Surgical equipments and their uses with special reference to surgical packs

Rekha PathakSenior scientist

Division of surgeryIVRI, Izatnagar, Bareilly, UP

The surgical instruments and their proper care is very essential for any surgery with good

outcome. The instruments should be of stainless steel is thus resistant to corrosion. The

strength of stainless steel is also good. The assistant should know how to place the

instruments at proper time and proper place so as to assist the surgeon properly. The care

and handling of the instruments should be known so that the instruments last longer.

Following are the various precautions which should be taken to maintain the surgical

instruments.

Care and keeping of surgical instruments: The instruments should be thoroughly cleaned

and kept dust free, moisture free and dirt free. Deionised water can be used to clean them.

It’s better to add some non corrosive neutral detergent. The instruments should not be

soaked in this solution for a long time. All the rough surface of the instruments should be

properly cleaned after use. They should be dried in air and kept.

The instruments should be very frequently then lubricated with mineral oil and grease so

that the jaws are not jammed. All the care should be followed to avoid rusting. The

instruments should be periodically looked for functioning properly with respect ot

realignment of tips, adjustment of shank and spring for conformation, resetting of ratchets,

sharpening of cutting edges. Following are the various types of surgical equipment which

substantially meets out the requirement of a surgery.

1. Tissue forceps: The tips should be smooth or may have teeth. The one with teeth is

used in holding the edges of skin and the smooth one is used on soft tissues and

viscera. At least one thumb tissue forecep should be there in instrument packs.

2. Haemostats: The haemostatic forceps have many transverse grooves on the inner

surface of the jaws and they are mainly used to clamp and hold the blood vessels

perpendicular to the surface. The smaller forceps called as mosquito forceps is used

to clamp the very small blood vessel more precisely. At least four haemostats two

curved and two straight should be there in a surgical pack.

3. Allis tissue forceps: They are used to hold the tissue edges to facilitate deeper

exposure of the underlying organs or tissues. In suturing also we need to hold the

edges of incision with the help of Allis tissue forceps. At least two to three allis tissue

foreceps should be included in a surgical pack

4. Needle holder: It may be either a long or a short one with either straight or curved

jaws. It is used to hold the needle during suturing. It has a longitudinal groove in the

middle of the jaw to facilitate holding of a needle without slipping or wobbling. If the

suturing of the tissues is done with the needle held in the needle holder it is very

smooth and easy than doing with the hands. It is important to check whether this

instrument opens smoothly and holds the needle tight. At least two such needle

holder big and small should be there in a surgical pack.

5. Scissors: The scissors may be curved or straight. They are classified based on the

nature of the two jaws as sharp-sharp, blunt-blunt and sharp – blunt. They can also

be plain and serrated depending on the type of the cutting edge. The scissors are

used to cut any tissue like skin or muscle. If the surgeon wants to save the underlying

tissues like visceral organs etc the blunt –sharp scissors should be used. It is better to

have all types at least one in number in a surgical pack.

6. Towel clamps: The clamps have pointed tips and are used to hold the drapes in

position. While applying the clamps it is kept in mind that small amount of skin need

to be grasped to secure the drape. At least four such clamps are necessary in a

surgical pack.

7. Groove director: It has a groove in the blade portion which facilitates incising /

cutting of the tissues without damaging underlined structures.

8. Bard Parker handle with blades: There are two sizes for this handles. They are size 3

and 4 and both are used to hold the surgical blades. Blades are available usually in

the sterilized packages in various sizes and shapes. The incision should be bold and

sharp with minimum trauma. The blades aid in such function and also help to give

deep incisions. The serrated area aids in better holding of the BP handle.

There are still other instruments for specialized surgery like surgery of the teat and udder.

The following instruments are used.

1. Teat plug: Used to retain medication inside the teat canal and plug the teat in case

of the leaky teats or trodden teats or if any surgery is to be done around the

sphincter.

2. Teat Bistouries: Used to enlarge the teat canal.

3. Lichty teat knife with sharp point: Used to cut the extra growth inside the teat canal

or mucous membrane.

4. Teat tumour extractor: to remove the small polyps in the teat canal.

5. Teat slitter: to cut the growth inside the teat canal and avoid injury to the teat

6. Udder infusion tubes: Used to infuse the intra mammary medications.

7. Milk tube: To infuse the intra mammary infusions or milk the animal after surgery of

teat or udder.

8. Teat scissors: It can be easily put in the teat canal to trim the extra growth or for the

closed teat surgery.

If these instruments are not kept clean, dried and disinfected they may introduce infection

and cause infections in the animals which leads to a heavy economic loss to the animals.