BASIC

SURGICAL
INSTRUMENTS
Prepared by: Ada Marie Magnayon,
RN, CLSSYB
 At the end of the session the
student will be able to:
1. Enumerate the categories of
Course surgical instrument
2. Identify the name of the
Objectives instruments and its functions
3. Demonstrate proper handling
and care of the surgical
instrument
 • Brief History of Surgical

Course Instrument
• Care and Handling of
Instrument
Outline • Parts of an instrument
• Instrument Categorization
Brief History
• A surgical instrument is a specially designed
device or apparatus used to carry out specified
task during a surgical procedure.

• Throughout history, surgical instruments have

been created from a variety of materials, such
as ivory, wood, bronze, iron, and silver.

• The discovery of anesthesia and asepsis in the

nineteenth century and the development of
stainless steel in the twentieth century started
the modern evolution of surgical
instrumentation.
Brief History
• The twenty-first century has already
seen advances in remote telesurgery,
robotics, and image-guided systems,
which have changed the way surgery is
performed and how instruments are
developed.

• The next generation of surgical systems

and new materials will revolutionize the
way surgical instruments are designed
and created.
Brief History
• Most surgical instruments, however, are
still manufactured from stainless steel.

• During fabrication, one of three types of

finishes is used on stainless steel
instruments.

• Gold plating on an instrument signifies

that tungsten carbide was incorporated
into the manufacturing process.
Care and Handling of
Instruments
• Properly preparing, using, and processing
instruments promotes patient safety,
prolongs the life of the instrument, and
decreases repair and replacement costs.

• All surgical instruments are designed for

a specific use.

• Misuse of an instrument can also

endanger patients.
Care and Handling of
Instruments
Simple steps can keep instruments in proper
working order.
• Before, during, and after surgery,
instruments should be placed onto the
designated area.
• To ensure patient safety, instruments should
be inspected and tested before each surgical
procedure.
• Instruments should be clean and free of
debris, properly aligned, damage free, and in
good working order
Care and Handling of
Instruments
• Edges or tips should be placed so that they
do not endanger the personnel who will be
cleaning them.
• Delicate instruments, rigid endoscopes,
cameras, and fiberoptic light cords should be
separated to prevent damage.
• All cords should be loosely coiled.
• Power saws and drills should never be
immersed in solutions
Parts of an Instrument
Main Components 
• Handles
• Ratchets
• Shanks
• Joints
• Jaws or blade
• Tips
Parts of an Instrument
Main Components 
• Handles
• Ratchets
• Shanks
• Joints
• Jaws or blade
• Tips
Parts of an Instrument
Main Components 
• Handles
• Ratchets
• Shanks
• Joints
• Jaws or blade
• Tips
Instrument Categorization

ACCESSORY CLAMPING AND CUTTING AND GRASPING AND

OCCLUDING DISSECTING HOLDING
is an instrument that used to compress vessels are designed to grip and
does not fall into any of used to incise, dissect,
and other tubular and excise tissues. manipulate body
the other categories but structures to impede or tissues. They are often
has a specific function obstruct the flow of used to stabilize tissue
and is an integral part of blood and other fluids that is to be excised,
the surgical procedure dissected,
repaired, or sutured
 Instrument Categorization

PROBING AND DILATING RETRACTING AND SUCTIONING AND SUTURING AND

EXPOSING ASPIRATING STAPLING
are used to explore a are designed to hold
are used to remove are used to ligate, repair,
structure, opening, or back or pull aside wound
blood, fluid, and debris and approximate tissues
tract edges, organs, vessels,
from operative sites. during a surgical
nerves, and other tissues
to gain access to the procedure
operative site
Accessory Instrument
ELECTROSURGICAL PENCIL
Bovie, cautery, monopolar cautery,
diathermy, electrocautery

Use(s):
Monopolar cautery uses electrical
current to coagulate and cut blood
vessels and tissues to provide
homeostasis; it is also used for
dissection.
Clamping and
Occluding
HALSTEAD FORCEPS
Mosquito forceps, Hartman forceps

Use(s):
Used for occluding bleeders in small or
superficial wounds before cauterization or
ligation. Used often for delicate or small
confined procedures. Some examples are 
plastic, pediatric, thyroid, and hand
procedures
Clamping and
Occluding
KELLY FORCEPS
Hemostat, Crile forceps, clamp

Use(s):
A curved or straight clamp with horizontal
serrations that run about half the length of
the jaws.

