Course Introduction
Module name : Foundation of nursing II
Course name : Operating room technique /ORT
Category : First year nursing
Discussion topics #5hrs
Surgical instruments
Hazards in the Operation room
Receiving and positioning of patients in the OR
By: Tarkie Abebe, (BSc, MSc)
Department of surgical nursing, UoG
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General Surgical
Instrumentation
By: Tarkie Abebe
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Learning objectives
After the completion of this chapter, students will be
able to:
1. Classify surgical instruments
2. Identify each instrument by name
3. Recognize the use and function of each
type of surgical instrument
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Introduction
Surgical instruments are tools or devices that are
used to perform surgical procedures.
Most surgical instruments are made from stainless
steel.
Surgical instrumentation is critical to the
surgical procedure.
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Introd……
Surgical instruments are
- precisely designed and manufactured tools.
- for single (disposable) or multiple use (non-
disposable),
- must be resisted physical and chemical effects,
body fluids, secretions, cleaning agents and
sterilization
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Introd……
Surgical instruments are designed to perform either
diagnostic or
Therapeutic operations to locate the cause of a
problem, or
To treat a problem once it has been found. Each of the
tens of thousands of surgical instruments is designed
to perform a specific function.
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Introd...
The performance of the OR team is improved when
team members know:
• each instrument by name,
• how each is safely handled, and
• how each is used.
Preparing the instrument for appropriate
processing will:
• prolong its use in patient care and
• decrease the costs for repair and
replacement.
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Classification of Instruments
Classifying surgical instruments helps:
• in memorizing instruments names, and
• to be familiar with the basic categories of
instruments.
Surgical instruments have specific purposes and may be
classified by their functions, and most fall into one of
four groups.
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Instruments are classified by their function
– Cutting & Dissecting
– Grasping & Holding
– Clamping & Occluding
– Exposing & Retracting
– Suturing & Stapling
– Viewing
– Suctioning
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1. Cutting and Dissecting
Cutting instruments Have sharp
edges/points.
They are used to dissect, incise,
separate, penetrate, or excise tissue.
These instruments should be kept
separate from other instruments, and the
sharp edges should be protected during
cleaning, sterilizing, and storing .
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To prevent injury to the handler and damage to the
sharp edges, proper precautions are necessary to
take during the handling and disposing of all
sharps, blades, or scalpels.
This group includes: scissors, knives, biopsy
punches, scalpels (blades), saws, osteotomes,
drills, curettes, needles, chisels, and etc.
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Cutting and Dissecting…
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Main function:
To cut and dissect
tissue To cut sutures,
clothing, bandages
Where used mostly
General surgery
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Lister Bandage Scissors
Used to remove bandages and dressings
Probe tip is blunt; inserted under bandages with relative
safety
Sharp/Sharp Scissors
Used to cut and dissect tissue
Both blade tips are sharp
Sharp/Blunt Scissors
Used to cut and dissect fascia and muscle
One blunt tip and one sharp tip
Curved Blunt/Blunt Scissors
Both blade tips are blunt
Can be curved or straight
Cutting and Dissecting…
Tissue Scissors
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Cutting and Dissecting…
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Cutting and Dissecting…
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Ear Curette
Can have sharp or blunt scraper ends
Used to remove ear wax from ear canal
Cutting and Dissecting…
Curet (curette): A spoon-shaped instrument for scraping or
cutting
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Cutting and Dissecting…
Curet (curette): A spoon-shaped instrument for scraping or cutting
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Cutting and Dissecting…
Chisel: A wedge-like instrument with a blade for cutting or
chipping
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Cutting and Dissecting…
Bone Cutting Scissors
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2. Grasping and Clamping
A clamp is an instrument that clasps tissue
between its jaws.
Clamps are available for use on nearly every type
of body tissue, from delicate eye muscle to heavy
bone.
The most common clamps are the haemostatic
clamps, designed to grasp blood vessels, crushing
clamps, noncrushing vascular clamps etc.
Grasping instruments are used to hold and manipulate
structures. Needle holder, tissue forceps, Allis forceps,
bone holders, tenacula (tenaculum, singular) etc. are
included in this category.
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Grasping and Clamping…
Parts of a clamp
Jaw- hold tissue securely
Box lock- hinge joint of it
Shank- area b/n joint and finger ring
Ratchets- interlock the instrument
Finger rings- allow the fingers for holding the
instrument
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Grasping and Clamping…
Parts of a clamp…
Forceps: A two-bladed instrument for handling tissues and dressings
Ratchet
Box Lock
Ring
Jaws
Handles
Tip
Shank
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Sponge Forceps
Used to hold gauze squares or
sponge to “mop up” the
surgical site
Jaws are serrated
Transfer Forceps
When sterile, transfer
forceps;
arrange items on sterile
tray
transfer items to sterile
field
Splinter Forceps
Fine tip for foreign object
retrieval
Toothed Tissue Forceps
Used for grasping and
holding tissue, muscle or
skin surrounding a
wound
Single toothed on one
side; fits between two
teeth on the other side
Plain Thumb Forceps
Used to hold tissue in place when applying sutures
Used to gently move tissues out of the way during
exploratory surgery
Used to insert packing into or remove objects from deep
cavities
Curved Mosquito Hemostat
Used to hold delicate
tissue
Used to compress bleeding
vessels
Jaws are fully serrated
Kelly Hemostat
Used to clamp small vessels or hold tissue
Jaws are partially serrated
Curved or straight
Needle Holder
Used to hold and pass a suturing needle through tissue
Has groove to hold needle within jaws
Towel Clamp
Adds weight to drapes and towels to ensure they stay in
place
Allow exposure of the operative site
Grasping and holding …
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Grasping and Clamping…
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Grasping and Clamping…
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Grasping and Clamping…
(Non-Toothed Tissue Forceps)
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Grasping and Clamping…
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Grasping and Clamping…
The curved or angled points on the ends of the jaws penetrate
tissues to grasp firmly
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3. Exposing and Retracting
Soft tissues, muscles, and other structures should be
pulled aside for exposure of the surgical site.
Exposing and retracting instruments are those that
hold tissue or organs away from the area where the
surgeon is working.
Retractors, like clamps, are available for use in all parts
of the body.
They may be very shallow, as for skin retraction, or
very deep, as for the retraction of abdominal contents.
Retractors can be handheld or self-retaining.
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Skin Hook
Flat end is a blunt retractor
Three-prong end may be sharp to dull
Used to retract small incisions or secure a skin edge for
suturing
Exposing and Retracting…
Hand-held Retractor
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Exposing and Retracting…
Hand-held Retractor
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Exposing and Retracting…
Self-retaining Retractor
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Exposing and Retracting…
Self-retaining
Retractor
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Exposing and Retracting…
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Exposing and Retracting…
Exposing
(viewing)
Equipment
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Vaginal Speculum
Used during gynecological
exam or procedure
Dilates the opening of the
vaginal cavity, allowing for
inspection of the vagina
and cervix
Facilitates access for
observation and treatment
Exposing and Retracting…
Malleable retractors
Malleable retractor is a flat length of low carbon
stainless steel, silver or silver plated copper that
may be bent to the desired angle and depth for
retraction.
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4. Probing and Dilating
A probe is used to explore a structure or to locate an
obstruction.
Probes are used to explore the depth of a wound or
to trace the path of a fistula.
Dilators are used to increase/enlarge the diameter
of a lumen, such as the urethra, uterine cervix, or
esophagus.
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The end
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