Surgical instrument
Among the surgical instruments (including surgical instruments) include all medical instruments , historically primarily in the surgery were used.
As a rule, there are special packages for different operations that are put together according to the operation objective.
designation
They often bear the names of surgeons who developed the instruments, such as the Kocher clamp after Emil Theodor Kocher , the Petz (a clamp sewing device) after Aladár von Petz, the Mikulicz clamp after Johann von Mikulicz or the Overholt . Today more and more universities or company names are coming into fashion. Instruments can also be found in catalogs that are marked with " Mod.n. Name " (= "modified according to"), after the most recent further developer, such as " Stanze, Mod.n. Thal ".
Material and surface
Because surgical instruments are used in open wounds, today primarily stainless steel , titanium or tantalum are used in their production .
In the past, silver was used because of its classy, clean, smooth surface. In addition, silver has an oligodynamic effect , goes into solution in small quantities and kills microorganisms. But silver also has disadvantages: it wears out and corrodes quickly during the sterilization process, which in turn makes mechanical cleaning more difficult and thus impairs sterility.
For many years, base metals such as brass (flexible, e.g. for probes or spatulas) or iron (inflexible) were silver-plated or chrome-plated.
A mirror-smooth surface is easy to clean, but dazzles the surgeon. Today, dark-colored or elegant, roughened surfaces are increasingly being tested in practice. The problem has lost some of its importance due to the minimally invasive surgical technique.
Classes of instruments
Surgical instruments can be divided as follows:
Stopping Instruments
They keep body entrances and wounds open and first allow access. All kinds of retractors , retractors , spreaders, speculums , trocar counting on this.
Holding instruments
With these, a specific tissue can be gripped safely and as gently as possible. These include tweezers, clamps and grasping forceps . Some of them have teeth on their tips (like surgical forceps).
Some clamps and grasping forceps have transversely or crosswise fluted jaws with or without a hardened lining . A locking lock is also very common. Although the needle holder should not hold any fabric for sewing , it also belongs here from the point of view of construction.
Clamping instruments
Clamps are often assigned to the holding instruments. Its purpose and some structural features alone make a partition seem appropriate. The clamps are also differentiated according to their clamping force, for example the soft clamp for temporary clamping for the intestine and fine vessels belong here. You do not need any special, holding tips. Your branches only exert a mild pressure adapted to the purpose and their surface is gentle on the requirements. They too usually have a locking lock.
The dissection clamp must also be classified in this group , although it is only rarely intended for clamping, but rather for separating structures. Its tip is finely rounded and its branches are slender and slightly curved. She doesn't always have a lock.
Cutting instruments
Knife ( scalpel ), scissors, electrotome , cautery , ultrasonic knife and others.
Suturing devices
This subheading includes all staple sewing devices (stackers) that set individual staples or entire rows, as well as staple removers .
Optics
In minimally invasive operations, endoscopes enable the surgeon to see in the first place. They are sterile inserted into the body cavity or joint via trocar sleeves.
Combined instruments
- Endostackers and staplers that clamp a hollow organ and at the same time cut precisely. With them, the staple magazines are usually exchanged with the knife or they are even single-use devices.
- Combined needle holders that, as a universal suturing device, can both grasp and cut.