Used for occluding bleeders before

cauterization or ligation
Clamping and
Occluding
PEAN FORCEPS
Péan, Mayo, Kelly-Péan forceps

Use(s):
Used for occluding larger blood vessels
and tissue before ligation, usually in a
deeper wound or on heavier tissue.
Clamping and
Occluding
MIXTER FORCEPS
Right angle forceps, Gemini forceps, Lahey
forceps, obtuse clamp, ureter clamp

Use(s):
Is used to clamp, dissect, and occlude tissue. Is
often used to place a tie or vessel loop under and
around a tubular structure such as a vessel or a
duct, enabling the surgeon to grasp the ligature
or loop and pull it up and around the structure to
either ligate or retract
Cutting and Dissecting
STRAIGHT MAYO SCISSORS
Suture scissors

Use(s):
Used for cutting sutures.
Cutting and Dissecting
CURVED MAYO SCISSORS
Heavy tissue scissors

Use(s):
Dissect or undermine heavy fibrous
tissues.
Cutting and Dissecting
CURVED METZENBAUM 
SCISSORS
Metz scissors, tissue scissors

Use(s):
Dissect and undermine delicate tissues.
Cutting and Dissecting
LISTER BANDAGE SCISSORS
Bandage scissors

Use(s):
Cut dressings, drapes, and other items and
used in a cesarean section to open the
uterus without harm to the baby.
Cutting and Dissecting
NO. 3 KNIFE HANDLE
A no. 3 handle holds blades 10, 11, 12,
and 15.

Use(s):
Knife handles are used to hold various
blades to create a scalpel. Scalpels are
used to make skin incisions or whenever a
fine precision cut is necessary
Cutting and Dissecting
NO. 7 KNIFE HANDLE
A no. 7 handle holds blades 10, 11, 12,
and 15.

Use(s):
Used when precision cutting is needed in
a confined space or a deep wound.
 Surgical Blades for No. 3 and 7

BLADE #10 BLADE #11 BLADE #12 BLADE #15

Sickle Knife
Used for making skin Used for puncturing the
used during Used for creating small
incisions skin or to initiate the
tonsillectomies, parotid precise incisions
opening of an artery
surgeries,
septoplasties, and cleft
palate procedures
Cutting and Dissecting
NO. 4 KNIFE HANDLE
The no. 4 handle will hold blades no. 20,
21, 22, 23, 24, and 25

Use(s):
Used with the no. 20 blade to create a
larger and/or deeper incision in heavy
tissue areas.
Grasping and Holding
ADSON TISSUE FORCEPS
Adson dressing forceps

Use(s):
Used for grasping delicate tissue
Grasping and Holding
TOOTHED ADSON TISSUE FORCEPS
Adson with teeth, rat tooth

Use(s):
Aligns the edges of the wound during
stapling of the skin; grasps superficial
tissues so that Steri-Strips can be placed
Grasping and Holding
PLAIN TISSUE FORCEPS
Semken dressing forceps, smooth forceps,
tissue forceps without teeth

Use(s):
Used for grasping tissue and dressing
application
Grasping and Holding
TOOTHED TISSUE FORCEPS
Semken tissue forceps, rat tooth, tissue
forceps with teeth

Use(s):
Used for grasping moderate to heavy
tissue and used during wound closure
Grasping and Holding
DEBAKEY TISSUE FORCEPS
DeBakey’s, DeBakes

Use(s):
Grasps numerous types of tissue;
commonly used in cardiac, vascular
surgery, and gastrointestinal procedures
Grasping and Holding
RUSSIAN TISSUE FORCEPS
Star forceps, Russian star forceps, Russians

