Surgical Instruments Flashcards
What sizes are these?
A - No4
B - No3
What blades will these accept?
A 20, 21, 22, 23
B 10,11,12,15
Why do you need different sized scalpel handles?
Handle A is more commonly used in large animal practice to accept larger blade sizes.
Handle B is generally used for small animal general surgery.
Other handles are available for different situations like ophthalmology.
Name and use
Littauer scissors
Used for removal of tight or awkward sutures
Name and use
Metzenbaum scissors
Good for fine dissection of tissues and more delicate work. Not for cutting suture material.
How would these be held?
Held in the Tripod grip.
Thumb in one ring and third or ring finger in the other ring.
1st and 2nd finger are used to stabilise the instrument along the blade.
Name and use
Mayo scissors
It is used for cutting heavy or tough tissue, such as fascia.
How would these be held
Held in the tripod grip.
Thumb in one ring and third or ring finger in the other ring.
1st and 2nd finger are used to stabilise the instrument along the blade.
name and use
dressing scissors
Used for cutting dressing material and general work.
Also used for cutting suture material during surgery.
How would these be held?
Held in the tripod grip.
Thumb in one ring and third or ring finger in the other ring.
1st and 2nd finger are used to stabilise the instrument along the blade.
Name the artery forceps/haemostats
A Mosquito
B Spencer Wells
C Rochester Pean
Name the bowel clamp
Doyen bowel clamp
which is the artery forceps and which is the bowel clamp and why?
Why are the ends different?
1 Artery forceps (serrated appearance is transverse on the blade)
2 Bowel clamp (serrated appearance runs lengthways along the clamp)
The bowel clamps striations are less traumatic and thought to be more secure in sealing the bowel during surgery.
Name and use
Spay forceps
Elevating the uterine horn in a cat spay. Most forceps have a plain grip, but these have a
Debakey grip which is a secure grip less traumatic than rat toothed forceps.
Good for surgery of ear, bowel or urogenital tract.
Name and use
Block ended serrated dressing forceps
Cheap dressing forceps, minimal use during surgery
Name, varieties and uses
Adson tissue forceps
Rat toothed - gives more grip when needed but can be traumatic, not for use with visceral organs.
Serrated end - has less grip but little trauma to tissue good for fine tissue handling.
Name and use
Treves tissue forceps
General purpose rat toothed forceps.
Used in general surgery.
Traumatic to tissues.
Name and use
Allis tissue forceps
Use for grasping and retracting more tough connective tissue for example the linea alba. They can be traumatic so not to be used on skin
name and use
Babcock forceps
For use in grasping more delicate viscera and retracting.
Less traumatic than Allis tissue forceps.
name and use
Gosset retractors
Rib/laparotomy retractor
name and use
Hohman retractors
Retraction of bones/bone fragments during fracture repair
name and use
Gelpi retractors
Joint surgery and spinal surgery
name and use
Travers retractors
retraction of skin and superficial soft tissue
name and use
senn retractors
fat pad retraction in medial meniscus repair
name and use
Balfour retractors
retraction of the body wall during an exploratory laparotomy
Name
Mayo needle holder (with tungsten carbide inserts)
name
Olsen hagar needle holder
name
gilles needle holder
Name
McPhails needle holder
What does B and C have that the others do not, how is this useful?
Scissor
For cutting suture during surgery no need for separate instrument.
Can continue suturing without putting needle holders down
What does A, B and D have the C does not. How is this useful?
Locking catch
Good grip of the needle
Name and use
Backhaus towel clamp
Securing drapes to patient
Name and use
Cross over towel clamp
Securing drapes to the patient
Are there towel clamps other than these that may be better?
Yes. There are some atraumatic towel clamps which are more friendly to the patient and less likely the pierce through the drape material.
They can sometimes be less secure.
name and use
spay hook
Atraumatically lifting the uterine horns within the abdomen.
name and use
Rongeurs
Nibbling away tough edges of bone
name and use
periosteal elevator
removal of periosteum from bone
name and use
Staple removers
What information can you gather from the packet of suture material?
Name of suture material - Monosyn
Monofilament or multifilament - monofilament
Absorbable or non-absorbable - absorbable
Diameter in USP and metric - 3/0 2m
Length - 70cm
Colour or undyed - violet
Details of needle - as illustrated in actual size
Manufacturer – B/Braun
Batch number – LOT 13254R
Expiry date – 2028-06-44
How it is sterilised – Ethylene oxide
What factors do you need to consider when choosing an appropriate suture material
-the type of tissue you are repairing and nature of the wound
-how long it needs support for
-the characteristics of the suture material
-size of suture material
-the type of needle – cutting or atraumatic
-what is available in the practice
-preference or what you are used to using
-Permanent or absorbable suture material?
-Long-term, medium-term or short-term support?
-Smallest size of suture material that provides adequate support
Rule of thumb - 3metric for dogs, 2 metric for cats
delicate tissue- reduce by 1 size
tough tissue- increase by one size
-Least traumatic needle that will do the job
Describe the use of the penholder grip
stable
good contact angle
allows only short slide cuts
Describe the use of the fingertip grip
less stable
flatter contact angle
allows long slide cuts
Describe the use of the ‘stab cut’
Visceral puncture
Difficult to control depth
Describe the use of the ‘push cut’
Large animal surgeries only
Deep incision
What is the purpose of a #10 blade
general purpose
small animal
What is the purpose of a #12 blade
suture removal
What is the purpose of a #15 blade
general purpose
cat
What is the purpose of a #20 blade
general purpose
large animal
Describe the use of artery forceps
Curved up - grasping tissue bunch
Curved down - picking up small bleeders
What suture material and size is suitable for the ligature of the uterus in a 25kg labrador?
Monosyn or Novosyn - size 3 metric (2/0)
What suture material and size is suitable for the linea alba in a 25kg labrador?
MonoPlus(PDS) (long term support) - size 3/3.5 metric (2/0 / 0)
What suture material and size is suitable for the subcutaneous and subcuticular tissue in a 25kg labrador?
Monosyn size 3 metric (2/0)
A Jack Russel terrier has had a tooth removed during a dental and the gum
needs suturing. What suture material would be suitable?
Monosyn Quick a short-term support
In an orthopaedic surgery, what suture material would be suitable for the following tissues?
Fascias
Tendons and ligaments
Joint capsule
Fascias – MonoPlus long term support
Tendons and ligaments – MonoPlus long term support.
Joint capsule – MonoPlus long term support
Size 3 metric (2/0)
What methods of skin closure are available
Suturing
Skin staples
Tissue adhesive
Describe the use of skin staples
quick and easy to apply, requires a special instrument to remove staples
Describe the use of tissue adhesive
useful in rabbits and other small animals as it is more
acceptable to them instead of skin sutures
