Surgical Instruments

‫بسم ال الرحمن الرحيم‬

‫يَرْفَعِ الُّ الّذِينَ آمَنُوا مِنْكُمْ وَالّذِينَ أُوتُوا‬ ‫الْعِلْمَ َدرَجَاتٍ وَالُّ بِمَا تَعْمَلُونَ خَبِيرٌ"‬ ‫صدق ال العظيم‬ ‫سورة المجادلة آية رقم ‪11‬‬

‫قال رسول ال صلى ال عليه وسلم‬

‫إذا مات ابن آدم انقطع عمله إل من‬ ‫ثلث صدقة جاريه أو علم ينتفع به‬ ‫أو ولد صالح يدعو له‬ ‫صدق رسول ال صلى ال علية وسلم‬

‫إعدا د‬

‫ا‪.‬د‪ /.‬جمال ابراهيم موسى‬ ‫أستاذ جراحة الجهاز الهضمى والمناظير‬ ‫كلية الطب جامعة طنطا‬

Mosqui to -1 :forceps

Straight

Curved

Us ed fo r: Ha emo st asis, in cat chi ng of smal l vess el as, subcutaneous or sub- mucosal vess el s bef ore ligation or cauteri zati on.

Blade Joint

Shaft Lock

Handle

:Artery

forceps

-2

•*U se d fo r. •# Ha emo st asis, In catching of medium sized vessels as subcutaneous or epiploic vessels during spleenectomy before its ligation. •# Pa rie tal perito neum elevation before its opening in abdominal operations.

Straight

Blade

Shaft

Handle

Curved

What is the di fference between the Mosqui to & Artery ?

Blade

3- Clamp forceps:

•Us ed fo r Ha emo st asis in catching of large size vessels as, • spleenic during spleenectomy & renal during nephrectomy before their ligation.

Straight

Curved

Shaft

Handle

What is the di fference bet ween thi s ?i ns trument s Clamp

Lar ge

Artery

Mosquito

Medi um

K ocher - 4 :f orceps

Teeth Blade

Use d fo r* Grasping tough* structures as tendon, sheath or .muscle Crushing the base*

Joint

Lock Shaft

of the appendix in .appendectomy Handle

What are the differences between Artery & Kocher? 1- Length of blade. 2- Teeth. 3- Depth of serration.

Blade

:N eedl e hol der -5 Grasp the needle*

Shaft

for stitching

Handle

Artery

Needle holder

What are the di fferences between arter y and needl e hol der: -1 le ngth o f th e • bla de in rela tion .t o shaft -2 Corr ugatio n • of t he blade Artery

Needle holder

Moyni han -6 Chol ecystectomy :)artery

(

Blade

Grasping the cystic vessels & cystic duct before their ligation during cholecystectomy operation.

Shaft

•Used in

Handle

What is the di fference between and arter y curve? Curved artery Obtuse

Moynihan Right

Moynihan

Blade. Flat-Thin-Non crushing

Intest inal -7 :cl amps

Blade

Grasp the intestinal loop in resection anastomosis. A- Non crushing intestinal type (flat thin blade) • Differ from artery in blade length in relation to shaft & Corrugation of shaft

Shaft

Handle

Straight or curved

B- Crushin g in te st in al clamp

Intestinal clamps

C-Ga stric cla mp:

Blade

Joint

D-D ouble Ga st ric cla mp

Ga st ro intestinal c la mps

-8 All is :f orceps

Blade

Used fo r* - Catching the skin as in scalp incision, thyroid surgery -Meso-appendix in appendectomy

Blade Toothed Closed at the tip only

Shaft

-Edge of bowel in bowel anastomosis Handle

What are th e diffe rences betw een ?a rte ry & A ll is bla de Artery Allis .Space after closure -1 Teeth on tip of Allis -2 Blade ( short, shallow .(Depression in between

Blade

Blade

Babcock -9 :f orceps

Blade

•En circ lin g str uctures as vas a nd u re te r. •Catch s tr uctures as

Shaft

appendix a nd bowel wa ll Handle

What are th e diffe rences betwe en Alli s a nd Babcock bla de?

Pin pointed end of the blade

Towel -10 :cl ips For * graspin g t he edge of the to we l over the patie nt aft er skin ste rili za tio .n

Blade

Shaft

Handle

* Another type of towel clips

11 - Tongue grasper .

