Lea Mae Cabigting

54 BASIC SURGICAL INSTRUMENTS

The arrangement of instruments on the Mayo Table follows a systematic approach, considering the
frequency of use, the nature of the instruments, and the specific needs of the surgical procedure. Surgeons
and surgical teams may customize the setup based on their experience and the unique requirements of
each surgery, contributing to the overall efficiency and success of the procedure.

Setup:
 Ensure that the Mayo table is clean, and the sterile field is properly established: Before
the surgery begins, the Mayo table is thoroughly cleaned, and the sterile field is set up.
This involves creating a controlled and sterile environment to prevent the introduction of
contaminants into the surgical site.
 Arrange sterile drapes on the table to create a sterile surface: Sterile drapes are carefully
arranged on the Mayo table to establish a clean and sterile working surface. These drapes
create a barrier between the instruments and the non-sterile environment, maintaining the
aseptic conditions required for surgery.
Instrument Trays:
 Separate instruments into specific trays based on their function: Instruments are grouped
based on their functions, and separate trays are designated for each group. For example,
cutting instruments (such as scalpels and scissors) may be in one tray, while grasping
instruments (such as forceps and needle holders) may be in another. This organization
helps the surgical team quickly locate the required instruments during the procedure.
Scalpels and Scissors:
 Place scalpels and scissors towards the top of the table: Scalpels and scissors, which are
frequently used for making incisions and cutting tissues, are positioned at the top of the
Mayo table for easy access by the surgeon. This placement ensures that these crucial
cutting tools are readily available when needed.
Forceps and Needle Holders:
 Arrange forceps and needle holders in the middle section of the table: Instruments used
for grasping tissues and manipulating needles during suturing, such as forceps and needle
holders, are placed in the middle section of the table. This central location facilitates
quick access during various stages of the surgery.

Hemostats:
  Position hemostats and other clamping instruments close to the surgeon: Hemostats,
instruments designed to control bleeding by clamping blood vessels, are strategically
placed close to the surgeon. This arrangement allows for immediate access in case of
unexpected bleeding, enabling prompt and effective hemostasis.
Suction Devices:
 Place suction devices towards the periphery of the table: Suction devices, which are used
to clear blood and fluids from the surgical site, are positioned towards the periphery of
the Mayo table. This placement ensures easy access without interfering with the central
working area and helps maintain a clear view for the surgeon.
Retractors:
 Arrange retractors strategically to hold tissues or organs in place: Retractors, used to
hold back tissues and organs, are strategically placed to provide a clear and unobstructed
view of the surgical field. Proper placement aids in maintaining visibility and
accessibility during the procedure.
Surgical Sponges and Towels:
 Place sterile sponges and towels in designated areas: Sterile sponges and towels are
positioned in specific areas on the Mayo table to quickly absorb blood and maintain a dry
surgical field. These designated areas help the surgical team efficiently manage blood and
fluids during the procedure.
Needle and Suture Material:
 Keep needles and suture material organized and easily accessible: Needles and suture
materials are organized and made easily accessible, often in a separate tray or container.
This ensures that the surgeon can quickly retrieve the necessary items for suturing and
wound closure.
Electrocautery or Diathermy:
 Position electrocautery or diathermy equipment to the side of the Mayo table: Electrical
cautery or diathermy equipment, used for cutting and coagulating tissues, is positioned to
the side of the Mayo table for easy access. This allows the surgeon to use the equipment
efficiently and safely during the procedure.
Speculum:
 If applicable to the procedure, keep the speculum in a designated area: If a speculum is
required for the surgery (common in gynecological or ophthalmic procedures), it is kept
in a designated area on the Mayo table for easy access when needed. This ensures that
specialized instruments are readily available for specific aspects of the surgery.

Cutting/Dissecting
#3 Knife Handle:
The #3 Knife Handle is a commonly used surgical instrument designed for holding various types of
blades, such as scalpel blades or other cutting implements. It typically features a straight, cylindrical
shape with a ribbed or knurled surface to provide a secure grip for the surgeon. The handle is often made
of stainless steel or other materials compatible with sterilization processes. The #3 Knife Handle is
versatile and allows for precision and control during surgical procedures.

