Basic surgical instruments

Basic surgical instruments

Many different types of surgical instruments have been developed over time and every type is designed to perform a specific function. Surgical instruments can therefore be categorized based on the function they perform during a surgery. While some instruments function to provide access to the surgeon, others are used to modify body tissues during surgery. A brief introduction to the different classes of surgical instruments is given below:

Clamps

A clamp refers to any surgical instrument that holds or occludes a tissue. E.g. Hemostat is a type of clamp that prevents blood flow through a blood vessel.

Clamps may be further classified into ‘partial occlusion clamps’ or ‘biting clamps’.

Suction Instruments

During a surgical procedure blood, tissue debris and other body fluids may accumulate at the site of surgery. These instruments provide suction to clear the site of surgery for unobstructed view of the surgical field.

Retraction Instruments

Since the body contains multiple layers of tissues, it is essential to hold superficial tissue layers in place when a surgeon attempts to access deeper tissues. Retractors help the surgeons in holding back tissue layers. Retractors may be self-retaining or handheld and their use depends on the type of requirement that arises during a surgery. The length and depth of surgical incision determines the type of retractor that a surgeon requires at a given stage during surgery.

Measuring instruments

A variety of measuring instruments are used during surgical interventions. Instruments that help in measurement include sizers, calipers, depth gauge or simple rulers etc.

Cutting Instruments

These surgical instruments include the blades, scissors, rongeur, shears, curette, osteotome, chisel, gouge, elevator, rasp and saws. Their functions are described below:

Blades are used for sharp cutting that helps in tissue dissection.

Scissors can be used to cut body tissues or to cut other objects (like wire-cutting scissors help in cutting sutures or stainless steel materials).

Rongeurs contain a spring-loaded hinge and during surgery they are used to sever and extract body tissues.

Shears are huge surgical cutting instruments that split/cut bone tissue.

Curette is a small cup-shaped instrument that is used to scoop out tissue.

Osteotome resembles a chisel and is used for cutting bone tissue.

Chisel is an orthopedic cutting instrument, that is used in situations where a straight-sided cut is desired.

Gouge can be considered a V-shaped chisel and it produces small troughs in bone tissue.

An elevator is used to ‘lift’ or ‘separate’ a body tissue.

Rasp: The purpose of using a rasp is to remodel bone tissue.

Saws are used in surgical procedures that need cutting of bones.

Forceps (pickups)

Forceps are non-locking surgical instruments used to manipulate body tissues or for grasping suture needles. Forceps may be ‘smooth’ or ‘toothed’. Toothed forceps contain teeth in the jaws and are described by the number of teeth and their slots on the opposing jaws. E.g. a 2x3 forceps contains 2 teeth and 3 slots.

Dilators & Probing Instruments

A living body consists of multiple tubular structures. These tubular structures may lose their patency due to disease. Probes are therefore used to assess a structure for patency. In other cases, probes may be used to ascertain the type of bone or similar tissue by touching it physically.

The tubular structures may require dilatation during a surgery. Dilators are cylindrical surgical instruments that are utilized to increase the internal diameter of tubular body tissues.

Suturing Instruments

These instruments are used for suturing body tissues. A ‘needle holder’ is a classic example of this class of surgical instruments. 

Surgical Stapling & Ligating Devices

Stapling instruments and hemostatic clips fall under this category.

Stapling instruments are capable of applying sutures either by firing individually or in double or multiple lines. The use of surgical stapler reduces trauma to body tissues and the applied sutures are more dependable. A variety of surgical staplers are used for surgical purposes. These include ligating-dividing stapler (LDS), skin stapler, Gastrointestinal anastomosis stapler (GIA), Thoraco-abdominal stapler (TA), end-to-end anastomosis stapler (EEA) and purse-string stapler etc.

Hemostatic clips made of stainless steel, tantalum, titanium or an absorbable polymer are V-shaped staples that function to occlude a blood vessel or duct.