Types of Surgical Instruments – Names and Instrument Selection

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If we classify them according to their function, there are three main types of surgical instruments:

  • Cutting surgical instruments – Such as blades, knives, scissors and scalpels.
  • Grasping surgical instruments – Anything you use to hold something in place, such as forceps.
  • Retracting surgical instruments – For holding incisions open, or for holding organs and tissues out of the way while you operate.

Types of Surgical Instruments For Cutting

These are some of the most common surgical instruments for cutting:

Blades, Knives and Scalpels

We categorise scalpels by their size and shape, and each type is good for a different sort of application. For example, surgeons usually choose a number 10 blade for making smaller incisions in skin and tissue. Whereas a number 15 blade, with its small curve, is better for making short and precise incisions, such as when removing a skin lesion or opening a coronary artery.

Surgical Scissors

Surgical scissors come in a huge range of sizes. At the top end of the scale are heavy-duty surgical scissors, which can cut through thick tissue, muscle, and even bone. Mid-size surgical scissors use a combination of sharp and serrated blades to give precise cuts with minimal tissue damage. Surgical scissors with curved blades help you to make clean cuts without hitting any underlying tissue.

Smaller scissors include Vannas scissors and Castroviejo scissors, both of which are good for delicate applications such as ophthalmic and neurosurgical procedures. Finally, small sapphire blades can create precise cuts while applying a minimum of pressure, making them perfect for microsurgery.

Types of Surgical Instruments For Grasping

Like scissors and scalpels, surgical forceps come in a range of styles and sizes, each one suitable for different applications. Forceps can either have straight tips or curved tips. Straight tips provide more grip and precision, while curved tips provide more visibility.

Thumb Forceps

Some forceps you squeeze to open. These are thumb forceps, and they’re good for dressing wounds, removing dressings, and tying sutures.

Reverse Forceps

Other forceps you squeeze to close. These are reverse-forceps, and their design provides uniform tension for added precision, especially when you’re wearing gloves.

Locking Forceps (Haemostats)

Some forceps resemble scissors. These are called haemostats or locking forceps, and surgeons use them to securely hold tissues during delicate operations, and to compress blood vessels to obstruct the blood flow when operating on organs.

Types of Surgical Instruments For Retracting

In surgery, retractors can either hold a wound or incision open, or hold an organ or tissue out of the way so you can work underneath.

Hand Retractors

Hand retractors require someone – or something – to hold them in place for the duration of a procedure. Surgical assistants usually undertake this role.

Self-Retaining Retractors

As the name suggests, self-retaining retractors do not require anyone to hold them throughout procedures. They can use screws, ratchets or clamps to hold tissue in place. Alternatively, wire retractors use a spring system to keep things secure.

Choosing The Right Surgical Instrument For Your Application

Some surgical instruments are versatile. You can use them in a range of applications. But certain applications will demand more specific surgical tools – smaller, sharper, or more precise, for example.

Your surgical instrument supplier should help you choose the right instrument for your specific application. But here are some things you should consider to help narrow down your choice:

  • What procedure are you performing? Almost every procedure you could conceivably perform over the course of your surgical career will have been performed before. This means that there’ll be published research papers about almost every procedure. These papers will often list the surgical equipment used during the procedure. They may even make clear recommendations for which equipment to use for best results.
  • How often will you use the surgical equipment? Of course you’ll keep your surgical instruments clean between use. But it’s also important to remember that surgical equipment doesn’t stay sharp forever. If you intend to make heavy use of your surgical equipment, look for those made with more durable materials, as they’ll stay sharp for longer.

Need more advice in choosing the right surgical equipment for your application? We offer one of the most comprehensive ranges of surgical instruments in the UK, and our experts are always on hand to help you choose the equipment you need. Find out more about our surgical instruments.

Lawton Brand Values

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Tips for Surgical Instrument Care & Handling

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Tips for Surgical Instrument Care

Use as intended

Misuse of instruments can lead to stress and irreversible damage.

Handle with care

Poor handling can lead to contamination, corrosion and fractures.

Avoid dried residue

Blood and other secretions can cause discolouration and corrosion

Avoid leaving wet

Instruments left in liquid can cause a galvanic current that can lead to galvanic corrosion

Avoid mechanical stress

This can lead to misalignment of instrument parts as well as tension corrosion

Stick to processes

Ensure that routines in the Central Sterilisation Department are strictly followed

Clean as advised

Always adhere to manufacturers instruments for cleaning and sterilisation

Avoid poor servicing

Always use a certified repair facility: inexpert servicing can ruin valuable instruments

8 useful tips for surgical instrument care

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High quality surgical instruments can be an amazing investment. Offering exceptional performance and durability, some studies have shown such instruments can last for well over 30 years.(1)

However, even the finest surgical instruments will only last if they are carefully handled, properly maintained and professionally serviced. Follow these 10 tips to help ensure your instruments last for as long as possible:

1.      USE AS INTENDED

Never use a surgical instrument for anything other than the purpose for which it was designed. By misusing instruments, you can cause irreversible damage by stressing the parts and damaging the surface.