#3 Knife Handled Long Angled:

The #3 Knife Handled Long Angled is a variation of the #3 Knife Handle with an extended and angled
design. This modification provides surgeons with a longer reach and a slight angle, offering enhanced
maneuverability in specific surgical situations. The extended length allows for better access to deep or
hard-to-reach areas during procedures. Like the standard #3 Knife Handle, this variation is compatible
with a variety of blades for different cutting purposes.

#7 Knife Handle:
The #7 Knife Handle is another type of surgical instrument used for holding blades during various
medical procedures. It is characterized by its distinctive shape, featuring a curved and tapered design that
provides a comfortable and ergonomic grip for the surgeon. The curve in the handle facilitates precise
control and maneuverability. The #7 Knife Handle is commonly used in specialties such as orthopedics,
plastic surgery, and general surgery. As with other knife handles, it is typically made of materials suitable
for sterilization processes, ensuring aseptic conditions in the operating room.
Metzenbaum Scissors:
Metzenbaum Scissors are a type of surgical scissors designed for delicate tissue dissection. They are
characterized by their long, thin, and curved blades with a relatively longer shank compared to standard
scissors. The longer shank provides the surgeon with better reach and control, making these scissors well-
suited for cutting and dissecting soft tissues without causing unnecessary trauma. Metzenbaum Scissors
come in various sizes, and they are commonly used in procedures requiring precision, such as in
gynecological or urological surgeries.

Mayo Tissue Scissors:

Mayo Tissue Scissors, also known as Mayo Dissecting Scissors, are versatile surgical scissors used for
cutting and dissecting various types of tissues. They have straight or curved blades with a longer cutting
edge, making them suitable for general tissue dissection. The design of Mayo Tissue Scissors allows for
controlled and precise cutting, and they come in different lengths to accommodate various surgical needs.
These scissors are commonly used in a wide range of surgical procedures, providing surgeons with a
reliable tool for tissue manipulation.

Mayo Suture Scissors:

Mayo Suture Scissors are specialized scissors designed for cutting sutures during surgical procedures.
They feature a distinctive hook-shaped or angled tip that allows for easy insertion under sutures,
facilitating the efficient cutting of stitches. Mayo Suture Scissors have a shorter blade length compared to
other surgical scissors, making them well-suited for precise and controlled cutting of suture materials.
These scissors are an essential tool for closing incisions and wounds after surgery. The design helps
prevent inadvertently cutting surrounding tissues while ensuring a clean and effective suture removal
process.

Suturing
A needle holder, also known as a needle driver, is a surgical instrument used by surgeons and medical
professionals to hold and control needles during various medical procedures, particularly in suturing
wounds or incisions. Needle holders are a crucial tool in surgery as they provide the surgeon with
precision and control when manipulating needles and sutures. Here's a description of a typical needle
holder:

Needle Holder / Needle Driver:

 Design: Needle holders have a scissor-like design with handles and jaws. The handles are
operated by squeezing them together, which in turn causes the jaws to close. The jaws of the
needle holder have a textured or serrated surface to securely grip the needle without slippage.

 Jaw Types: The jaws may come in different types, such as straight jaws or curved jaws. The
choice of jaw type may depend on the specific procedure or the surgeon's preference.

 Locking Mechanism: Needle holders typically have a ratcheted locking mechanism that holds the
jaws closed, providing a secure grip on the needle during suturing. This feature allows the
surgeon to maintain control while passing the needle through tissues.

 Material: Needle holders are commonly made of high-quality stainless steel to ensure durability,
resistance to corrosion, and compatibility with sterilization procedures.
  Sizes: Needle holders come in various sizes to accommodate different surgical needs and the
surgeon's preference.

During surgery, the surgeon places the suture needle in the jaws of the needle holder, and the jaws are
then locked into place, securing the needle. The surgeon can then use the needle holder to guide the
needle through tissues and facilitate the suturing process. Needle holders are instrumental in achieving
precise and controlled needle movements, ensuring accurate suturing for wound closure.

Suctioning

Frazier Suction Tip:

The Frazier Suction Tip is a slender, straight suction instrument with a small diameter, often used in
delicate surgical procedures or in areas where precision is essential. It features a fine, tapered tip that
allows for effective suction in confined spaces. Frazier suction tips are commonly used in neurosurgery
and other procedures where a smaller, more focused suction is required.

