Surgery Instruments

Bard Parker Handle

• Reusable flat handle intended for combined use with surgical blades of varying shapes and sizes
• Sizes 3, 5, 7 and 4 used
o Handle No. 3 ,No.5 and No. 7 is compatible with Blade No. 10, 11, 12 and 15. 
o Handle No. 4 is compatible with Blade No. 20, 21, 22, 23 and 26.

• Used to make skin incisions

• Sterilization by Autoclaving @121°C at 15 lb. / inch2 for 30 minutes
Rampleys Sponge holding forceps

• Presence of a ratchet mechanism and serrations on the inner aspect of the oval shaped blades
• Used for holding swabs or sponges in medical procedures
o Cleaning skin surface before incision
o To swab oozing areas
o To hold the gallbladder during cholecystectomy

• Sterilization by Autoclaving @121°C at 15 lb. / inch2 for 30 minutes

(Doyens cross action type) towel clip

• Used to fix draping sheets

• Used for fixing diathermy cables, suction tubes,
laparoscopic cameras and fiber optic light
cables etc. draping sheets
• Maybe used to hold ribs while elevating the
flail segment of chest

• Sterilization by Autoclaving @121°C at 15 lb. /

inch2 for 30 minutes
Kocher's hemostatic forceps
• There is a single tooth at the terminal end of one blade
and groove in the other.
• Both blades have transverse serrations
• Ratchet locking mechanism present

• Used for,
o Subtotal or hemi-thyroidectomy (removal of thyroid
tissue) for holding the margins of thyroid so that the
remaining tissue may not bleed when excision takes
place
o To crush the stump of the appendix during
appendectomy

• Sterilization by Autoclaving @121°C at 15 lb. / inch2 for

30 minutes
Spencer wells (curved) artery forceps

• Blades are approximately half the length of shaft

• Full length of the blades contains serrations

• (Tip is curved) and non toothed

• Ratchet locking mechanism present

• Used during surgery to compress the artery, clamp and

seal small blood vessels or hold the artery out of the way

• Sterilization by Autoclaving @121°C at 15 lb. / inch2 for

30 minutes
Kelly’s (curved) artery forceps
• Blades are approximately half the length of shaft

• Distal half of the blades contains serrations

• (Tip is curved) and non toothed

• Ratchet locking mechanism present

• Used to clamp small to medium blood vessels providing hemostasis

and clamping of tissue

• Sterilization by Autoclaving @121°C at 15 lb. / inch2 for 30 minutes

Mosquito (curved)Hemostatic forceps
• Blades are approximately half the length of shaft

• Full length of the blades contains serrations

• (Tip is curved) and non toothed

• Ratchet locking mechanism present

• Used as a ratcheted hemostat to secure and clamp bleeding vessels.

Sterilization by Autoclaving @121°C at 15 lb. / inch2 for 30 minutes

Lister’s sinus forceps
• Long straight blades with ring handles but without a ratchet
lock.

• The tip of the blades is blunt and has transverse serrations

• Commonly used for inserting or removing packing in

the sinus cavity

• Sterilization by Autoclaving @121°C at 15 lb. / inch2 for 30

minutes
Allis’ Tissue forceps
• The terminal end of the blades bears short teeth. The
teeth have grooves in between so that when the two
blades meet, one tooth of the blade fits in the groove of
the other blade.

• The blades may be curved or straight.

• Ratchet locking mechanism present

• Used to
o Holding tough structures like rectus sheath during
abdominal surgeries
o Holding up Linea Alba during suturing
o Hold skin margins during incisional hernia
operation to raise the skin flap
Babcock’s Tissue forceps
• The blades have a triangular orifice, along with a
horizontal groove at the terminal end in one blade
and a ridge in the other blade.

• When the instrument is closed the ridge fits into

the groove securing the held structure from
slipping. The instrument is non traumatic.

• Has a ratchet mechanism and ring handles

• Used to
o Holding tubular soft tissue such as Appendix
or fallopian tubes
o To hold intestines during resection and
anastomosis operations
Lane’s Tissue forceps
• Heavy forceps with the terminal parts of the blade
curved and fenestrated

• Tooth in one blade and groove in the other

• Ratchet locking mechanism present

• Used for
o Holding bulky tissue
o Breast during mastectomy
o Appendix and mesoappendix during
appendectomy
Plain dissecting forceps Toothed dissecting forceps
Czerny’s retractor (Hernia Retractor)

• Retractor with two hooks on one end and a

broad surface on the other.

• Uses
o During closure of a midline laparotomy
wound to retract the superior or inferior
edges to facilitate insertion of the first
mass closure stitch.
o Hernia repair
 Deaver’s Retractor Morris retractor

• The Deaver’s Retractor is a hand-held • Hand-held retractor

retractor. Has a curved retracting blade and • L shaped, wide blade and handle
flat handle. ( s shaped ) • Lower end of the blade curved inwards at right angle
• Used to  • Used to
o Retract the liver during cholecystectomy o Retract abdominal wall during appendectomy
o Retract stomach during o Retract the strap muscles and SCM during
pancreatojejunostomy thyroidectomy
Balfour retractor (self retaining)

• Balfour retractors are a 3-sided retractor with the

ability to add a 4th blade.

