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The World of
SURGICAL
INSTRUMENTS
The Definitive
Inspection Textbook
2nd Edition

501
full color pages
1,198 high
resolution photos
Glossy, hard cover
Lay flat design

by RICK SCHULTZ
SCISSORS

Frequently Asked Questions

Q: Do all scissors go dull?
A: Yes. Every scissor goes dull no matter what size, specialty, manufacturer, or design.
Q: Does sterilization dull a scissor?
A: Generally, no. However, when old autoclaves produce dirty steam, the scissor blade
edges can become stained, which can cause the scissor not to cut.
Q: Can all scissors be resharpened?
A: Yes. Every scissor can be resharpened. Make sure the repair vendor is properly
trained, especially on SuperCut scissors (black-handled).
Q: How often should scissors be tested?
A: Scissors should be tested 1 to 2 times per week. The proactive approach is picking
2 days per week as scissor testing days. Using an instrument tracking system will
allow the facility to track sharpening frequency. Eventually, a large percentage of
scissors will be sharp.
Q: Is the scissor testing standard red and yellow scissor test material?
A: Yes. The industry standard is to use red scissor test material for scissors longer than
41⁄ 2" in overall length and yellow scissor test material for scissors that measure 41⁄ 2"
and shorter. Yellow scissor test material is used on 41⁄ 2" scissors.
Q: Do all repair technicians know how to sharpen scissors?
A: No. Experience and proper training is key, and many times repair technicians are
learning on your expensive instrument inventory. The hospital should verify how
many months of training/employment the repair technician has. On average, a
repair technician needs 9 to 12 months of training. This training should not be
performed on the facility’s inventory of instruments. You cannot teach experience.
Q: Is it true that certain scissors need to be sharpened more often?
A: Yes. The black-handled SuperCut scissor needs to be sharpened the most
(quarterly) because it has a knife edge.
Q: Can scissors be over-sharpened?
A: Yes. Scissors can be over-sharpened by inexperienced repair technicians. Only send
out dull scissors for resharpening. Not all scissors in a set need to be sharpened.
Q: Can serrated scissors be sharpened?
A: Yes. The repair technician should know how to sharpen a serrated
scissor. But remember, experience cannot be taught. An inexperienced Diagram of a black
repair technician may not know the correct method. handled scissor
Q: Do all black-handled scissors have a serrated edge?
A: No. Black-handled SuperCut scissors have the option of serrated edges
or not. One serrated blade and one knife blade is the most popular Serrated edge
configuration.
Q: Should gold-handled scissors be sharpened more often?
A: No. Gold-handled scissors stay sharper longer. They should first be
tested before sending them out for sharpening. Knife edge
 SCISSORS

Mayo Scissor, Tungsten Carbide

Instrument Name: Mayo Scissor, Tungsten Carbide
Also Known As: Gold Mayo
Similar Instruments with Same Inspection: All scissors
Overall Length: 51 ⁄ 2" (14 cm), 63⁄ 4" (17.1 cm), 9" (22.9 cm), straight or curved
Instrument Use: Cutting tissue and skin
Tray Assembly Tip: Sterilize with rings slightly open
Sharpness Test Standard: Red scissor test material

Tips should Inspect for separation

Inspect both blades
be rounded. of metal.
for cracks and dents.
Inspect seams
for pitting.
Inspect
blades for
cracks.
Inspect for
cracks on
both sides.

Separate the rings and Inspect

inspect for blood and seams
tissue on both sides. for pitting.

Open and close rings.

Cutting action should
be smooth.
 NEEDLE HOLDERS

Types of Needle Holders

Closed position

Olsen- Heaney Crile- Ryder Mayo- Mayo-

Hegar Wood Hegar, Hegar
Tungsten Standard,
Carbide non-
Open position carbide

Scissor
Blade.

