CLAMPING AND OCCLUDING
2. KELLY FORCEP
Used to clamp largerblood vessels
Available in short & long sizes
Usually half/incompletely serrated
Pag half-serrated, 90% most likely Kelly
na yun!
Jaw-handle ratio: almost 2/3 ng handle
yung jaw

 Remember:  Check niyo dissecting set

Kelly-hating niyo, meron dun straight and
serration  curved.  Hehe
CLAMPING AND OCCLUDING
3. PERITONEAL FORCEP
Also called as Pean Forcep/ Rochester Pean/
Crile (though peritoneal forcep is a general term
for all the forceps used on peritoneum, try mo
hanapin sa Google using this term, iba’t ibang
klaseng peritoneal forcep lalabas, pero sabi ni
doc mata peritoneal forcep daw eh,eh di yun
isagot haha  )
Can be curved or straight
Full serration on the jaw (just like the
mosquito, mas malaki nga lang ito)
Jaw-handle ratio: equal

ACTUAL INSTRUMENT
CLAMPING AND OCCLUDING
4. MIXTER FORCEP 5. CRUSHING CLAMP (PAYR PYLORUS CLAMP)
90 degrees angle of the jaw Used to occlude the end of the bowel to be resected

Walang straight/curved niyan (utang na loob, No serrations (w/c may destroy blood vessels)
wag mong ipilit haha)

6. NON-CRUSHING CLAMP (DOYEN INTERSTINAL CLAMP)

 Used to temporarily occlude lumen of bowel
CLAMPING AND OCCLUDING
7. KOCHER (OCHSNER) FORCEP
Also classified as a holding/grasping instrument
Can be straight or curved
HOLDING AND GRASPING
Used to hold tissue, drapes or sponges
May have teeth, serrations, or may have smooth edges
Can be curved or straight
HOLDING AND GRASPING
1. THUMB FORCEP 2. TISSUE FORCEP
 Used for grasping and holding tissue, muscle
Consist of two tines held together at one or skin surrounding a wound
end with a spring device that holds the tines
 Has teeth which prevents it from slipping
open
 Rat-tooth: Interdigitating teeth to hold tissue
To be used in handling vital structures, without slipping
those which should not be perforated
Have smooth or smoothly serrated tips

3. ADSON/ DURA FORCEP (mataba na

pumayat!!!)
 Smooth: used to grasp delicate tissue; or
 With teeth: used to grasp the skin
HOLDING AND GRASPING
4. ALLIS FORCEP
Its tip consists of apposing serrated
edges with fairly short teeth
Slightly traumatic
Used for grasping fascia or breast
tissue
Used for traction on the skin (not
applied directly to the skin but rather
on the tissue immediately beneath the
skin )
May also be used to hold wound
drapes in place
ACTUAL INSTRUMENT
HOLDING AND GRASPING
5. THYROID TENACULUM
Bite deep into the thyroid
tissue so that traction can
be exerted on the gland
without ripping it
“fork-like”, bent teeth
Teeth are longer and
fewer as compared to Allis

ACTUAL INSTRUMENT
HOLDING AND GRASPING
4. BABCOCK FORCEP
More delicate than Allis, less
directly traumatic
Broad, flared ends with smooth
tips
Used to atraumatically hold
viscera (bowel and bladder)
5. KOCHER (OCHSNER) FORCEP
 The blades have transverse serrations
running along the full length and long
sharp points are found at the tips.
 Has considerable grasping power and
allows one to exert a considerable
amount of tension on tissues.
 Commonly used on heavy fascia or
bone
 HOLDING AND GRASPING
Smooth/ Without serration
6. OVUM (SPONGE) FORCEP
Can be straight or curved
Can have smooth or serrated jaws
Used to atraumatically hold viscera
(bowel and bladder); Used after D&C
(dilatation and curettage)
Used to hold the sponge when
prepping
Other names: Sponge stick, Fletcher,
Ring forceps, Foerster Sponge, Pick-up

With serration
ACTUAL INSTRUMENT
 HOLDING AND GRASPING
7. TOWEL CLAMP/ CLIP 8. LUNG/ HEMORRHOIDAL FORCEP
 Grasp hemorrhoidal varicosities or lung
Adds weight to drapes and
tissue prior to excision
towels to ensure they stay in
 Triangular, serrated jaws
place
Allow exposure of the
operative site

