Surgical Instruments Usage- Forceps

 Different types of surgical instruments are used for number of functions such as:

•       Clamping
•        Grasping
•       Holding
•         Cutting
•        Dissecting
•         Dilating
•         Suctioning etc.

Instruments must be inspected before , during, and after the surgical / examination procedure.

Main Risks associated with the surgical instruments use are:

  Infection due to improper sterilization techniques.

·        Improper use of instrument by operator.

·        Leaving an instrument inside patient’s body.

·        Use of defective instrument.

Now we go through the introduction and usage of some of the most commonly used surgical instruments

Forceps:

Originated from the Latin word “Forca” meaning to trap, grip something.

In medical field, forceps are used for grasping tissues, blood vessels, holding organs. These are commonly made from Stainless Steel (Martensitic)

Normal they are either with locks (ratchet) such as Kelly forceps, mosquito forceps, Crile forceps or without locks (ratchets) such as Thumb dressings forceps.

Some of the different types of forceps used in the medical field include:

Dressing Forceps:

These forceps are normally used during dressing of wounds and removal of dressings.

These are manufactured with straight, curved and with special angled tips for various tasks during operations.

Very fine delicate dressing forceps are used in eye surgery.

Hemostats Forceps:

Such forceps are used to prevent the flow of blood from operating area (blood vessels) during surgery i.e. for controlling hemorrhage, for grabbing and holding.

All of the hemostats forceps are with locking mechanism called ratchets to control the grasping action of the instrument.

Some of the types include Crile, Kelly, Mosquito, mixter, splinter etc.

Splinter Forceps:

Such forceps are used for special purposes like removing sharp pointed pieces of bones (splinter) from flesh, to handle sutures, and to manipulate very narrow areas due to their fine tip and triangular shape.

These are manufactured with smooth and serrated tips, curved, straight with or without ratchets.

Different types of splinter forceps includes carmalt, Hunter, Stieglitz etc.

Sponge Forceps:

Due to their holding shapes these are commonly used for clamping, holding, gripping, twisting tissues, inserting any external things into the body such as IUD.

Spongeforceps are extensively used in gynecological procedures like during abortion, sterilization, examinations and for handling sponges, gauzes, wipes etc.

Needle Holders:

These are mainly used to hold needles during suturing procedure.

These are available with normal tips and with tungsten carbide tips ( for more hard and firm needle grip with gold plated rings for identification from normal ones).

Usually these are with ratchets (automatic lock) to hold the needle during suturing..

Obstetric Forceps:

 These forceps are used to assist in the child delivery procedure. They are designed to smoothly hold and pull the baby head during vaginal delivery.

Tissue Forceps:

They differ with the dressing forceps due to their teeth in jaws. These teeth provides better grip to hold Tissues. The teeth are designed to avoid the damage to the tissues .

The types depend on shape of the forceps and number of teeth on both sides like adson tissue forceps 1×2 teeth, Adson brown tissue forceps 9×9 teeth, Allis tissue forceps (hinged ring-ratchet type).

Tubing Forceps (clamp):

These are used to introduce tubes in to small blood vessel during operation hence also know as tubing introducer.

  Towel Forceps:

These are used to hold/place pieces of towel/drapes at correct position in the operating area. They are very important surgical instruments tool and helps in recovering towels pieces after the operation.

What are surgical instruments…?

So what are these….? Simply “These are the tools used by a Surgeon during operation, examination etc.”

For every part of a human body there are specially designed instruments which are used such as ophthalmic instruments used in Eye surgery, cardiovascular instruments use in heart surgery, Skin instruments, Kidney instruments etc.

Surgical Instruments are also categorized as single use and reusable.

Those instruments which are marked as single use  (encircled 2 with a crossing line) are usually sterilized packed and can only be used once where as reusable instruments can be used again and again after sterilization, provided their maintenance is carried out as per standard procedure.

History

Archeologist found different objects such as bones , bamboo , stones in the crude instruments form from the period around 10,000 B.C  which were used for medical purposes at that time.

More sophisticated tools were found in the late Bronze and Iron ages and the early Egyptian civilization. These tools were far more superior function wise as compared to the stone ages tools and showed us a continued improvement in the designs fulfilling the human needs.

In the middle Ages and the Renaissance surgical instrument development continued in Europe and a whole range of instruments used exclusively for surgery emerged.

Surgical Instruments can be broadly categorized as follows:

•      Cutting Instruments: those with a cutting edge such as saws, knives,    some of these requiring Grips / handles.
•       Gripping instruments such as  , Thumb Dressings , Tweezers, Spatulas

·                Paired items like Forceps, Scissors , Rongeurs .

Production simply starts with Forging, then machining followed by some filing , Grinding  and Polishing .

From the 17th century to the 19th century, new studies and research in the surgery field led to the development of more sophisticated tools with specialized functions to be used on different parts of human bodies.

In the 20^th century people started using stainless steel for manufacturing surgical instruments because of its properties such as corrosion resistance, hardness, formability, long life and till present stainless steel is considered to be the most suitable material for majority of the instruments etc.

Recent development includes the use of other material like titanium ,Silver alloys, Laser guided instruments and micro surgery instruments.