Poole Suction Tip:

The Poole Suction Tip is a broader, multi-perforated suction instrument designed for the removal of larger
volumes of fluid and debris during surgery. It typically has multiple openings on the tip and may have a
removable guard to prevent large tissue fragments from entering the suction tubing. Poole suction tips are
frequently used in abdominal and laparoscopic surgeries.
Yankauer/Andrews/Tonsil Suction/ Pynchon Suction Tip:
The Yankauer suction tip, also known as the Andrews or Tonsil suction tip, is a rigid, angled instrument
with a bulbous tip. It is widely used for general-purpose suctioning of fluids and debris from the surgical
site. The Yankauer suction tip is commonly utilized in procedures where a larger bore suction is needed,
such as in oral and throat surgeries. It is not typically used in delicate or precision surgeries.
The Pynchon Suction Tip is a specialized instrument designed for deep suctioning in the oral and
pharyngeal areas during oral and maxillofacial surgeries. It has a curved shape with a small, tapered tip,
allowing for effective suction in confined spaces. The curvature is designed to navigate the oral cavity
comfortably. Pynchon suction tips are commonly used in dental and oral surgeries.

Clamping and Occluding

Carmalt Clamp:
The Carmalt Clamp is a hemostatic clamp with serrated jaws and longitudinal grooves. It has a distinctive
design with straight, transversely grooved tips. Primarily used for clamping blood vessels or tissues
during surgical procedures to control bleeding. The longitudinal grooves provide a secure grip, and the
clamp may have a locking mechanism to maintain constant pressure on the clamped vessel. Often used in
abdominal and vascular surgeries.

Crile Clamp:
The Crile Clamp, also known as the Crile Hemostatic Clamp, is a curved, hemostatic clamp with serrated
jaws. Used for clamping small to medium-sized blood vessels or tissues during surgery to achieve
hemostasis. The curved design allows for better maneuverability in various anatomical areas, and the
serrated jaws provide a secure grip. Widely utilized in a variety of surgical procedures, including general
surgery and vascular surgery.

DeBakey Clamp:
The DeBakey Clamp is a fine, atraumatic vascular clamp with atraumatic jaws and a longitudinal design.
Specifically designed for clamping delicate structures such as blood vessels without causing excessive
trauma. The atraumatic jaws have fine teeth, and the clamp may have a ratcheted locking mechanism for
controlled and precise application. Commonly used in cardiovascular and vascular surgeries, particularly
in procedures involving delicate tissues.

Fogarty Clamp:
The Fogarty Clamp is a vascular clamp with a balloon at the tip that can be inflated to occlude a blood
vessel. Specifically designed for temporary occlusion of blood vessels during vascular and cardiovascular
procedures. The balloon at the tip allows the surgeon to block blood flow in the vessel without damaging
the vessel walls. Often used in procedures where a blood vessel needs to be temporarily blocked to
facilitate surgical repair, particularly in vascular surgeries.

Doyen Intestinal Clamp:

The Doyen Intestinal Clamp is a bowel clamp with atraumatic jaws and a curved or straight design.
Designed for clamping the intestines during gastrointestinal surgeries without causing excessive trauma.
Atraumatic jaws minimize tissue damage, and the clamp may have a locking mechanism for secure and
controlled clamping. Widely used in abdominal and gastrointestinal surgeries, particularly in procedures
involving the intestines.

Kelly Clamp:
The Kelly Clamp, also known as the Kelly Hemostatic Forceps, is a straight, hemostatic clamp with
serrated jaws and a locking mechanism. Primarily used for clamping blood vessels or tissues to control
bleeding during surgical procedures. Serrated jaws provide a secure grip, and the clamp may have a
ratcheted locking mechanism for maintaining constant pressure. Used in a variety of surgical procedures,
including general surgery, vascular surgery, and various specialties where hemostasis is required.

Lahey Right Angle Clamp:

The Lahey Right Angle Clamp is a hemostatic clamp with a right-angled, cross-action design. Designed
for clamping blood vessels during surgery to control bleeding. The right-angled design allows for easy
access to vessels in confined spaces. The cross-action design provides a secure grip on the vessel, and the
clamp may have a ratcheted locking mechanism for controlled pressure. Typically used in abdominal and
vascular surgeries, particularly in situations where a right-angled approach is advantageous.