Backhaus (Penetrating) Edna (Non- ACTUAL INSTRUMENT

ACTUAL INSTRUMENT penetrating)
EXPOSING AND RETRACTING
1. MANUAL RETRACTOR
A. Zenn (Senn) retractor
Usually used in hand and foot
surgeries
Double-ended
Blades at each end; can be blunt
(delicate) or sharp (more traumatic,
used for fascia)
1st end: L shaped
2nd end: Three bent prongs-may be
sharp or dull
ACTUAL INSTRUMENT
EXPOSING AND RETRACTING
C. Richardson
1. MANUAL RETRACTOR Retractor
 Used to retract
B. Army Navy Retractor deep
(Nagutom tuloy ako T-T) abdominal or
chest incisions
Used to retract shallow or
superficial incisions
D. Farabeuf Retractor
EXPOSING AND RETRACTING
1. MANUAL RETRACTOR F. Malleable/ Ribbon Retractor
 Used to retract deep wounds
E. Deaver Retractor
 May be bent to various shapes
Used to retract deep abdominal
or chest incisions
Available in various widths
EXPOSING AND RETRACTING
G. Goulet Retractor
To retract shallow or superficial incisions

H. Skin/ Hook Retractor

EXPOSING AND RETRACTING
B. Mastoid/ Jansen Mastoid Retractor
 Used in mastoid surgeries
2. SELF-RETAINING RETRACTOR
A. Weitlaner Retractor
Ends can be blunt or sharp
Has rake tips
Ratchet to hold tissue apart

ACTUAL INSTRUMENT
EXPOSING AND RETRACTING
D. Balfour Abdominal Retractor
2. SELF-RETAINING RETRACTOR  Used to retract wound edges during deep
C. Gelpi perineal retractor abdominal procedures

Has single point tips. Bladder blade 

Ratchet to hold tissue apart.

E. Finochietto Retractor
 Separate ribs in thoracic surgery
 “rib spreader
VIEWING
1. HOLLOW ENDOSCOPES
Permits viewing in a forward direction with a light carrier supplied by a
fiberoptic cable that provides illumination

2. LENSED ENDOSCOPES
Have either rigid or flexible sheaths
Used in combination with video-assisted technology
Can record action videos and stills
VIEWING
3. NASAL SPECULUM 4. VAGINAL SPECULUM 5. RECTAL SPECULUM

ACTUAL INSTRUMENTS
VIEWING
6. ANOSCOPE WITH OBTURATOR
Visualize rectum and the lumen of the sigmoid colon
For the examination of the anal canal and the distal aspect of the
rectum
Consists of a stylus or removable plug (Obturator) which is used
during the insertion of many tubular instruments (Anoscope)
SUTURING AND STAPLING
1. NEEDLE HOLDER
Tungsten carbide jaws –eliminate the
twisting and turning of the needle
Crosshatched serrations –provide a
smoother surface and prevent
damage to the needle  Smooth jaws
Smooth jaws –used with small  With crosshatched serration
needles such as those used for plastic
surgery
Use: Hold and pass a suturing needle
through tissue
Short jaws as compared to the shank
Has groove on its jaws

ACTUAL INSTRUMENTS
SUTURING AND STAPLING
2. STAPLER/ STAPLES
Clip appliers
Terminal end
Internal anastomosis
End-to-end circular

A. Intestinal Stapler
SUTURING AND STAPLING
B. Skin Stapler

ACTUAL INSTRUMENT
SUTURING AND STAPLING
C. End to End Anastomosing Stapler

D. Staples Remover
ACTUAL INSTRUMENT
DILATING AND PROBING
Instruments used to enter natural openings such as the common bile duct or fistulas
Dilating instruments expand the size of an opening, such as the urethra or the cervical os

1. GROOVE DIRECTOR 2. PROBE

 To explore the depth and direction of body
ducts, sinuses, or cavities
 To aid in dilating or irrigating an area of the
body, such as a duct
SUCTIONING AND ASPIRATING
1. SUCTION APPARATUS
MEASURING
1. CALIPERS
ACCESSORY INSTRUMENTS

1. CAUTERY MACHINE
MICROINSTRUMENTATION
REMINDERS!!! 
1. NEVER EVER INTERCHANGE BLADE HOLDER NUMBER WITH ITS
CORRESPONDING BLADE NUMBER!!!
 WHAT HAPPENS IF YOU DID INTERCHANGE?
REMINDERS!!! 
2. When asked what classification does the instrument belong, NEVER
EVER FORGET TO WRITE THE WORD “INSTRUMENTS.”
 Or else, you’ll only get 0.5 point
REMINDERS!!! 
3. When an instrument can be further classified as straight or
curved, WRITE STRAIGHT OR CURVE! (NEVER PLACE IT IN A
CLOSED/OPEN PARENTHESIS)
 Or else, you’ll only get 0.5 point
GOODLUCK AND GODBLESS fin