PINES CITY COLLEGES DOCTOR OF MEDICINE

2.0 2025
Title: Surgical and Laparoscopic Instruments
Lecturer: Dr. Casuga

BASIC SURGICAL INSTRUMENTS

SURGICAL DETAILS/ILLUSTRATION USES

INSTRUMENTS

1. FORCEPS PROPER WAY OF GRIP/HANDLING of FORCEPS

GROOVES/SERR
ATIONA:
PEAN- PUNO

KELLY- KULANG A. CURVED FORCEPS

A. CURVED FORCEPS: use same size Used during cutting/ ligation of vessels
Proper Placement:

DETAILS:

Improper:

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 PINES CITY COLLEGES DOCTOR OF MEDICINE
2.0 2025
Title: Surgical and Laparoscopic Instruments
Lecturer: Dr. Casuga

Adv. of curve over straight: easier to

mobilize tissues

Big curved clamps may be used on

bigger/thicker tissues, or clamping
edges during closing of wounds,
fascia. For thinner tissues, vessels use
a smaller curve, because bigger
curves are more traumatic.

B. STRAIGHT CLAMPS B. STRAIGHT

Used in colostomy to hold the skin.
When you need ties for ligation of
vessels, ‘tie in the stick’, yung straight
clamp ang stick, use for example
ligation of vessels deep in the
abdomen.

C. Used for grasping tissue or objects.

C. MOSQUITO CLAMPS- maliit lang siya, can be
• Can be toothed (serrated) or
straight or curved
non-toothed at the tip. Can be
MOSQUITO FORCEPS OCHSNER FORCEPS
small or large (straight or curved).

D. Slightly rounded jaw

D. ALLIS
- Used to grasp the intestines
For grasping tissues, since traumatic
siya, use allis on the specimen na
tatanggalin rather on the tissues na
maiiwan.
Using it on a bowel, which are very
delicate and thin structure, will cause
perforation. So use this on thicker
tissues or on the specimen part.
Used also in grasping fallopian tubes
during cystectomy, as long as hindi sa
maiiwan na tissue.

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 PINES CITY COLLEGES DOCTOR OF MEDICINE
2.0 2025
Title: Surgical and Laparoscopic Instruments
Lecturer: Dr. Casuga

E. Traumatic, used in abdominal

E. OCHSNER
edges, peritoneum, fascias, skin on
closure, fallopian tubes

F. MIXTER/ RIGHT ANGLE F. Used in vessels, lalo na sa ilalim,

compared to a curved clamp, use the
same sized mixter

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 PINES CITY COLLEGES DOCTOR OF MEDICINE
2.0 2025
Title: Surgical and Laparoscopic Instruments
Lecturer: Dr. Casuga

G. TOWEL CLIPS G. Used to hold draping/towels to

expose a certain part

LORNA/ EDNA(flat tips) BACKHAUS CLAMPS (pointed)

H. THUMB and TISSUE Forceps (ADSON) H. THUMB/ADSON FORCEPS

- stainless steel tweezers used to
move and hold tissue in place during
delicate surgical procedures

Maybe short or long, tissue (without

teeth) is used for vessel, bowels or
delicate ones,
while a adson/thumb forceps (with
teeth) is used for skin, abdominal
wounds. Longer thumbs are used

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 PINES CITY COLLEGES DOCTOR OF MEDICINE
2.0 2025
Title: Surgical and Laparoscopic Instruments
Lecturer: Dr. Casuga

when placing or grasping on deep

areas.

Hold it like a chopsticks or a pen.

I. BABCOCK I. Atraumatic, use in grasping the

appendix rather than the allis,
maybe in intestines

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 PINES CITY COLLEGES DOCTOR OF MEDICINE
2.0 2025
Title: Surgical and Laparoscopic Instruments
Lecturer: Dr. Casuga

2. RETRACTORS A. DEAVERS A. Used to hold back abdominal wall

Narrow Wide Narrow: Used in appendectomy,
hinanap ang appendix, sumisingit ang
abdomen
Wide: Small intestines, bowels
Use gauze before retracting

B. ARMY NAVY B. Used to gain exposure of skin

layers, retract/ spread tissues, use
the long ends on deeper tissues,
and short ends for superficial
tissues.