Olsen- Heaney Crile- Ryder Mayo- Mayo-

Hegar Wood Hegar, Hegar
Tungsten Standard,
Carbide non-
carbide
NEEDLE HOLDERS

Mayo-Hegar Needle Holder,

Tungsten Carbide Jaws and Standard Jaws
Instrument Name: Mayo-Hegar Needle Holder, Tungsten Carbide Jaws and Standard Jaws
Also Known As: Needle driver
Similar Instruments with Same Inspection: All other needle holders
Overall Length: 7" (17.8 cm)
Instrument Use: Driving suture needles in the suturing process
Tray Assembly Tip: Sterilize with ratchets in the open position

Jaws
Tungsten carbide jaws. Standard stainless jaws.
• Much harder metal than Once these jaws wear out,
stainless steel. Box lock the instrument cannot be
• The jaw tread wears out rejawed and must be replaced.
very slowly. Jaws last
longer.
• Grips the suture needle
better.
• When the jaws wear
out, the repair vendor Shanks
can simply replace.
• Tungsten carbide is
indicated by 24-karat Rings
gold rings.

Tread wear area.

Tungsten carbide jaw. Stainless steel jaw.

Jaw Tread Wear

Tungsten Carbide Jaw
Acceptable Not acceptable
LAPAROSCOPIC

Frequently Asked Questions

Q: There is a space between the insulation and the tip
of the instrument. Is this okay?
A: No. The instrument must be immediately removed from service
and sent out for repair. A gap can allow blood and fluids to
enter under the insulation. If the abdomen is insufflated, it will Gap in insulation
cause the blood to be forced under the insulation.
Q: How is loose laparoscopic insulation visually
Insulation tested?
“pull test”
A: To test the insulation visually, inspect the entire shaft for any nicks
or cuts. Next, lightly pull back on the insulation. If the insulation slides
back, the instrument is in need of re-insulation.
Q: What is the port near the handle used for?
A: This port is used to flush the instrument during the cleaning process.

Proper Flushing and Irrigation

With the distal tip underwater, connect
syringe to irrigation port and draw up water
from cleaning sink. Force cleaning fluids in
and out of shaft.

Q: Where are the most difficult areas to clean on a laparoscopic

instrument?
A: The most challenging areas to clean are the jaws and distal working
portion (linkage). This is where blood and fluids can hide. Manual
cleaning and the use of an ultrasonic irrigator will assist in cleaning
these areas.
Q: How are laparoscopic scissors tested for sharpness?
A: Unless stated differently in the Instructions For Use (IFU), laparoscopic
scissors are tested on one thickness of gift wrap tissue paper or yellow
scissor test material.
Q: How is the jaw tension tested on laparoscopic graspers?
A: Gently clamp a lint-free towel with the laparoscopic grasper and pull back.
The grasper should not slip from the towel.
Q: What methods can be used to prevent damage to the tips of
laparoscopic instruments?
A: Using a tip protector will help protect sharp tips and delicate instruments
from damage or place instruments in a secure instrument rack and tray.
 LAPAROSCOPIC

Laparoscopic Claw Forcep, 10 mm

Instrument Name: Laparoscopic Claw Forcep, 10 mm
Also Known As: Claw grasper, Clickline®
Similar Instruments with Same Inspection: All three-piece laparoscopic grasping forceps
Overall Length: Shaft: 36 cm, 43 cm
Width: Diameter: 5 mm, 10 mm
Instrument Use: Grasping tissue during minimally invasive procedures

Inspect teeth for

blood and tissue.
Drive rod/insert.

Inspect collar for

secure fit. There
should be no gap.

Flushing may
assist during Outer
the cleaning Inspect post for shaft/tube.
process. bends/damage. Inspect handle
for cracks.

Inspect for
*Inspect for Proper size cracks on
missing/ brush may both sides.
torn assist with
insulation. cleaning. *Inspect for
missing/torn
insulation.
Handle.
Press to
remove
drive rod.

