What Are the Different Types of Surgical Instruments?

The basic instruments commonly used in surgery are basic surgical instruments, which are divided into many types according to their structural and functional characteristics ^[1] . Familiar with the use of surgical instruments is the most basic requirement for the surgeon.

The basic instruments commonly used in surgery are basic surgical instruments, which are divided into many types according to their structural and functional characteristics ^[1] . Familiar with the use of surgical instruments is the most basic requirement for the surgeon.

Chinese name

Basic surgical instruments

Foreign name

Basic Instruments

Definition of basic surgical instruments

Surgical instruments commonly used in surgery.

Scope of basic surgical instruments

Any surgical operation.

Classification of basic surgical instruments

According to the "Medical Device Classification Catalog" released in 2018, basic surgical instruments can be divided into:

Serial number	name	Product name example	Management category
1	Medical suture needle (without thread)
2	Basic surgical knife	Surgical handles and blades, dermatomes, wart strippers, lancets, spatulas, razors, dander scrapers, picks, sharp knives, pedicure knives, manicure knives, scalpels	I
3	Basic surgical scissors	General Scissors, Tissue Scissors, Comprehensive Tissue Scissors, Disassemble Scissors, Plaster Scissors, Anatomical Scissors, Gauze Bandage Scissors	I
4	Basic surgical forceps	Ordinary hemostatic forceps, small blood vessel hemostatic forceps, mosquito hemostatic forceps, tissue forceps, carbide insert needle forceps, ordinary needle forceps, wound slitting forceps, skin rolling forceps, bullet forceps, gauze stripping forceps, sponge forceps, Towel pliers, leather pipe pliers, instrument pliers	I
5	Basic surgical forceps	Small blood vessel tweezers, non-invasive tweezers, tissue tweezers, plastic tweezers, needle-held tweezers, health tweezers (simple tweezers), plucking tweezers, towel tweezers, dressing tweezers, dissection tweezers, hemostatic clip	I
6	Needles and hooks for basic surgery	Aneurysm needle, probe, push needle, hair transplant needle, pick needle, straight needle for teaching, vein hook, wound hook, flat hook, double head hook, skin hook, anatomical hook	I
7	Other basic surgical instruments	Blade holders, anesthesia masks, anesthesia openings, lighting aspirator heads, acne extractors, blackhead acne extruder, skin curettes, skin cover scrapers, skin scratch testers, skin check rulers, skin tissue drills Perforator, opener, cotton roll	I

1. Medical suture needle (without thread):

Medical suture needles are instruments used for various tissue sutures, and consist of three basic parts: the tail, the needle body and the needle tip ^[2] . classification:

1) According to the shape of the suture needle, it is divided into straight needle and curved needle.

Straight and curved needles

2) According to the shape of the needle tip, it is divided into round needle and triangular needle. Round needles are divided into 1/2, 1/3 radians, etc. according to the different curvatures. The larger radians are mostly used for deep tissues. The front half of the triangular needle is triangular and sharp. It is used to suture tough tissues such as skin, cartilage, and ligaments, which are more damaging. Therefore, round needles are used in addition to the above types of tissues. In addition, when using a curved needle for suture, the direction of force should be the same as the curved direction of the curved needle, and the needle should be pulled out of the tissue along the arc of the curved needle when pulling the needle, otherwise it is easy to break ^[2] .

Round and triangular pins

3) According to the shape of the needle tail, it is divided into eye type, split type and fitting type. Generally, threaded needles are used, and split-type needles that press the thread into the needle end often cause the thread to tear and break easily, so it is relatively rare. Because the needle tail of the needle is relatively thick and relatively damaging, so-called non-invasive needles (fitting type) can be used for some delicate and delicate tissues, such as blood vessels, nerves, and intestinal walls. Needle for suture ^[2] .

2. Basic surgical knife:

Scalpels are generally used to cut and peel tissue, and there are also scalpels with hemostatic functions, such as various electric knives, laser knives, microwave knives, plasma scalpels, and high-pressure water knives. However, these knives require a complete set of equipment . Here, an ordinary scalpel is taken as an example. Generally, a scalpel is composed of a blade and a handle. It is mainly used to cut tissue, and sometimes the end of the handle can also be used as a tool to bluntly separate tissue ^[1] . Blades are round, pointed, curved and sized.

Scalpel

There are four kinds of correct operation methods ^[1] , as shown in Figure 1:

1) Bow-holding style: It is a commonly used sword-holding method. It has a wide range of movements and flexibility. The force involves the entire upper limb, mainly on the wrist. For longer skin incisions.

2) Writing style: movement and strength are mainly in the fingers, used to dissect blood vessels, nerves, peritoneal incisions and short incisions.

3) Holding type: This method is relatively stable. The movement involves the entire upper extremity, with strength mainly at the wrist. For cutting a wide range of incisions, such as amputations, tendon incisions, long skin incisions, etc.

4) Anti-pick-up style: By using finger movements and strength, the blade is pulled up to avoid damaging deep tissues. Mostly used for abscess incision and cavity organ surgery such as blood vessels, trachea, bile ducts, and ureters.

Fig. 1 Knife holding method

Regardless of which knife holding method is used, the protruding surface of the blade should be perpendicular to the tissue, and the tissue should be cut layer by layer, and do not operate with force on the tip of the blade. The height of the knife should be moderate, too high control is unstable, too low and hinder sight ^[1] .

