Part of the TeachMe Series

Surgical Instruments

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Last updated: March 10, 2021
Revisions: 4

Last updated: March 10, 2021
Revisions: 4

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Introduction

There are a wide array of instruments available for use during a surgical procedure, each with their specific uses and advantages (and disadvantages).

As a surgeon, it is important to know not only their names but when they should be used, and each speciality will have their own specific kit.

In this article, we cover the main instruments found in a general set for open abdominal surgery.

Ratcheted Forceps

Allis

Allis forceps are toothed surgical instruments, used to grasp firm tissues (such as fascia).

Figure 1 – Allis Forceps

Babcock

Babcock forceps are jawed instruments with a smooth end, allowing for more delicate structures (such as bowel) to be held in an atraumatic manner

Figure 2 – Babcock tissue forceps

Dunhills

Dunhill forceps are small forceps with curved serrated ends, often used to grasp vessels prior to ligation

Figure 3 – Dunhill forceps

Lane Tissue Forceps

Lane tissue forceps have interlocking teeth, allowing the grasping of tough tissues, such as fascia

Figure 4 – Lanes tissue forceps

Littlewoods

Littlewood forceps have blunt ended teeth, used to grasp tough tissues, such as fascia. They are often used to gain entry via the umbilicus for laparoscopic surgery.

Figure 5 – Littlewood forceps

Sawtell

Sawtell forceps are curved forceps with a serrated end, often used to grasp vessels prior to ligation

Figure 6 – Sawtell forceps

Spencer Wells

Available as curved or straight, Spencer Wells forceps can be used to clamp medium to large sized vessels prior to ligation

Figure 7 – Spencer Wells forceps

Non-Ratcheted Forceps

Debakey

Debakey forceps are non-toothed forceps used in a wide variety of procedures, importantly can be used to grasp tissues (such as bowel) without damaging them

Figure 8 – Debakey forceps

Lanes

Lanes forceps are toothed instruments, useful for grasping tissues and are widely used within all surgical specialities (however not to be used to grasp bowel)

Figure 9 – Lanes forceps

Gillies

Gillies forceps are narrow toothed forceps, often used to grasp skin (not to be used to grasp bowel)

Figure 10 – Gillies forceps

Scissors

Mayo

Mayo scissors are heavy scissors, with semi-blunt ends, often used to cut thick tissues or sutures, either straight or curved

Figure 11 – Mayo scissors

McIndoe

McIndoe scissors are used often for cutting or dissecting tissues, characteristically have a curved blade

Figure 12 – McIndoe scissors

Retractors

There are multiple types of retractors available, all of varying sizes and length, such as Langenbeck, Travers, Morris, or St Mark’s retractors. There use is dependent on the operation and wound involved, however the most common are discussed below.

Langenbeck

The Langenbeck retractor is a hook shaped retractor with an L-shaped end, used to keep back tissue or separate the edges of wounds. They come in small, medium, or large sizes, depending on the depth of the cavity required

Figure 13 – Langenbeck retractors (A) Small (B) Medium (C) Large

Norfolk and Norwich

The Norfolk and Norwich retractor is a self-retaining retractor, used to keep deep wounds and cavities open, with blunt ends to reduce risk of iatrogenic tissue injury

Figure 14 – Norfolk and Norwich retractor

Travers

The Travers retractor is a self-retaining retractor, with short ends for use in keeping superficial wounds open

Figure 15 – Travers retractor

Other

Needle Holder

For holding needles, will come in varying sizes and length depending on the needle and tissue in question

Figure 16 – Needle holder

Sponge Holding Rampley

Rampleys can be used for handle guaze or sponges

Figure 17 – Sponge-holding Rampley

Towel Clips

Towel clips are most commonly used to secure towels or drapes in place, however can be used to grasp tissue if required

Figure 18 – Towel clips

Key Points

  • There are a wide range of surgical instruments available, all with varying designs and uses
  • Ensure to learn the names and advantages of all instruments available in the operating theatre