Tonsil Clamp:
The Tonsil Clamp, also known as the Tonsil Seizing Forceps, is a hemostatic clamp designed for grasping
and securing the tonsils during tonsillectomy procedures. Primarily used in ear, nose, and throat (ENT)
surgeries to secure and manipulate the tonsils during removal. The clamp may have a locking mechanism
to maintain a secure grip during the tonsillectomy procedure. Widely used in tonsillectomies and other
ENT procedures where the secure handling of tonsil tissue is required.

Mosquito Clamp:
The Mosquito Clamp, also known as a mosquito hemostat or forceps, is a small, fine, and straight
hemostatic clamp. Designed for clamping small blood vessels or delicate tissues during surgery to achieve
hemostasis (control of bleeding). It has slender jaws with fine serrations that provide a secure grip on
small vessels. The clamp may have a locking mechanism to maintain constant pressure. Frequently used
in various surgical procedures, including general surgery, plastic surgery, and other specialties where
precision is crucial.

Right Angle Mixter Clamp:

The Right Angle Mixter Clamp is a hemostatic clamp with a right-angled design, combining the features
of a clamp and scissors. Designed for clamping and cutting tissue simultaneously during surgical
procedures. The right-angled design allows for easy access to tissues in confined spaces. It typically has a
clamp-like structure on one side and a cutting blade on the other. Used in various surgeries, particularly in
gastrointestinal and abdominal procedures where clamping and cutting are required simultaneously.

Grasping/Holding
Adair Forceps:
The Adair Forceps is a specialized instrument designed for use in obstetric and gynecological procedures.
It often has a curved or S-shaped design with atraumatic tips. Used to grasp and manipulate the cervix
during gynecological examinations or procedures. The atraumatic tips help minimize tissue trauma during
manipulation.

Towel Clamp:
The Towel Clamp, also known as Backhaus Towel Clamp, is a hemostatic clamp with pointed ends and a
ratcheted locking mechanism. Used to secure surgical drapes or towels to the patient's skin during a
surgical procedure. The pointed tips pierce the drape and anchor it in place, preventing it from slipping
during the operation.
Allis Forceps:
The Allis Forceps is a grasping forceps with multiple interlocking teeth along the jaws and a handle with
a ratcheted locking mechanism. Used for grasping and holding tissues during surgery, particularly in
general and abdominal procedures. The interlocking teeth provide a secure grip on tissue, and the
ratcheted handle allows for maintaining constant pressure.

Edna/Lorna/Non-penetrating/Atraumatic Towel Clamp:

This type of towel clamp is designed to be non-penetrating or atraumatic. It has a gentle grip to secure
towels or drapes without piercing. Used for securing towels or drapes in situations where atraumatic
clamping is preferred, such as in delicate or superficial procedures. The design aims to minimize tissue
trauma during the clamping process.

Babcock Forceps:
The Babcock Forceps is a grasping forceps with a gentle, atraumatic jaw design and a handle with a
ratcheted locking mechanism. Used for grasping delicate tissues, particularly in gastrointestinal and
gynecological procedures. The atraumatic jaws have a fenestrated design that provides a gentle yet secure
grip on tissues.

Foerster/Sponge/Ring Forceps:
The Foerster (Sponge) Forceps, also known as Sponge Holding Forceps, has a ring-handled design with
serrated jaws. Primarily used for holding and manipulating surgical sponges or gauze during procedures.
The serrated jaws provide a secure grip on sponges, and the ring handles allow for easy manipulation and
control.
Adson Brown Forceps:
Adson Brown Forceps, also known as Adson forceps, have fine, toothed tips and a handle with a thumb
and ring finger grasp. Typically used for delicate tissue handling, such as grasping skin, fascia, or delicate
structures during plastic and reconstructive surgery. The fine teeth on the tips provide a secure grip
without causing excessive trauma to the tissue.

Kocher Ochsner Forceps:

Kocher Ochsner Forceps, often referred to as Kocher forceps, have a robust design with transverse
serrations along the entire length of the jaws. Used for clamping and grasping tougher tissues, such as
muscle or fascia, during various surgical procedures. The transverse serrations provide a secure grip, and
the forceps may have a locking mechanism for maintaining constant pressure.

