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SURGICAL INSTRUMENTS AND SUTURES

Common surgical instruments

  • There are hundreds of different surgical instruments which we will not be able to cover in this section

  • We aim to outline the common surgical instruments required for basic surgical skills

    • Scissors

    • Needle holder

    • Haemostat

    • Forceps

Common surgical instruments.JPG
Common surgical instruments

Scissors

  • Designed for the right hand -  left-handed scissors are available on manufacturer catalogues but not common in theatres

  • Insert thumb and ring finger into the rings of the scissors so that just the distal phalanges are within the rings

  • Use index finger to steady the scissors by placing it over the joint

  • When cutting tissues or sutures, especially at depth, it often helps to steady the scissors over the index finger of the other hand

  • Cut with the tips of the scissors for accuracy

Straight scissors.JPG
Scissors

Needle holder

  • Primarily designed for the right hand -  left-handed needle holders are available on manufacturer catalogues but not common in theatres

  • Diamond-shaped milling of the teeth allows the shaft of the needle to be held securely at any angle

  • Held in similar fashion to the scissors

  • Hold the needle in the tip of the jaws about two-thirds of the way along its circumference

  • Needle holders vary in size, rachet and some incorporate scissors as well

Needle holder.JPG
Needle holder

Haemostat

  • Also known as artery forcep or artery clip

  • Primarily right handed device

  • Available as curved or straight

  • Held in similar fashion to scissors

  • Place on vessels using the tips of the jaws

  • Secure position using the ratchet lock

  • Learn to release the haemostat using either hand

    • For right hand, hold the forceps as normal, then gently further compress the handles and separate them in a plane at right handles to the plane of action of the joint​

    • For left hand, hold the forceps with the thumb and index finger grasping the distal ring and the ring finger resting on the undersurface of the near ring. Gently compress the handles and separate them again at right angles to the plane of action

Haemostat clip.JPG
Haemostat

Dissecting forceps

  • Hold gently between thumb and forefinger

  • Two main types available:

    • Toothed - for tougher tissues​ (skin or fascia)

    • Non-toothed - for delicate tissues (bowel or vessels)

    • Debakey have special longitudinal grooves which can grip tissues and needles

Toothed forceps.JPG
Dissecting forceps

Scalpel

  • Scalpel blades are very sharp - Handle with great care and never directly

  • When attaching the blade to the handle, the needle holder must not cross the cutting edge of the blade or it will blunt

  • The angle at the base of the blade must be matched with the angled slot on the handle so that the blade can slide down the groove in the handle and lock in place

  • Only remove the blade down on the instrument trolley or into a suitable container

  • Two ways of holding the scalpel:

    • Hold scalpel in the palm of the hand, with index finger guiding the blade​

    • Hold scalpel like a pen

Scalpel
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