Use(s):
Used for grasping dense tissues and used
during wound closure
Grasping and Holding
TOWEL CLIP (PENETRATING)
Backhaus towel clip, Roeder towel clip,
Jones towel clip

Use(s):
Used for holding towels in place when
draping, when grasping tough tissue, and
during reduction of small bone fractures
Grasping and Holding
NONPENETRATING TOWEL CLIP
Atraumatic towel clamp

Use(s):
Used for attaching Bovie and suction to
the drapes
Grasping and Holding
FOERSTER SPONGE FORCEPS
Fletcher sponge forceps, sponge stick
forceps, ring forceps

Use(s):
Used for creating a sponge stick, for
grasping tissues such as the lungs, or for
removing uterine contents
Grasping and Holding
ALLIS FORCEPS

Use(s):
Used for lifting, holding, and retracting
slippery dense tissue that is being
removed. Commonly used for tonsils; for
vaginal, breast, and thyroid tissues; or for
grasping bowel during a resection.
Grasping and Holding
BABCOCK FORCEPS

Use(s):
Used for grasping and encircling delicate
structures such as the ureters, fallopian
tubes, bowel, ovaries, and appendix.
Grasping and Holding
KOCHER FORCEPS
Koch forceps, Ochsner forceps

Use(s):
Used for grasping tough, fibrous, slippery
tissues such as muscle and fascia
Retracting and
Exposing
ARMY-NAVY RETRACTOR
Army’s, Navy’s, U.S. retractor

Use(s):
Used for retraction of small superficial
incisions to allow better exposure
Retracting and
Exposing
SENN RETRACTOR
Cat paw retractor

Use(s):
Used for retraction of skin edges and
deeper tissues of small incisions
Retracting and
Exposing
MURPHY RETRACTOR
Rake retractor

Use(s):
Used for superficial retraction of wound
edge
Retracting and
Exposing
RIBBON RETRACTOR
Malleable retractor

Use(s):
Used for retraction of organs and
intestines in a wound
Retracting and
Exposing
SKIN HOOK
Joseph hook, Gillies hook

Use(s):
Used for retraction of the skin edges.
Retracting and
Exposing
WEITLANER RETRACTOR

Use(s):
Holds wound edges open.
Retracting and
Exposing
GELPI RETRACTOR

Use(s):
Provides wound exposure, ranging from
superficial to deep depending on the
wound depth
Suctioning and
Aspirating
FRAZIER SUCTION TIP

Use(s):
Used for suctioning in confined spaces
such as the nasal cavity, in lumbar and
cervical procedures, or in craniotomies.
Suctioning and
Aspirating
POOLE SUCTION TIP
Abdominal sucker

Use(s):
Used for suctioning large amounts of
blood and/or fluids from a body cavity.
The inner cannula of this suction tip can
be used to suction down the shaft of the
femur during a total hip replacement
procedure
Suctioning and
Aspirating
YANKAUER SUCTION TIP
Tonsil suction tip, oral suction tip

Use(s):
Used for suctioning in all types of wounds.
It allows for effective suctioning without
aspiration damage to the surrounding
tissue
Suturing and Stapling
CRILE-WOOD NEEDLE
HOLDER
Fine needle holder, fine needle driver

Use(s):
Used for holding delicate to intermediate-
sized needles when suturing
Suturing and Stapling
MAYO-HEGAR NEEDLE
HOLDER
Heavy needle driver

Use(s):
Used for holding heavy needles
when suturing
Suturing and Stapling
RYDER NEEDLE HOLDER
Ryder needle driver, fine needle
driver

Use(s):
Used for holding delicate to
intermediate-sized needles when
suturing. Often used for vascular
procedures.
Suturing and Stapling
SKIN STAPLER

Use(s):
Used during wound closure for skin
approximation
Suturing and Stapling
STAPLE REMOVER
Staple extractor

Use(s):
Used for the removal of skin
staples from the wound.
 • Nemitz R. (2019). Surgical
Instrumentation, An Interactive
Approach. Third Edition, Elsevier
• Goldman M. (2008). Pocket guide to the
operating room. Third Edition. F.A. Davis
Company

REFERENCES