Surgical Nursing and Anesthesia

Instruments

Kelly Forcep

•Also known as Kelly Hemostatic Forceps•Hemostats are used to control hemostasis•Jaws can be straight or curved•Serrations are horizontal and only extend ½ the length of the jaw

Rochester-Carmalt

•Has horizontal serrations and vertical serrations on the tip of the jaw giving a checkerboard appearance•Usually 8” long•Jaw is 3 1/2” long•Used to clamp large vessels or large tissue masses

Crile Hemostatic Forceps

•Similar to Kelly

•Serrations extend the entire length of the jaw

Allis Tissue Forceps

•Fairly traumatic•Used for grasping skin such as the linea alba or tissue being removed from patient (e.g. tumor, skin, etc.)

Ferguson Angiotribe

•Not a true hemostat•Very traumatic in design (crushing)•Can be used on any vessel that is not viable to the body (i.e. uterine stump)

Adson Dressing Forcep

•No teeth on tip•Has flat, atraumatic serrations•Used to aid in the placement of bandages or wound dressings.

Adson-Brown Tissue Forceps

•Tip has two parallel rows of nine shallow teeth•Commonly used in general surgery•Found in most surgical packs

Adson Tissue Forceps

•Lacks shallow teeth of Adson-Brown•Instead has “2x1 teeth” at posterior end•Very traumatic

Dressing Forceps

Surgical Blades

•Most common is #10• #11 used for a stab incision•#12 used for declaw•#15 is the same shape as a #10 but half the length (mini #10)•Larger blades generally used for Large animal practice

Bard Parker Handle

• 3 handle is used for blades #10-19• 4 handle is used for blades 20-29•Units of measurement are used for photographic documentation

Groove Director

•Aids surgeon in making incisions in the linea alba•Provides a “channel” that the scalpel can follow to avoid accidental incising of the abdominal viscera

Backhaus Towel Clamp

•Penetrating design•Used to secure drape to the patient•Available in 3 1/2” or 5 1/2” size

Backhaus Roeder Towelclamp

•Balls on the tips prevent excessive penetration into the tissue

Jones Towel Clamp

•Smaller and more lightweight than Backhaus style towel clamps•Ideal for smaller or exotic patients

Spay Hook

•Also known as a “Snook Hook”•Used to locate and exteriorize the uterine horns when an ovariohysterectomy is performed

Mayo-Hegar

•Commonly used needle holder•Available in a variety of lengths depending upon surgeon’s preference and procedure

Olsen-Hegar

•Available in a variety of sizes•Scissors are built into jaw for cutting suture•Inexperienced individuals may cut suture while attempting to grasp needle

Army-Navy Retractor

•Used to deflect or retract tissue away from working surgical field•Handheld•Double-ended•Blades vary in size•Cause little trauma

Senn Retractor

•Handheld retractor•Double-ended•One end is a narrow, blunt blade•The other end is a toothed, traumatic end•Teeth may be sharp or blunt

Gelpi Retractor

•Self-retaining retractor•Fairly traumatic•Not used in soft tissue surgery as often as orthopedic and neurological procedures

Weitlander Retractor

•Self-retaining•Has teeth which can be blunt or sharp•Generally used in orthopedic procedures, but can be used in soft tissue surgery

Iris Scissor

Lister Bandage Scissor

Metzenbaum Dissecting Scissors

•Used for delicate surgical dissection•Blades are thin, delicate, and ~1/4 of the overall length•Blades can be straight or curved

Mayo (dressing) Scissors

•Used when cutting through large muscle masses, cartilage, or other non-delicate tissue or suture and drapes•Blades are thick and ~1/3 of instrument length•Can be curved or straight

Wire Cutting Scissors

Instruments for Orthopedic Surgery

Jacob’s Bone Chuck

Chuck and Key

Extender

Jacob’s Bone Chuck

Bone Forceps

•Also called “bone cutters”•Have a sharp edge on both jaws•Used for cutting through bone and removing small pieces of bone

Bone Rongeurs

•Have cupped tips with sharp edges•Used to break up bits and pieces of bone for grafting purposes•Also used to remove pieces of unnecessary bone

Kerns Bone-Holding Forceps

•Designed to hold bone fragments until permanent fixation can be achieved

Intramedullary (IM) Pins

This is an Albatross

•Made from metal and range in size from 1/16-1/2 in diameter.•Used to stabilize certain types of fractures or soft tissue in orthopedic surgery•Can be smooth tipped or threaded (like a screw)•Can be used or in conjunction with wire, plates, and screws•Placed using a hand chuck, electric drill, or a nitrogen air drill.

Osteotome

•Used for cutting segments of bone

Periosteal Elevator

•Used to prepare fractured bone for permanent fixation•Elevates the periosteum so that an implant may be placed•Come in a variety of shapes and sizes

Dental Instruments

What’s the dental formula for a lamprey??

Tartar Removing Forceps

•Allow for easy removal of heavy calculus from the tooth surface

Root Elevators

•Used to expand alveolus with a rocking motion while advancing toward periodontal ligament•Loosens tooth for extraction without breaking tooth into pieces

Tooth Extracting Forceps

•Used to grasp tooth and remove from socket once loosened

Tooth Splitter

•May also be called a “Crown Splitter”•Used to break tooth for better removal

Scalers

Jacquette•Used to remove plaque and calculus from the tooth surface, good for tight spaces•Hand instrument

Curette•Used to clean plaque and calculus from the tooth root surface. •Not a hand instrument: Why?

Scalers cont’d

Universal ScalerUsed to remove plaque and calculus from the tooth surface.

Explorer ProbeUsed to measure gingival attachment loss and the depth of pockets around the tooth indicating periodontal disease

Scalers cont’d

Claw Type ScraperUsed for scraping calculus from tooth, specifically canine teeth

Sickle Scaler

•Hand instrument with two cutting edges. •Used in a pulling motion to remove heavy accumulation of calculus from crown surface.

Dental Hoe

•Used (in human dentistry) in a pulling motion to smooth and shape the floor and sides of dental caries Veterinary Dentistry? Used for scaling enamel surface.

Insert

•Used in conjunction with an ultrasonic dental machine.•Uses ultrasonic vibration to remove plaque from teeth•Many styles available

Diamond Cutting Wheel

•Used for leveling and reducing teeth

Prophy Angle

•Used to polish teeth after dental cleaning is completed to fill in any grooves that may have formed.

This slide show was created by Emily Dzek Fall 2007

With help from:

Busch, Sara J. Small Animal Surgical Nursing: Skills and Concepts. Elsevier Mosby: St. Louis, Missouri, 2006.