SPECIAL INSTRUMENTS

Special Instruments

To obtain tissue for histopathologic examination is an important part of a surgeon’s functions. Scrappings from cavities are obtained by Volkmann Scoop and Sims uterine curet. Menghini needle and Silverman needle obtain access through unbroken skin and Walton rectal biopsy forceps and Chevalier Jackson biopsy forceps are for obtaining biopsy material under vision through proctoscope or a sigmoidoscope.

         Biopsy instruments are used for obtaining material for histologic examination and those in use are:

•       Volkmann’s scoop (Fig. 8.112)

•       Sim’s uterine curet (Fig. 8.113)

•       Menghini needle (Fig. 8.114)

•       Silverman needle (Fig. 8.115)

•       Chevalier-Jackson biopsy forceps (Fig. 8.116)

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DILATORS & PROBES 2

Probes and Dilators

Probes are used to gain entry to small (openings) to get information about their depth, direction and size; they are usually blunt ended.

Dilators are used to investigate the patency and dilate hollow tubular passages.

         Infection trauma and surgical accidents can result in healing by second intention in hollow organs this result in strictures.

         In the past these strictures have been treated by dilatation.

         The dilators have been made of metal or gum elastic. The agreed gauge has been utilized to ensure uniform size in all the sets.

         This also helps the surgeon to choose the correct sized dilator. As dilatations are done gradually over a period of the time, the surgeon records the degree of dilatation achieved so as to start at the next level on the subsequent attendance.

         Corticosteroids can also be used to minimum edema and fibrosis.

         The dilators in use are:

         •       Lister (Fig. 8.106A)

         •       Clutton (Fig. 8.106B)

         •       Tuner-Warwick (Fig. 8.107)

         •       Canny Ryall bougie (Fig. 8.108)

         •       Jackson esophageal bougie (Fig. 8.109)

         •       Neoplex (Fig. 8.110)

         •       Bake’s bile duct (Fig. 8.111).

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PROBES & DILATORS 1

Probes and Dilators

Probes are used to gain entry to small (openings) to get information about their depth, direction and size; they are usually blunt ended.

Dilators are used to investigate the patency and dilate hollow tubular passages.

         Infection trauma and surgical accidents can result in healing by second intention in hollow organs this result in strictures.

         In the past these strictures have been treated by dilatation.

         The dilators have been made of metal or gum elastic. The agreed gauge has been utilized to ensure uniform size in all the sets.

         This also helps the surgeon to choose the correct sized dilator. As dilatations are done gradually over a period of the time, the surgeon records the degree of dilatation achieved so as to start at the next level on the subsequent attendance.

         Corticosteroids can also be used to minimum edema and fibrosis.

         The dilators in use are:

         •       Lister (Fig. 8.106A)

         •       Clutton (Fig. 8.106B)

         •       Tuner-Warwick (Fig. 8.107)

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Skin Hook retractors

Skin-Hooks and Retractors

Examples are:

•       Gillies skin hook (Fig. 8.102)

•       McIndoe skin hook (Fig. 8.103)

•       Kilner’s skin retractor (Fig. 8.104)

•       Alms skin retractor (Fig. 8.105).

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SELF RETAINING RETRACTORS

Self-retaining retractors, i.e. Travers, Norfolk, Norwich, Balfours, Alms and Jolls have atleast two blades joined by a hinge joint or bar. It is thus possible to create lateral pressure against both margins of the wound. This helps to retain the retractor in position throughout the duration of the operation.

         Thus freeing the hands of the assistant for assisting the surgeon in other ways.

         Examples are:

         •       Travers (Fig. 8.98)

         •       Norfolk (Fig. 8.99)

         •       Balfour abdominal (Fig. 8.100)

         •       Joll thyroid (Fig. 8.101).

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WOUND RETRACTORS Hand Held 2

         Other retractors are :       

         Deaver (Fig. 8.94)

         •       Lloyd Davies (Fig. 8.95)

         •       Czerny (Fig. 8.96)

         •       Allison lung (Fig. 8.97).

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