3. Basic surgical scissors:

There are sharp, blunt, straight, curved, long and short types according to the structural characteristics of the surgical scissors. According to its use, it is divided into tissue shears, line shears and line-cutting shears. Tissue shears are mostly curved, sharp and fine, and are used to dissect, cut or separate tissue. Straight scissors are usually used for shallow surgery and curved scissors are used for deep surgery. Thread shears are mostly straight shears, which are divided into thread shears and thread-cutting shears. The former is used to cut sutures, dressings, drainage, etc., and the latter is used to remove sutures. The difference between line scissors and tissue scissors is that the blades of tissue scissors are sharp and thin, while the edges of line scissors are blunt and thick. Never use a convenient and greedy map. Use tissue shears instead of line shears to damage the blade and shorten the life of the scissors. ^[2]

Surgical scissors

The correct cutting position is that the thumb and ring finger (ring finger) are respectively buckled into the two rings of the scissors handle, the middle finger is placed on the scissors handle of the ring finger, and the index finger pressure stabilizes and guides the shaft (see Figure 2). Beginners often make the mistake of holding the middle finger into the handle ring, and this wrong method of cutting does not have a good triangle stabilization effect, which directly affects the stability of the movement (Figure 3). When using scissors, the normal shear method is generally used, as well as the reverse shear method (as shown in Figure 4), the assisted shear method (as shown in Figure 5), or other operations ^[2] .

Correct cutting posture

Fig. 3 Error holding scissors

Fig. 4 Positive and negative shear method

Fig. 5 Shearing method

4. Basic surgical forceps:

Surgery forceps, tissue forceps, needle-holding forceps, and towel forceps are the most commonly used for surgery.

1) Hemostatic forceps: Hemostatic forceps are mainly used to clamp hemostasis. When hemostasis is used, only the stump of the blood vessel and a small amount of tissue around it can be clamped. It can also be used for blunt separation of tissues. There are two types of straight and curved shapes, each of which is divided into large, medium, and small. When using it, you can choose different shapes and different specifications of hemostatic forceps according to the surgical site, the depth of the surgical field, and the tissue being held. ^[3] .

Hemostatic forceps

Hemostatic forceps schematic

2) Tissue forceps: Tissue forceps, also known as rat tooth forceps, are used to hold tissues, such as flaps, fascias, or tissues and organs that are about to be removed. They are also used to fix gauze pads and subcutaneous tissues. The head end has a row of fine teeth, which has better elasticity, the pliers handle is narrower, and there are also different sizes. It is appropriate to choose ^[3] .

Tissue forceps

Schematic diagram of tissue clamp

3) Needle holding pliers: Also called needle holder. It is used to hold suture needles to sew various tissues. Sometimes it is also used as a device for knotting. Its basic structure is similar to that of vascular forceps, but the front end is short and thick. Make the performance of the instrument more excellent and durable. There are different specifications of needle holders, which can be flexibly selected according to the depth of the surgical site and the size of the needles [3]. It is advisable to clamp the rear 1/3 of the needle with the tip of the needle holder when suturing, as shown in Figure 6 ^[1] .

Fig. 6 Pin clamp method

Pinch method

4) Towel pliers: Also known as towel pliers, referred to as towel pliers, used to hold and fix surgical towel sheets. Be careful not to pinch normal skin tissue during use. The structure is similar to that of vascular forceps, but the head end is curved with two fine teeth overlapping each other ^[1] .

Towel pliers

Schematic diagram of towel pliers

5. Basic surgical forceps:

Surgical forceps are used to hold tissue to facilitate dissection and suture. They are divided into long tweezers and short tweezers according to different lengths. According to whether the tip is toothed, it is divided into toothed tweezers and toothless tweezers (flat tweezers). The teeth are divided into coarse teeth and fine teeth. The coarse tooth forceps are used to hold hard tissues and are more damaging. The fine tooth forceps are used for fine surgery, such as tendon sutures and plastic surgery. Toothless forceps are used for fragile tissues and organs. The tip of the forceps is divided into a pointed tip and a blunt tip. Fine pointed flat tweezers have less damage to tissues and are used for vascular and nerve surgery ^[2] .

Surgical forceps

Schematic diagram of surgical forceps

The method of holding tweezers is to use the thumb, forefinger, and middle fingers to grip the middle of the photo (see Figure 7) ^[2] .

Fig. 7 Method of holding tweezers

6. Needles and hooks for basic surgery:

Take probes and hooks as examples.

1) Probe: Also known as probe. According to different uses, there are many shapes, which are generally divided into three categories: ordinary probes, special probes and slotted probes. The general types are divided into straight, curved, flat and round heads. Ordinary and special probes are used to detect foreign body tissues, organ lumen depth, fistula or sinus depth and direction; slotted probes are used to guide incision of the surface tissue of the fistula ^[3] .

Probe

Probe schematic

2) Pull hook: Also known as retractor, it can have various specifications with different shapes and sizes. It is mainly used to expose the surgical field ^[3] .

Pull hook

Draw hook schematic

7. Other basic surgical instruments:

Take a curette as an example. Curettes are mostly used to scrape blood clots, necrotic tissue, and granulation tissue in sinuses. They are also commonly used to scrape dead bone. According to the shape, it can be divided into straight and curved types, and each type is divided into large, small, blunt, and sharp. According to different tissues and uses, choose the appropriate shape and size of the curette ^[3] .

Curette

Curette schematic