COMMON SURGICAL INSTRUMENTS

The operating room contains a multitude of instruments fit for accomplishing a number of procedures. Note
that this is not an exhaustive list of instruments, but rather some that you will encounter frequently.

SCALPEL
Used for initial incision
and cutting tissue.
Consists of a blade and
a handle. Surgeons #10 Blade: Used primarily for #11 Blade: Used for making #15 Blade: Smaller version of
often refer to the making large skin incisions, precise or sharply angled #10 blade used for making finer
instrument by its blade e.g., in laparotomy. incisions. incisions.
number.

Pott’s Scissors:
Fine scissors used
for creating
SCISSORS incisions in blood
vessels.
Used for cutting tissue,
suture, or for Iris Scissors: Used
dissection. Scissors Mayo Scissors: Heavy scissors Metzenbaum Scissors: Lighter
for fine dissection
available in multiple varieties. scissors used for cutting delicate
can be straight or and cutting fine
Straight scissors are used for tissue (e.g., heart) and for blunt
curved, and may be cutting suture (“suture scissors”), dissection. Also called “Metz” in
suture. Originally
used for cutting heavy for ophthalmic
while curved scissors are used practice.
or finer structures. procedures, but
for cutting heavy tissue (e.g.,
now serves
fascia).
multipurpose role.

Bonney DeBakey Russian

Forceps: Forceps: Forceps:
Heavy Used for Used for
Tissue Forceps: Non-toothed atraumatic
FORCEPS forceps used for fine handling
forceps
used for tissue
atraumatic
tissue
Also known as non- of tissue and traction during holding grasping grasping
locking forceps, dissection. thick tissue during during
grasping forceps, (e.g., fascial dissection. dissection.
thumb forceps, or closure).
pick-ups. Used for
grasping tissue or
objects. Can be toothed
Adson Forceps: Forceps
(serrated) or non-
toothed at the tip used for
toothed at the tip. handling dense tissue, such as
in skin closures.

Crile Kelly Kocher Allis and

Hemostat: Clamp: Clamp: Babcock
aka “snap,” Larger size Traumatic Clamps:
CLAMPS atraumatic
and non-
variation of
hemostat
toothed
clamp
Slightly
rounded
Also called locking toothed with used to jaws,
forceps, these are clamp used to similar hold both are
ratcheted instruments grasp tissue function tissue used for
used to hold tissue or or vessels for that will grasping
objects, or provide that will be grasping be intestine.
hemostasis. Can be tied off. Also larger removed.
traumatic or atraumatic. used in blunt tissues or
dissection. vessels.

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 COMMON SURGICAL INSTRUMENTS
Needle Types Suture Sizing Suture Types
Needles must dissect through tissue to pass Available in sizes between #5 There are two main types of
suture. They come in various sizes, types, and and #11-0. Higher numbers suture. The first is braided and
NEEDLES & shapes depending on the application. Here are a indicate larger suture non-braided, or monofilament.
few (though not all) examples:
SUTURE diameter (e.g., #3 is larger
than #2), and more zeros
The second is absorbable and
non-absorbable. Additionally,
Needles come in many indicate smaller suture suture can be made with
shapes and cutting diameter (e.g., #4-0, or natural or synthetic materials.
edges for various #0000, is smaller than #3-0, Some (brand) names and uses
applications. Suture or #000). are shown below.
can be absorbable, non Tapered Needle Conventional Cutting
Needle is round and Needle Suture Types
absorbable, and is tapers to a simple point. Needle is triangular with Absorbable Non-Absorbable
available in different Most commonly used in sharp edges, and one edge
Braided Monofilament Braided Monofilament
sizes. softer tissue such as faces the inside of the
intestine but may also be curved needle. Used for Vicryl® Monocryl® Silk Prolene®
used in tougher tissue tougher tissues such as Polysorb® Maxon® Surgipro®
such as muscle. skin. PDS® Monosof®
Needle Shape Chromic gut Nylon
The shape of the needle is also important. The
curvature of the needle allows for use in Internal Fascial closure Vessel ligation Skin closure
specialized applications. Curved needles are used Skin Glue and anastomosis Subcuticular Reapproximate
in most general surgical procedures, while straight Staplers skin closure lacerations
needles are used for skin and subcuticular suturing. For skin closures, in
particular, staplers
and skin glue may be
used in lieu of
suture. This is
usually based on
cosmetic outcome
and surgeon
preference.

RETRACTORS
In varying forms,
retractors are used to
hold an incision open,
hold back tissues or
other objects to
maintain a clear surgical
field, or reach other
structures. They can Deaver Retractor: Army-Navy Retractor: Weitlaner Retractor: Self- Richardson Retractor: Bookwalter Retractor:
Used to gain exposure retaining for exposing deep Used to hold back deep Self-retaining retractor
either be hand-held or Used to hold back
the abdominal wall. of skin layers. or smaller surgical sites. tissue structures. Also system that is anchored
self-retaining via a to the operating table.
Also called “Wheaty.” called “Rich.”
ratcheting mechanism.