2.      HANDLE WITH CARE

Poor handling of surgical instruments is a sure-fire way to damage them, so don’t start throwing them around or leaving them in unsuitable conditions. If you do, you may quickly find that your instruments suffer fractures or become contaminated and corroded.

3.      AVOID DRIED RESIDUE

Clean used instruments quickly to avoid any residue drying onto the surface. This is because, blood and other secretions can cause discolouration and corrosion.

4.      AVOID LEAVING WET

Once cleaned, make sure the instruments are dried properly. Instruments left in liquid cause a galvanic current that can lead to galvanic corrosion.

5.      AVOID MECHANICAL STRESS

Don’t stress an instrument beyond its capabilities as this can lead to misalignment of instrument parts. It can also cause tension or stress corrosion: the spontaneous cracking of instrument parts subject to high tensile pressure, such as screws and welded sections.

6.      STICK TO PROCESS

Make sure that routines in the Central Sterilisation Department are strictly followed. This includes ensuring that instruments are cleaned at the correct temperature, using the correct detergent and that they are stacked and dried correctly.

7.      CLEAN AS ADVISED

Always adhere to manufacturer’s instructions for cleaning and sterilisation. In particular, it is important to stick to dosage and duration guidelines for the detergent you are using.

8.      AVOID POOR SERVICING

Always use a certified repair facility, as inexpert servicing can ruin valuable instruments. By having your surgical instruments professionally inspected, refurbished and realigned, you can help ensure that they are restored to top condition.

If you found the above tips useful, you can click here to view and download our handy infographic for surgical instrument care. 

WANT MORE SURGICAL INSTRUMENT CARE TIPS?

For ongoing tips on how to maintain your valuable surgical instruments just click here and follow our LinkedIn page. As well as tips on instrument care, we also post news on upcoming surgical events, advances in surgical technology and new product updates.

REFERENCES:

(1)   Dahl G, Ölveback T, Wiklung L. Quality surgical instruments best investment. Presented: SEORNA, Swedish Operating Nurse Association Conference Meeting, 29-30 November 2012

Poor quality instruments put patients at risk

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Fears that contaminated surgical instruments are causing unnecessary illness and deaths because of the risk of infection continue to hit the headlines.

From Alzheimer’s proteins to HIV, Hepatitis B or C and many more dangerous diseases, there seems to be a steady stream of stories about how patients’ health has been put at risk.

What is not often mentioned in conjunction with these stories however, is the fact that poor quality surgical instruments are often to blame for poor standards of infection control.

What’s more, despite a BBC documentary “Surgery’s Dirty Secrets” revealing several years ago that large numbers of surgical tools used in the NHS failed to meet quality standards, the problem of poor quality instruments is still rife.

In fact, Tom Brophy, a lead technologist with Barts Health NHS Trust went on record at the time to say that about 20% of all the instruments that he received were rejected because of flaws that could put patient’s health at risk.

So why do poor quality surgical instruments pose a risk?

Poorly manufactured surgical instruments can risk patient health for a number of reasons:

·         Micro-punctures in surgeons’ gloves

Poor quality surgical instruments are often machine-made and finished, leaving metal fragments and sharp burs that can lacerate surgical gloves.

As these punctures can be miniscule, they can easily go undetected during a surgical procedure, creating an easy pathway for infection to be transferred to the patient.

·         Defects that are invisible to the naked eye

In addition to revealing sharp burs and microscopic shards of steel, an inspection of a poor-quality instrument under a microscope will often reveal numerous other defects that can pose a risk to patients.

This is because by using low-grade steel, such instruments can easily become corroded or pitted and even develop hairline fractures.

This means that whilst an instrument might seem perfectly clean to the naked eye, a look under a microscope can reveal numerous areas that could be harbouring dangerous bacteria and viruses.

·         Unclean manufacturing facilities

Although Swedish craftsmanship and German-quality stainless steel may come to mind when one thinks of surgical instruments, two-thirds of the world’s instruments are actually made in Pakistan.