Rotating knob
should move Laparoscopic Claw
left and right. Laparoscopic Claw Forcep, Assembled
Forcep, Disassembled
*Insulation testing may assist in locating
pin holes which are usually not visible.
 HEMOSTATIC/
RING-HANDLED FORCEPS

Most Common Hemostats

Hartman Halsted Kelly Crile Rochester- Ochsner

3 1/2" 5" 5 1/2" 5 1/2" Pean (Kocher)
6 1/4" 5 1/2", 6 1/4", 6 1/2", 7 1/4",
7 1/4", 8", 8", 9", 10"
9", 10"

Hartman Halsted Kelly Crile Rochester- Ochsner

Pean (Kocher)
 HEMOSTATIC/
RING-HANDLED FORCEPS

Kelly Forcep
Instrument Name: Kelly Forcep
Also Known As: Snaps (often confused with Rochester Pean)
Similar Instruments with Same Inspection: All hemostats
Overall Length: 51 ⁄ 2" (14 cm), half serrated jaws, straight or curved
Instrument Use: Clamping off vessels
Tray Assembly Tip: Sterilize with ratchets in the open position

Inspect both jaws for dents.

Inspect serrations for blood Tips should meet
and tissue. evenly with no overlap.

Separate the rings and inspect for

blood and tissue on both sides.

Inspect for cracks on

Inspect both sides.
both jaws
for blood
and tissue.
Crile forcep
has fully Kelly forcep
serrated has half
jaws. serrated
jaws.

Test ratchet. Verify it

locks in each position.

Dr. Howard Atwood Kelly (1858-1943)

Credited with establishing gynecology as a specialty by developing
new surgical approaches to GYN diseases. One of the founders of
Johns Hopkins University School of Medicine (Baltimore, MD,1893)
UROLOGY

Resectoscope
Instrument Name: Resectoscope
Also Known As: Bipolar resectoscope, Urology resectoscope
Instrument Use: Removal or biopsy of lesions of the bladder, prostate, or urethra
Tray Assembly Tip: Very delicate instrument. A protection case may reduce damage.

Resectoscope, assembled
Verify connection Proper size brush may
is secure. assist with cleaning.

Inspect for bent

handles/levers.

Inspect for cracks

on both sides.

Color indicates
the diameter of
the sheath. Yellow Color indicates
indicates 26 scope degree.
French (Fr.) Red indicates 30º.

Inspect ceramic tip

Connection should for cracks and chips.
be secure.
Inspect holes for
blood and tissue.
Inspect for dents. Open and close
testing spring
tension.
 CARE AND HANDLING

Damaged Laparoscopic Spatula

Cause: The insulation may have been damaged during use. Over time, the insulation
may become brittle and chip off.
Effect: The insulation is torn/missing. The instrument should be removed from service
immediately and sent for repair. Continued use may result in the insulation
dropping into the surgical site and cause a significant patient risk.
Prevention: This instrument requires visual inspection and insulation testing after every
use.

Torn insulation. REMOVE

FROM SERVICE
IMMEDIATELY AND SEND
OUT FOR REPAIR.
The World of
SURGICAL INSTRUMENTS
The Definitive Inspection Textbook 2nd Edition
This inspection textbook, featuring over 1,100 high-resolution images, teaches surgical instrument
names, inspection points, sharpness testing, measuring, and much more. The step-by-step approach
of this textbook is designed as a resource for healthcare professionals, both to increase patient safety
and improve surgeon satisfaction.
Discover How To:
» Identify critical inspection points of surgical instruments
» Properly measure surgical instruments
» Know the difference between a SuperCut and a standard scissor
» Assemble instrument trays to reduce repairs
» Differentiate surgical grade instruments from floor grade (economy) instruments
» Inspect the different types of coated instruments
» Know the enemies of surgical instruments
» Evaluate a surgical instrument repair vendor
» Inspect needle holder jaws for wear
» Test instruments for sharpness
» Identify damaged instruments

Customer Reviews, Pre-Released Version

“I was familiar with Rick’s first book. We used it often in our department. This new book was a real surprise because
I didn’t think it could get much better. Wow, the photos and the FAQs are brilliant teaching tools. Great book.”
C. A. H., CRCST, CIS — Sterile Processing Manager

“Great reference and training textbook to new personnel coming into our operating room.
Easy to read, along with photos, makes this textbook a must have.”
P. M. — Surgical Technician

“This book will really help the industry. Simple to read and it solves a lot of issues
we have had. Great resource, great teaching.”
C. T., R.N. — OR Manager

HOW TO ORDER:
www.instrumentlearning.com
FOR QUESTIONS: sales@rickschultz.org or call 330-714-9092