SUCTION
Suction tips, combined
with a suction source,
help to remove debris
and fluid from the Malleable Retractor: Rake Retractor:
surgical field. It can Yankauer Suction Poole Suction Tube: Frazier Suction Tip: Can be bent and Hand-held retractor
also be used to clear Tube: Used Used to remove large Used primarily in customized. Also with sharp teeth
primarily for surface amounts of fluid from ENT and neurosurgery.
surgical smoke. used to protect used to hold back
suction and some the surgical field, as well Usually angled. intestines during surface structures.
intra-abdominal as intra-abdominal abdominal closure.
suction. suction.
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 COMMON SURGICAL INSTRUMENTS

STAPLERS
AND CLIPS
Used for reanastomosis
of viscera, vessel
ligation, and excision of
specimens. Can be
one-time use,
reloadable, manual, or Linear Stapler: Creates a Linear Cutter: Creates a linear Circular Cutter: Performs Clips: Used in the ligation
electronically powered. linear staple line; no cutting cut and immediately staples circular cut and staple. Used of vessels, may be metal or
both free edges. Used in in reanastomosis of hollow absorbable material. Open
Staples come in function. Used in ligation and
anastomosis. May be curved. separation and anastomosis. viscera, e.g., large bowel. and lap applicators.
multiple sizes.

ENERGY
SYSTEMS
Broad term used to
describe various
methods of cutting
tissue or sealing
vessels. May use Electrosurgery: Instrument that Ultrasonic: (Harmonic®) uses high- Endostapler: Used in laparoscopic
cuts or cauterizes tissue via an frequency sound to concurrently procedures, provides simultaneous cutting
electricity or sonic
alternating electrical current. cut and seal tissue. Less thermal and stapling. May be manual or electronic.
waves. Available in Some feature articulating heads to
Open (shown) and laparoscopic spread than electrosurgery, but
open or laparoscopic more time consuming. accomplish more difficult placement.
(Ligasure®) applications.
forms.

LAPAROSCOPIC
INSTRUMENTS
Many instruments are
similar to those used in
open surgery, adapted to
fit through narrow ports
placed through the skin.
Laparoscopic work is then
conducted via the ports.
Camera: The camera is the hand-
held component and connects to
a variety of lenses. There are
usually settings for focus and
white balance.
Light Source: Fiber optic cable
Lens: Available in multiple viewing
connects to lens and illuminates
angles to achieve better
field of vision. Caution around
visualization of anatomical
internal structures as light
structures. May require occasional
output can be hot.
defogging.

Image attributed to Magnus 1313 at English Wikipedia Image attributed to Ignis

Insufflator: Injects carbon dioxide
into the abdominal cavity to
create a working space for trocar
placement and surgical
procedures.
Veress Needle: One method of
achieving pneumoperitoneum.
Consists of blind placement of
needle into abdomen and
subsequent injection of gas.
Trocars: Transabdominal working
ports where laparoscopic
instruments are inserted. Also for
insufflation or removal of
specimens. Available in multiple
sizes, e.g., 5, 10, and 12 mm.
Laparoscopic Instruments: Hand-
held and shafted implements
used to work through trocars.
Can perform grasping, retracting,
cutting, cauterizing, and other
functions.

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 SPECIAL SURGICAL CONSIDERATIONS
Most surgical subspecialties have specialized equipment specific to the procedures they commonly perform.
This guide provides a brief overview of some of that equipment for familiarity.

Cardiopulmonary

CARDIO- Bypass: Pump circuit

that diverts blood
THORACIC away from heart,
oxygenates blood, and
SURGERY removes wastes, with
a separate circuit for
Cardiopulmonary
cardioplegic solution.
bypass, bronchoscopy, Operated by a cardiac Image attributed to Cancer Research UK Image attributed to Cancer Research UK

and equipment for perfusionist. Adequate Bronchoscope: Endoscope Video-Assisted Thorascopic

minimally invasive anticoagulation narrow enough to view, Surgery (VATS): Minimally
thoracic procedures are required for proper aspirate, or remove specimens invasive surgical technique for
frequently encountered. function. from airway and branches procedures in the thorax.
Image attributed to Pfree2014

Cystoscope:
Endoscope, either
Ureteral Stent: Semirigid
flexible or rigid, that
tube that is used to
UROLOGIC is used for
visualization of the
maintain patency of ureter.
SURGERY genitourinary system
May be used as temporary
measure for obstruction or
Minimally invasive for either diagnosis or
placed prior to abdominal
cystoscopic equipment procedures.
surgery to identify ureters.
Combined with saline
is frequently used for Usually placed with
circulation to create
both visualization and viewing space in
cystoscopy.
performing procedures. bladder.
Image attributed to Cancer Research UK Image attributed to Hildpeyi at English Wikipedia

ORTHOPAEDIC
SURGERY
Joint replacements and Image attributed to Arthroscopist Image attributed to Netha Hussain Image attributed to Bszsurgico
other procedures Arthroscope: Endoscopic Orthopaedic Implants: Rongeur: Sharp-edged Bone Saw: Battery
require specialized technique to diagnose and Synthetic pins, nails, or other and sturdy instrument powered and used for
equipment. treat joint, ligament, and prostheses used to fix broken used for removing cutting bone, either free
tendon disorders. Combined bones or replace worn joints. bone or creating a hand or with the
with saline circulation to Usually implanted using window in bone. assistance of a jig.
create joint space. special surgical equipment.

Robotic Surgical
System: Electronically-
powered instrument
ROBOT- usually with multiple
arms and
ASSISTED interchangeable
SURGERY surgical tools. Surgeon
works from a console
Increasingly used for while surgical Surgeon Console: Operation Robotic Arm: Apparatus
procedures in urology, technicians replace center for surgical system, holding surgical instruments.
gynecology, endocrine instruments as needed. consisting of controls for Allows for increased range of
surgery, and other System usually robotic arms and stereotactic motion over laparoscopy
specialties. operates via video offering three- through articulating
laparoscopic approach. dimensional view of field. instrument heads.

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