Dissecting Forceps

Dissecting Forceps

These are also called thumb forceps because their shafts are closed by the surgeon’s thumb. They are used to grasp tissues in order to facilitate dissection or suturing and are divided into toothed and non-toothed.

     Dissecting forceps have two shaft and no joint the tip is serrated and may have teeth. When pressed they provide a firm grip on tissues but the firmness depends on how much pressure is put on the shafts. There is no locking catch on the shafts. The shafts spring back to open position when pressure is released. They are used to hold tissues while dissecting. The varieties are:

•   Canadian 

•   Mitchell’s (toothed and non-toothed) 

•   Adson’s 

•   Lane .

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Gall bladder Trochar and Trephines

Ochsner Gallbladder Trochar (Fig. 8.42)

Is used for entering a distended gallbladder so as to drain its contents.

Trephines

Trephines in use are:

•   Rowbotham (Fig. 8.43)

•   Buchanan (Fig. 8.44)

•   Hudson burr (Fig. 8.45)

•   Hudson brace (Fig. 8.46)

     Trephines are used to create openings into the cranium for access to the structures within. The burr holes can be used for obtaining biopsy material or for draining a collection of blood or pus.

            Burr holes can also be enlarged or intervening bone between burr holes removed to provide greater access to the brain.

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Scissors

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Scissors

The choice of surgical scissors is large. They can be long or short, strong or fine blunt or sharp pointed, straight or curved either on the flat side or on the edge.

     More expensive scissors have tungsten edges which are sharp, tough and long lasting.

     The choice will depend on many factors and the surgeon’s preference is perhaps of most importance.

•   For surgical cutting, short scissors are appropriate, and long scissors are used in deep dissection as in thoracic and pelvic surgery.

•   Curved scissors are more popular for dissection because, with the convexity of blades pointing away from the surgeon, structures being cut on both sides of the tip are visible.

     It should be realized that the longer the instruments the more pronounced is the tremor transmitted. The varieties of scissors in use are:

•   Mayo (Fig. 8.32)

•   McIndoe (Fig. 8.33)

•   Nelson (Figs 8.34A and B)

•   Metzenbaum (Figs 8.35A and B)

•   Lloyd Davies (Fig. 8.36)

•   Abel (Fig. 8.37)

•   Potts (Fig. 8.38)

•   DeBakey (Fig. 8.39)

•   Microvascular (Fig. 8.40)

•   Satinsky (Fig. 8.41)

     Potts, DeBakey and Microvascular are the scissors used in vascular surgery.

            Guys plaster scissors are used to cut plaster of Paris at the time of removal of the plaster or to loosen a tight plaster

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Rib Cutters

Rib Cutters

Rib cutters are:

•   Vehmehren (Fig. 8.29)

•   Doyen (Fig. 8.30)

•   Giertz (Fig. 8.31).

     Access to the chest for procedures within the thorax or for draining of an infected pleural cavity may require rib cutters.

            These are of different shapes to match requirements of different ribs. There is a surface that protects the pleura from injury by the cutting edge of the cutter.

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