General Surgery Instruments Catheters & drains

Catheters

The Foley catheter is a plastic two-lumen tube with an inflatable balloon. The balloon is inflated via a small channel.

     Suprapubic cystostomy is an alternative way of draining the urinary bladder. The Malecot catheter is well suited for this purpose. It is a rubber or latex tube with two wings at the tip. The de Pezzer catheter is based on a similar principle except that instead of wings, it has a bulbous end which can be straightened and recoils back when the wire introducer is removed.

     The catheters used are:

     •   Foley 

     •   Gibbons 

     •   Malecot 

     •   DePezzer 

     •   Tiemann 

     •   Secured tube drains 

     •   Corrugated

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General Surgery Tubes 2

Nasogastric

Tubes may have to be passed into the stomach, or even beyond, for decompression, sampling or delivery of drugs or food. 

         Ryle’s tube is most commonly used for decompression of the stomach following abdominal surgery or for intestinal obstruction.

         The other tubes used are:

         •       Nasogastric  

         •       Sengstaken

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General Surgery Tubes Catheters

Tubes and Catheters and Drains

Tubes

Without endotracheal tubes modern anesthesia would be unthinkable. The traditional tubes of the Magill pattern are made of red mineralized rubber. Except for the smallest they all have an inflatable cuff near the distal tip to protect the lower respiratory tract form soiling as well as providing an air-tight seal. Each number refers to the internal diameter of the tube in millimeters.

         All tubes in the past have been made of rubber and have been recycled in practice by autoclaving. All these instruments and nasogastric tubes are now made of nonreactive plastic material and come presterilized in packs. These tubes are all disposable and thus do not require recycling. 

         The tubes in use are:

         •       Endotracheal  

         •       Uncuffed oral endotracheal tube  

         •       Negus tracheostomy  

         •       Chevalier Jackso.

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General Srgery Needle straight curved cutting edge

Needles (Straight and Curved) and Sutures

Round Bodied

Cutting  Cutting edge needles have sharp edges commencing at the point and prolonged along their shafts to help them penetrate dense tough tissues such as skin or tendon. Shapes of needles are shown i.

Sutures  Sutures may be organic, synthetic or metallic in origin. Their characteristics and indications are discussed in detail

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General Surgert Needle Holders

Needle Holders

Needle holders are modified box-lock forceps designed to hold curved needles. The surgeon should thus be able to manipulate the needle with ease during suturing near the surface (short needle holders) or at a depth (long).

     Since the function of needle holders is to grasp needles the instruments look like artery forceps:

1.  Serration at the tips to prevent slipping of needle.

2.  Shafts with rings for thumb and fingers.

3.  Locking device.

     Fine needle holders are damaged by large needles and small needles are damaged by large needle holders. The varieties in use are:

•   Mayo needle holder 

•   Gillies needle holder 

•   Naunton Morgan needle holder 

•   Kilner needle holder 

•   Mayo-Hegar needle holder 

•   Microvascular (Doious) needle holder 

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General Surgery gastric & intestinal clamps

Gastric and Intestinal Clamps

Intestinal clamps are large self-retaining forceps with a primary function to occlude the bowel lumen.

     These clamps are indeed tissue forceps to allow firm holding of stomach and intestines.

     The non-crushing intestinal clamps do not cause permanent injury to the wall of the held viscus.

•   They occlude the viscus lumen and prevent spillage of infected bowel contents.

•   Temporarily occlude circulation in the bowel wall and thus keep the operative field free of blood.

•   Facilitate anastomosis by allowing the bowel ends to be approximated and manipulated.

     The varieties of clamps in use are:

     •   Doyen’s 

     •   Kochers 

     •   Lane 

     •   Lane twin anastomotic clamp 

     •   Lloyd Davies Rectal occlusion forceps 

     •   Payr intestinal clamp crushing

     •   Lang Stevenson 

     •   Parker Kerr 

     •   Zachary Cope crushing .

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