C. RICHARDSON C. Used to hold back deep tissues

1. Richardson- Bigger one structures
2. Baby Richardson- small one Big richardson: abdomen retraction,
breast
Baby richardson: oropharyngeal

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 PINES CITY COLLEGES DOCTOR OF MEDICINE
2.0 2025
Title: Surgical and Laparoscopic Instruments
Lecturer: Dr. Casuga

D. MALLEABLE D. Used for example to press down

intestines while closing the
abdominal wound. Can be bent and
customized. Also used to protect
intestines during abdominal
closure.

E. BLADDER RETRACTOR E. Use in OB

F. SELF-RETRACTOR

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 PINES CITY COLLEGES DOCTOR OF MEDICINE
2.0 2025
Title: Surgical and Laparoscopic Instruments
Lecturer: Dr. Casuga

3. NEEDLE • Used to hold a suturing needle for

HOLDER closing wounds during suturing and
surgical procedures.

● The parts of a simple needle

holder are the jaws, the joint
and the handles.

• The serrations in the jaw are

different from that of the serrations
seen in mosquito forceps and clumps.
~para siyang “pangfile” ng kuko

• Used to hold on the needle and

the suture

Pag nakaclamp, make sure na walang

space, para di lumusot yung sutures,
use longer one on the deep areas,
huwag sa skin, kasi it will be
uncomfortable for the surgeons.

4. BLADE ● A surgical blade holder characterized

HOLDER by a handle with a hollow head
portion at an obtuse angle with the
longitudinal axis of the remainder of
the handle

• The head portion has a first slot for

accommodating a blade- retaining ring
which is attached to a shank passing
through at least the hollow head
portion of the handle.

• “knife”
Blade holder no. 4: for blade 20, used
for skin incision
Blade holder no. 3 for 10, 11,12,15
blades

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 PINES CITY COLLEGES DOCTOR OF MEDICINE
2.0 2025
Title: Surgical and Laparoscopic Instruments
Lecturer: Dr. Casuga

5. NEEDLES and Absorbable vs Non-absorbable

SUTURES Has 2 types non-absorbable and
absorbable (90-120 days, depends),
the longer time of absorption, use for
thicker tissues like fascia.
Applied non-absorbable should be
removed.
Absorbable on the outside is not used
such as sa skin kasi magfifibros and
kukulubot, so in the face use
non-absorbable then remove it after 5
days, sa extremities 7 days.
Joints:use non-absorbable kasi
madaling mapunit and absorbable.
Skin staples or nonabsorbable in
contaminated procedures
(appendicitis, ruptures, peritonitis,
bowel surgery), cesarean: may use
absorbable sutures.
Polyglycolic are absorbable.
Fascial closure: use either but
synthetic absorbable are expensive
and thick, thus use them on tissue na
lang,kasi longer na ma-absorb,
therefore the longer it will hold the
tissues together

Natural vs Synthetic
Most sutures are synthetic.

Braided vs Monofilament
Monofilament: 1 suture only, less for
infection
Braided: Multiple braided sutures, mas
maraming pwedeng pasukan ng
bacteria

Violet arrow
Needle Size
3.0 thickness of needle, the smaller
the number the thicker the needle
Suture numbers: 0-9.0
Small number=Thicker needle=Thicker
strands=longer suture nd v.v

Yellow Arrow
Round symbol: Needle is round and
tapers to a simple point
Used in softer tissues- intestines, but
can be used in muscles.

Triangular symbol: Needle is

triangular with sharp edges, used for
tougher tissues such as skin.

Red Arrow and Blue arrow

Needle shape
Curved needles are used in most
general surgical procedures, while
straight needles are used for skin and
subcuticular suturing

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 PINES CITY COLLEGES DOCTOR OF MEDICINE
2 2025
Title: Surgical and Laparoscopic
Instruments

Green arrow
Length of the needle

Black arrow
Length of the suture

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