While some of these manufacturers adhere to high standards of manufacture, others have been found to operate in dust-filled environments near to open sewers, piling newly made instruments on the floor and failing even to carry out a visual inspection with a magnifying glass before marking their wares with a CE quality stamp.

Clearly this then begs the question just how clean these brand-new instruments are by the time they get into the hands of our UK surgeons.

·         Low grade materials

It is clear to see why both UK surgeons and NHS procurement teams would want to avoid poor quality instruments that pose such risks of infection and harm, even when the pricing can differ so significantly between high-quality and poor-quality instruments.

Of course, German stainless steel is recognised as the very best material for making surgical instruments, but in a time of ongoing budgetary pressures on the NHS, surely it makes sense to buy less expensive ‘German’ instruments than recognised brands?

However, due diligence is needed here as well, as the ‘Dirty Secrets’ documentary also revealed Pakistani representatives offering to sell tools made with Pakistani and French steel that are stamped “Made in Germany”.

The result is that hospitals may still end up paying a lot for substandard instruments that pose a risk to hygiene and health.

·         Design limitations that affect cleanliness

Another issue with poorly manufactured surgical instruments is that they have not been designed to be dismantled for cleaning and inspection.

As infection is harder to eradicate around instrument joints, being able to fully separate parts can significantly reduce the risk of cleaned instruments continuing to harbour germs.

LOOKING FOR HIGH QUALITY SURGICAL INSTRUMENTS?

Why not browse our range of Stille and Lawton quality surgical instruments by clicking here?

You can also contact the Cairn instrument team on 0845 226 0185 to discuss individual instruments, recommended instrument sets or to arrange for a demonstration of specific instruments.

Surgical Instrument Care Infographic

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Micro Surgery Instruments: Micro Scissors, Forceps & Needle Holder Technology

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When it comes to selecting micro instruments for your next instrument set, you can rest assured that there are some exceptional products on the market.

In this article, we look at a number of materials and design features that are enabling cutting-edge instrument performance in the field of micro surgery.

Micro Scissors Innovations Making the Cut

German Surgical instrument manufacturer, Lawton, has developed a wide range of micro-scissors with flat spring or round spring type handles that incorporate a number of innovative design features.

In addition to stainless steel, they can be made from titanium. This non-magnetic material allows for use during MRI and minimises the inconvenience of magnetised needles during procedures.

Fracture-proof and corrosion resistant, titanium is stronger and more durable that stainless steel, whilst its lightness facilitates precise working without fatigue.

Lawton has also developed a number of stainless steel and Titanium models with a ceramic coating to provide a much harder instrument surface and higher sliding capability.

In addition, some of Lawton’s micro scissors with flat spring handles offer increased sliding capability due to a streamlined design at the joint.

Whilst some of Lawton’s round spring handled models come with a lightweight handle with special cavities to enable fatigue-proof working.

Swedish instrument manufacturer, Stille, has also been expanding its line of micro instruments to include new titanium patterns. Its micro scissors are the only ones on the market with Supercut scissor blades: one knife blade and one scissor blade providing precise cutting to the very tip.

The innovative joint screw design also allows for easy removal for instrument servicing.

If you would like a demonstration of any of these micro scissors contact our surgical instrument team now on 0333 015 4345 or email info@cairntechnology.com.

Get a Grip of these Advances in Micro Forceps

If you are looking for micro forceps with greater durability than stainless steel and improved gripping of fine sutures, then Stille’s titanium Diamond Jaws models are definitely worth trying out.

Lawton has also enhanced the performance of micro forceps with its PERFECT-GRIP jaws, which are specially coated to ensure a gentle, non-slip grasping of vessels, tissues, needles and sutures.

Some of their round spring typed handled forceps also incorporate a lightweight handle with special cavities to enable fatigue-proof working.

If you are interested in comparing the look and feel of these micro forceps, call our surgical instrument team now on 0333 015 4345 or email info@cairntechnology.com.

Micro Needle Holders to Keep an Eye On

Again incorporating Diamond Jaws for greater durability and enhanced gripping capability, Stille’s micro needle holders are designed to hold the finest sutures in a tight and secure grip. For heavier models, the use of tungsten carbide inserts allows for an even stronger grip.

Lawton’s range of micro needle holders also incorporates a number of features to optimise performance during surgery. From titanium and ceramic coated instruments giving enhanced durability and improved sliding capability, through to PERFECT-GRIP jaws and a lightweight handle design, Lawton’s range is packed with features to accommodate every micro surgeon’s preferences and needs.

If you would like a demonstration of any Stille or Lawton micro needle holders, please contact our surgical instrument team now on 0333 015 4345 or email info@cairntechnology.com.

