Surgical Instruments Used for Preparing the Surgical Patient

In this article, I will discuss about the main instruments which are used in preparation for the main job-surgical operation.

Cheatle's Forceps

It is an instrument which is used to select and pick sterilised and autoclaved articles like drapes, instruments etc. The instrument is used to avoid touching sterilised articles with hands while transferring them from one tray to another tray. It is usually kept dipped in an antiseptic solution such as Cidex, Detol water etc. 

Features

1. It is a large, heavy metallic forceps with curved blades.
2. The blades have large serrations which help in getting a better hold of instruments being held with it.
3. it has no lock.

Rampley's Sponge Holding Forceps

Uses

1. Most common use is for cleaning the operative field.
2. It is also used for swabbing a cavity e.,g., vaginal canal.
3. It can similarly be used for packing cavities, e.g., for packing the prostatic cavity after prostatectomy. 
4. It can also be sued for mopping ooze from operative area, so that the structures can be identified easily, e.g., in cystic duct identification.
5. It can be used to hold soft hollow organs during operations, e.g., holding gall bladder form Hartmann's pouch cholecystectomy.
6. It can be used for blunt dissection at dept e.g., for dissecting the perinephric fat. 
7. it may be used to hold cervix in a pregnant patient.
8. it can be used in place of ovum forceps.

Features

1. It is a long instruments (9½") with thin shafts.
2. It has a catch-lock which helps in holding the sponge/swab firmly, while cleaning.
3. The blades are fenestrated near its distal end and the inner aspect of the blades is serrated.

Note: Alternative to Rampley's sponge holding forceps is Foerster sponge holding forceps. 

Towel Clips

Types:

1. Backhaus's towel clip.
2. Mayo's towel clip.
3. Moynihan's tetra-towel clip
4. Doyen's cross action type clip.
5. Gray's towel clip (now obsolete).

Uses

1. Most important use of the towel clip is to fix the drapes in a manner, so that only the operative field is exposed to the atmosphere. The rest of the area is covered with sterile drapes held in place by these clips. 
2. It is also used to fix the suction tubing to drapes so that the tube does not fall of the operating table.
3. It can be substituted for umbilical cord-holding forceps
4. It is also used to hold ribs, particularly while elevating ribs in a stove-in-chest injury.
5. It can be used in place of tongue holding forceps but it bites the tongue.
6. It may be used to hold and retract the cord during hernial repairs.

Features

1. It is an instrument which is light but strong about 4-5" in length.
2. The blades are small and curved.
3. The curvature of blade is such so that the whole thickness of drapes can be held easily and firmly.
4. The tips of the blades are sharply pointed for better grasping.
5. It has a catch-lock mechanism.

Moynihan's Tetra-Towel Clip

It is used for holding drapes. The most important use of Moynihan's tetra-towel clip is to cover the cut margins of incisions with towels from all sides, so that the chances of contamination further decline. 

Features

It is like any other towel clip except that it has four teeth instead of two.