Lahey Thyroid Forceps:

Lahey Thyroid Forceps have a delicate, narrow jaw design with cross-serrated tips and a handle with a
thumb and ring finger grasp. Specifically designed for use in thyroid surgery, these forceps are used for
delicate tissue manipulation and handling during thyroidectomy procedures. The narrow, serrated jaws
provide a precise grip on thyroid tissues, and the delicate design is suitable for fine dissection.
 Retracting/Viewing

Adson Beckman Weitlaner:

The Adson Beckman Weitlaner is a type of self-retaining retractor with prongs or blades that can be
adjusted to hold back tissues during surgery. Used for a variety of surgical procedures where hands-free
retraction of tissues is necessary. The prongs can be adjusted and locked in place to maintain retraction,
and it often has a ratcheted mechanism.

Balfour Self-Retaining Retractor:

The Balfour Retractor is a self-retaining abdominal retractor with adjustable blades and a central frame
that allows it to be secured to the operating table. Primarily used in abdominal surgeries to hold back the
abdominal wall and provide a clear view of the organs. The adjustable blades and central frame allow for
flexibility in retraction, and the retractor can be securely attached to the table.

Weitlaner Self-Retaining Retractor:

The Weitlaner Retractor is a self-retaining retractor with outward-curving blades that can be locked in
place. Used in various surgical procedures to hold back tissues and create a clear surgical field. The
retracting blades are typically blunt, and the retractor can be easily adjusted and locked into position.

Hirschman Anoscope:
The Hirschman Anoscope is a specialized instrument designed for examining the anal canal. It typically
has a hollow tube with a light source. Used in anoscopic examinations to visualize the interior of the anal
canal. It may have a built-in obturator for easy insertion and removal.

Bard Parker/Band Retractor:

The Bard Parker or Band Retractor is a handheld, double-ended instrument with a flat, wide blade at one
end and a narrower blade at the other. Used for holding back tissues during various surgical procedures.
The double-ended design provides versatility, allowing the surgeon to choose the appropriate width for
retraction.

U.S Army Navy Retractor:

The U.S. Army Navy Retractor is a handheld, double-ended retractor with one side having a slightly
curved blade and the other side having a straight blade. Used for retracting tissues during general surgical
procedures. The curved and straight blades offer flexibility in tissue retraction, and the instrument is
commonly used in abdominal surgeries.
Senn Rake Retractor:
The Senn Rake Retractor is a handheld, double-ended retractor with three prongs or rake-like projections
on each end. Used for holding back tissues and exposing the surgical field during various procedures. The
rake-like projections on each end provide multiple points for tissue retraction, offering versatility in
holding tissues away from the surgical site. Widely used in general and plastic surgery procedures.

Cushing Vein Retractor:

The Cushing Vein Retractor is a delicate, fine-tipped instrument used in neurosurgery to gently retract and
expose veins in the brain during surgical procedures. Specifically designed for use in neurosurgical
interventions where precise retraction of veins is necessary. The fine tips allow for careful manipulation
and retraction without causing damage to the delicate tissues.

Richardson Appendectomy Retractor:

The Richardson Appendectomy Retractor is a handheld retractor with a fenestrated blade and an angled
handle. Used in appendectomy procedures to retract and hold back tissues, providing access to the
appendix. The fenestrated blade design allows for effective tissue retraction without compromising
visibility.

Kelly Richardson Retractor:

The Kelly Richardson Retractor is a self-retaining retractor with a rake-like shape and multiple prongs.
Used for self-retaining retraction in various surgical procedures where a broad retraction is required. The
rake-like design provides multiple points of contact for holding back tissues during surgery.

Volkman Retractor:
The Volkman Retractor is a handheld, double-ended instrument with a flat blade on one end and a curved
blade on the other. Used for holding back muscles and tissues during various orthopedic and general
surgical procedures. The double-ended design offers versatility in tissue retraction, and the flat and curved
blades provide options for different surgical needs.

Deaver Retractor:
The Deaver Retractor is a handheld, broad, and flat retractor with a curved or angled shape. Used for
retracting and exposing abdominal organs during general surgical procedures. The broad, flat design
provides extensive surface area for holding back tissues, offering a clear view of the surgical field.

Malleable/Ribbon Retractor:
The Malleable or Ribbon Retractor is a flexible, malleable instrument that can be bent and shaped as
needed. Used in various surgical procedures where the retractor needs to be custom-shaped to fit the
anatomy and provide effective retraction. The malleable nature allows surgeons to adjust and shape the
retractor according to the specific requirements of the procedure.