Blade

Used for traction of the tongue outwards Blade

Joint

Shaft

Lock

Handle

1- St one forceps

Scope on blade

) Ureter ic, bi liar y and Bl adder (: •Us ed fo r

Shaft

Stone extraction from the ureter, common bile duct and urinary bladder. Ureteric & Billiary

Handle

Bladder

What ar e t he dif ferences ?& bl adder forceps

between

uret eri c

-2 :Sci ssors .Us ed fo r Tissue* .dissection

Sti tches

Ti ssue

Blade

Joint

cutting Tissue* Opening* .peritoneum Stitchremoval*

Shaft

Handle

3- Bone cutti ng forceps.

Blade

Us ed fo r.

Joint

1- Cutting ribs. 2-Cutting small bones. 3-Circumcision.

Spring

Handle

Blade

4- Cr ocd yle forceps

Joint

5- Pr octoscope

Blade

)Ano- scope( Used for. *In sp ectio n o f the a nal c anal & lo we r rectu m before o r durin g anal o peratio ns

Handle

Joint

-1 : Retra ctores *Retraction of the abdominal wall. *Liver retractors. *Retraction of viscera. To open surgical A- Hand )Non-self field. Retaining(.

1- Skin retra cto rs

Mu sc le -2 :r etr actors

3- Abdominal wa ll retr actors:

4- Liver o r v isceral re tracto rs :

B- Self

Lock

retai ning retrac tors Blades

Ot her ty pes Self reta ining retr actors

Tip

2Di lat ors: A- U re thral

Rounded blunt tip

- Ur eteric - B illia ry

Shaft

Base

B-Hegar , s dil ato r. With d ouble size end

C- He gar )F ento n( d ila to r. With one size end.

Ti p

Bas e

-3 :Ti ssue f orceps A - No n toothed fo r c atching fine stru cture a s in te st in e, bladder o r .t ube B - To oth ed fo r c atching tough stru cture a s skin , .tendon or muscle Toothed

4- Fistul ae di rect or:

Tip

In sertion in side •fistulae tracts before fistulotomy.

Shaft (grove)

• Inside constricting hernia ring. • Its handle (base) may used in tie tongue Base

Scal pel -5 .handl e

For scalpel inserti on

Encircling the rib

:Ri b diss ector -6 For separation of the rib* from its bed Handle

Sharp edge

-7 Per ios teal :el evator For elevation of * periosteum as in amputation .and skull surgery

Handle

Opening for thread insertion

Aneurysm :needl e

-8

For encircling vessel or * tubular structure with a .thread

Spoon

9- C ur ette spoon )Bone curett e(. *Curettage for chronic ulcer, sinus or chronic osteomyelitis

Handle

Spoon

9- Circumcision device

-1 Corr ugated :rubber drai n *Advantages. Simple, Not expensive . *Disadvantages. Introduce infection and we can not measure the amount of discharge.

Vacuum drain -2 :))Negative pressure ,Closed system* not introduce infection from outside measure the amount of * .discharge But may lead to* visceral injury if present intra-peritoneal by negative .suction and expensive

*O th er typ es of drain : --Sump drain -- T ube drain -* In dic atio ns of d rains? -* Time of drain

-3 Fl ui d inf usio n :set For intravenous• infusion of any fluid as glucose .and saline Another type*• for blood with large needle and filter inside its . bulb

Needle

Bulb

Lock

4- Blo od inf usio n set Needle Bulb

Lock

What are t he dif ferences bl ood inf us ion set ? 1Needl e 2Fi lt er

between

flui d &

5- Selo ce t )infusi on set for neonates & chil dren(

:Catheter s- 6 A-Foley (self .(retaining With double or .triple ways Left inside the bladder for .time B-Nelaton. Removed after evacuation of the .bladder

C- Depezer catheter.

head

7- Rayel tu be:

Distal (inner) end

•For g astr ic aspira tio n. •Aft er la parotomy • In te st in al obst ru ction

Proximal (outer) end

• Afte r anasto mosi s Cat heter

Di ffer ence betw een Rayel ?catheter

and Nel aton

8- T- tube *In dicatio n s. *Time o f remo val. Ver ti cal limb Inside common bile duct

Ho rizo nt al limb

?Are you know this instruments