Surgical Instruments
DeBakey forceps Non-toothed dissecting forceps designed for use on blood vessels Adsons forceps Toothed tissue forceps for holding and manipulating delicate tissues Allis forceps Used to hold or grasp heavy tissue. Also used to grasp fascia and soft tissues such as breast or bowel tissue. Due to the sharp teeth they can cause damage, so are mainly used in tissue about to be removed. Babcock forceps Similar to Allis but cause less trauma. Non-perforating forceps used to grasp delicate tissue in laser procedures. Frequently used in intestinal and laparotomy procedures. Kelly forceps Primarily used for clamping large blood vessels or manipulating heavy tissue. May also be used for soft tissue dissection.
Available curved or straight. The jaws are 1/3 the length of the shanks and serrations are 1/2 the length of the jaws. Mosquito forceps Used in multiple procedures as a hemostat for small blood vessels. Toothed variation available for grasping delicate tissue in skin grafting, biopsies, or ophthalmologic procedures. Known for their fine tips, and short, fully serrated jaws. Available curved or straight. Right angle forceps Commonly used for working in obscured surgical sites. Most frequently used for clamping, dissection, or grasping tissue. Kocher forceps Heavy instrument designed to aggressively grasp medium to heavy tissue or occlude heavy, dense vessels. Horizontal serrations the entire length of the jaw as well as 1 X 2 teeth at the tip.
Basic Instrument Suture Tie
When tying suture knots, properly squaring successive throws is important. That is, each tie must be laid down perfectly parallel to the previous tie by reversing the loops in each successive throw. When tying rope, this is accomplished using the memory aide “left over right and twist, and then right over left and twist.” With instrument ties, this is accomplished by alternating sides as the suture is twisted around the needle driver. This procedure is important in preventing the creation of a granny knot, which tends to slip and is inherently weaker than a proper square knot. The first throw in the knotting sequence is often looped or twisted twice, producing the surgeon’s knot. When the desired number of throws is completed, the suture material is cut (if interrupted sutures are used) or the next suture may be placed (if running sutures are used). An absolute minimum of three throws are needed for knot security, but some sutures require more throws to remain tied. When in doubt, five throws will hold almost all sutures securely.