• These retractors are referred to as self-

retaining retractors as there is not a need for a
surgeon, nurse or tech to hold the blades, only
place them in the designated position

• Can be used with  table-mounted retractor and

instrument holder for an entirely “hands-free”
retraction system. 
 Intestinal Occlusion
Clamp Lahey’s Forceps

• It has slightly concave jaws, therefore both the ends meet only
at the extreme when locked. Hence the lumen of intestine or
vessels lies in the center of concavity ensuring sustained • Terminal part is slightly bent
pressure which is just enough to occlude the lumen but not to • Similar to hemostatic forceps
damage it. • Used for dissecting blood vessels

• Used to occlude the lumen of the intestine and the blood

vessels as they are specially designed to handle delicate
structures
Cholecystectomy
forceps
• Used for the common treatment of
symptomatic gallstones and other
gallbladder conditions
• Used for surgical removal of the
gallbladder
Desjardins choledocholithotomy forceps
• The shafts are curved, the blades are small and fenestrated centrally.
• There are no serrations in the blade and there is no catch.
• Used
o During choledocholithotomy forceps introduced into the bile duct
and the stones are removed
o During laparoscopic cholecystectomy, gall bladder is opened and
the stone removed
o Used during removal of kidney, ureteric or bladder stone.
Proctoscope (Kelly’s Rectal Speculum)
A short, straight, rigid, hollow metal tube, and usually
has a small light bulb mounted at the end. It is
approximately 5 inches or 15 cm long

Used for
Diagnostic
o Hemorrhoids
o Rectal Polyps
o Rectal Carcinoma
o Ulcerative colitis

Proctoscopy is commonly done in left lateral position, Therapeutic

with right leg bent at the knee and hip, and drawn o During injection of sclerosants to piles
towards the abdomen o During polypectomy
o To take biopsy from rectal or anal growth
Proctoscope is lubricated (2% xylocaine gel) and inserted
into the rectum, initially upwards and forwards( towards
umbilicus) then upward sand backwards (towards Sterilized by dipping in 2% gluteraldehyde solution
sacrum). Obturator is removed, allowing an unobstructed
view of the interior of the rectal cavity
Cheatles forceps Needle Holding forceps

• Specialized hemostat tools used to hold

the needles during surgical operations.
• These needle holders help in suturing by clamping
Used to remove sterilized instruments
the needle firmly.
from boilers and formalin cabinets. • Has a ratchet mechanism and ring handles
They are used to ensure that as each item
is removed, others are not infected.
The forceps are placed in a container of
methylated spirits when not in use.
Needles
Suture Material
Foley’s self retaining balloon catheter (Indwelling catheter)

2-way Foley catheters (retention catheters)

• Has an inflatable balloon that encircles the tip near

the lumen or opening of the catheter.

3-way Foley catheter (retention catheter)

• One lumen drains the urine through the catheter

into a collection bag.
• The second lumen holds the sterile water when
the catheter is inflated and is also used to deflate
the balloon.
• The third lumen may be used to instill medications
into the bladder or provide a route for continuous
bladder irrigation.

Common balloon size used is 5 mL, and it is typically inflated with 10
mL of sterile water, which accounts for the lumen volume and the
balloon volume
Indications for catheterization
• On patients who are anesthetized or sedated for surgery or other medical care
• On comatose patients
• On patients with acute urinary retention
• On patients who are unable to use either standard toilet facilities due to paralysis or physical injury
• Following urethral surgeries
• On patients with kidney disease whose urine output must be constantly and accurately measured
• Before and after cesarean section
• Before and after hysterectomy
• On patients who have had genital injury

Contraindications for catheterization

• Blood at the meatus. Insertion of the catheter can worsen an underlying
injury.
• Gross hematuria.
• Evidence of urethral infection.
• Urethral pain or discomfort.
• Low bladder volume/compliance
 Simple Rubber Catheter Kehr’s T tube

• Non-self retaining,, radio-opaque catheter • Used for short term post operative drainage of
• Used for giving bladder wash, enema, bowel wash and common bile duct.
to drain the urine in case of acute retention of urine. • Radio opaque line provided throughout the tube
• Used for retrograde cystourethrogram (MCU). for X-ray visualization.

• Sterilized by cleaning in cold running water with

detergent and then boiling /autoclaving/chemical
disinfection/or gas sterilization and thus can be reused
again
Intercostal chest tube with water seal bag
• Is a method of removing air & fluid substances from the pleural
space
• It creates a one-way mechanism that will let air/fluid out of the
pleural space and prevent outside air/fluid from entering into the
pleural space
• The distal end of the drainage tube is submerged in 2cm of H2O
• The tube is inserted through the chest wall and into the pleural
space between the 5th and 6th intercostal space in the mid-
axillary line

Complications
• Pain – chest wall/ neck / shoulder
• Failure to enter the pleural space
• Infection at insertion site or intrapleurally
• Penetration / lacerations to lungs
• Penetration of peritoneal space - laceration of the
diaphragm
• Hemorrhage, Blocked drains, Pleural sepsis, Subcutaneous
emphysema