There are a myriad of instruments needed for surgical procedures. Choosing the right surgical instruments makes a difference in the procedure.
Some instruments grasp or hold tissue to enable surgeons to have a closer view of their field. Examples include hemostatic forceps for clamping blood vessels, tissue forceps, towel clamps, and rat toothed forceps.
Hemostats
Hemostats are an essential tool for many surgical procedures. They are used to clamp blood vessels and prevent bleeding during surgery. They are available in a variety of styles and patterns to fit various surgical practices.
Hemostatic forceps are tools with interlocking jaws and ratchet locks. They are available in curved and straight patterns and can have half or fully serrated tips. They can also have different color coatings to distinguish them between other instruments. Some examples include Adson Forceps, Mixter Forceps, Rochester Ochsner Forceps, Dandy Forceps, Mosquito Forceps, and Schnidt Tonsil Forceps.
These hemostatic forceps can be used for a variety of purposes, from clamping small blood vessels to hemorrhage control to grasping superficial fascia securely while debriding wounds. They are made from high quality surgical stainless steel to ensure low irritation around soft tissue and easy cleaning and sterilization. They are also durable, allowing surgeons to use them for prolonged periods of time. For a more precise grip, curved hemostats can be used to grab fine tissues. The curved beaks allow them to get into tight spaces that are difficult for straight hemostats to access.
Clamps
In general surgery, clamps help hold tissues firmly to prevent blood vessels from bleeding. They come in various shapes, sizes and curved designs. They may be stainless steel so that they can be sterilized and used again or disposable plastic for a singular use.
Like forceps, they can be straight or curved and may or not have teeth. They can also be self-retaining or hand-held. The most common ones are Kelly, Fogarty, vascular (glover), clamp tubing and mosquito.
Other types of clamps include the Duval clamp, which resembles a pair of tweezers with sharp but blunt prongs to grasp tissue without causing any damage, most often used in rectal and intestinal surgeries. Another similar clamp is the Alexander Periosteotome which has a giraffe-like neck to reach into the nasal cavity during sinus surgery.
Staplers are a more specific category that provides simultaneous cutting and sealing of tissue or vessels. They can be one-time-use, reloadable, manual or electronically powered. They can be linear cutters or circular staplers, which both cut and then immediately seal free edges.
Forceps
Forceps are a smooth metal medical device that look like a large pair of spoons or tongs. They are used to help guide a baby’s head through the birth canal during childbirth.
They are inserted in the uterus and locked together, then maneuvered to cradle the fetal head, and finally traction is applied to effect delivery. The handles of a forceps have two prongs that grasp the fetus, each with a different curve, called the cephalic or face blade and the pelvic or maternal introitus blade. The handles can be molded to fit the shape of the fetal head, and the blades can either be smooth or fenestrated (with holes).
Obstetricians generally only use forceps during labor when the baby is not turning in a normal position or if your body cannot produce enough contractions to push the baby out. They also typically do an episiotomy to reduce the risk of tears in the perineal area. If you need a forceps delivery, your obstetrician will usually perform a cesarean section at the same time in case the forceps fail.
Needle Holders
Surgical needle holders are essential tools to ensure patient safety, hygiene and performance of medical procedures. They offer a secure grip on the needle which improves handling and prevents accidental needle breaks. They are available in various configurations to support physician preference for jaw shapes and sizes and to ensure high performance during particular medical procedures.
They are usually made from stainless steel and are able to accommodate different needle sizes. Often, the needle holder jaws are textured with patterns or have replaceable tungsten carbide inserts that reduce wear and tear while increasing precision and gripping power. Some specialty needle holders are the Castroviejo needle holder that can hold both curved and straight needles, as well as the Mathieu needle holder that is used for plastic surgery and has a ratchet handle lock to increase control.
A tip for assessing whether a needle holder is wearing out is to shine a bright light through the closed jaws. If a significant amount of light is visible, the jaw insert or stainless steel may need to be replaced.
Sutures
Sutures are an essential part of most surgeries. The surgeon’s preference for needle types, along with the specific requirements of each surgical technique, dictates the type and size of suture used in a procedure. There are a plethora of needle options available, including different curvature arcs and lengths, which allow the surgeon to isolate tissue without damaging nearby structures.
There are also a wide variety of retractors designed to aid in exposing the structures that need to be accessed in surgery. These instruments may be handheld, such as a crile hemostat, or self-retaining with a ratchet mechanism, such as a Kelly clamp or Allis retractor.
There are also two main types of sutures: absorbable and non-absorbable. Absorbable sutures require the doctor to remove them from the wound after the operation, whereas non-absorbable sutures are left in place permanently. For example, clear polypropylene sutures (trademark name: Prolene) are often used in obstetrics to secure the skin after a Caesarean section and in trauma laparotomies to close fascial defects and secure mesh. These sutures are long-lasting, durable and easy to handle, allowing the surgeon to make precise knots with minimal hand fatigue.