More Information on Micro Instruments

If you would like more information on our titanium micro instruments. You can also contact us to arrange an appointment to see or trial our micro instruments. Just call us on 0333 015 4345.

Are Stille SuperCut Scissors Really a Cut Above the Rest?

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If you are a surgeon with an eye for excellent surgical instruments, you may have noticed that SuperCut-type scissors are no longer made exclusively by Stille, except when it comes to micro scissors.

This is despite the fact that the Swedish instrument company actually invented and launched the original SuperCut scissors in 1982.

However, despite there now being other makes of SuperCuts on the market, several independent studies have shown that Stille SuperCuts are continuing to outperform other brands. In fact, the findings might surprise you.

So what’s so good about Stille’s SuperCuts?

There are four key areas that set Stille SuperCut scissors above other brands:

1. Unique design for cutting

Designed for cutting all types of soft tissue, Stille’s SuperCut scissors have two cutting surfaces that are sharp to the very tip and work together in a unique way.

That is because one cutting surface is a scissor blade and one is a knife blade. This means that the surgeon can use the scissors to cut with extreme precision, relying on an instrument that combines maximum cutting power with minimal force to produce the perfect cut.

All other brands of so-called ‘SuperCut’ scissors are made differently from Stille, usually with serrations on one blade that are allegedly designed to grip tissue. However, due to the way that Stille handcrafts its SuperCut scissors, they are actually much sharper than other brands of ‘SuperCut’ scissors.

2. Ergonomic, ambidextrous design

Stille has also put a lot of thought into the design and ergonomics of their SuperCut scissors to create a light but balanced instrument that minimises fatigue and maximises efficiency.

With smooth finger rings, shanks designed for feeling and balance and a strong screw joint for maintaining the correct tension between blades, the scissors provide the surgeon with a smooth fingertip feeling.

The scissors are also flexible for the needs of different surgeons. For example, due to the way in which the scissors are sharpened, they can be used by both left and right-handed surgeons.

What’s more, the scissors have larger finger rings than some other brands, which is useful for surgeons with larger hands or those that use a double glove technique.

3. A removable screw for effective servicing

Another unique feature of Stille’s SuperCut Scissors compared to other brands is that its joint screw can be removed by Stille’s technicians during servicing to inspect for corrosion.

Other SuperCut brands do not have this capability, meaning that both the cleanliness and longevity of these instruments can be compromised.

This was supported by a study(1)that compared two German brands of scissors with Stille scissors. The study found that only Stille’s scissors had a screw that could be removed during servicing; it was also the only scissor with no signs of corrosion under the joint.

What’s more, the removable screw design ensures that the SuperCut scissors can be sharpened back to their original condition by Stille’s expert craftsmen during servicing. This is because large amounts of blade material do not need to be ground away, something that would inevitably change the shape and size of the blades until they are no longer close enough for a good cut.

In addition, by removing the screw during servicing, the surface of the blades can be fully resurfaced, removing any crevices where pockets of dirt may hide.

4. An outstanding 30-year warranty

Unlike other brands, Stille guarantees that their SuperCut scissors will last for 30 years, providing that they are handled and sterilised correctly and that Stille’s own expert craftsmen carry out any servicing.

In fact, Stille offer the first service for free, which is typically required after three years of use, although the surgeon decides when his or her instruments are ready for servicing.

Whilst a 30-year warranty might sound very long, date codes on Stille instruments returned for servicing often show that they have been in regular hospital use for more than 40 years.

This was also shown to be the case in an independent study to test whether Stille hand-crafted surgical scissors really did deliver on the manufacturer warranty of 30 years. In fact, the study found that 74% of the Stille scissors used in a busy surgical centre were actually over 50 years old.(2)

Want to see Stille SuperCut scissors in action?

If you would like to find out more about our Stille SuperCut scissors just click here (Link to new SuperCut Scissors section on website).

You can also contact our Cairn instrument team on 0845 226 0185 to arrange for a demonstration of our Stille SuperCut scissors or to evaluate an instrument on loan.

REFERENCES:

(1) Anette Karppinen, ORN, Access to crevices critical for surgical instrument safety. Presented SEORNA, Swedish Operating Nurse Association, Conference Meeting, 29-30 November 2012. http://www.stille.se/files/studies/whitepaper_instrument_safety.pdf

(2) Dahl G, Ölveback T, Wiklung L. Quality surgical instruments best investment. Presented: SEORNA, Swedish Operating Nurse Association Conference Meeting, 29-30 November 2012