Sep. 08, 2025
The journey of laparoscopy, which is now reaching single-incision and robotic surgery, began with our quest to find ways to reduce operative morbidity. Since those first steps were taken, gynaecological surgery with the use of minimally invasive techniques continues to change rapidly. With computerised design and microchip-controlled safety features, the laparoscopic surgeon is dependent on the equipment and needs to understand the electromechanical function of the instruments. In this changing environment, it is vital to understand the characteristics of the commonly used surgical instruments. The basic equipment essential for any laparoendoscopic procedure includes: endoscope, camera, light source, video monitor, insufflator, trocars and surgical instruments. However, there are many variants of each available.
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The cost effectiveness of disposable versus reusable instruments is a subject of debate. The choice of the instrument is multifactorial and depends on function, reliability and cost. So, during most laparoscopic procedures, a combination of disposable and reusable instruments is used. Frequently, disposable trocars and scissors are used, while reusable instruments can be graspers, coagulation spatula/hook and needle drivers. The commonly used laparoscopic instruments are described below.
These allow uterine positioning and expand operating space. Several uterine manipulators are available – the HUMI® (Cooper Surgical), the RUMI® (Cooper Surgical), Spackman, Cohen, Hulka, Valtchev, Pelosi and Clearview® (Endopath). Some are reusable while others are disposable. Most come with a channel to perform chromotubation; however, some (such as Hulka tenaculum and Pelosi) lack this channel. With 210˚, Clearview has the greatest range of motion in the anterior-posterior plane. Hulka tenaculum, Spackman’s and Cohen’s have a straight shaft, hindering their range of motion and limiting their use in advanced laparoscopic procedures.
This is a specially designed needle with a blunt-tipped, spring-loaded inner stylet and a sharp outer needle, used to achieve pneumoperitoneum while performing closed laparoscopy. It is available in disposable and reusable form, with 12cm or a 15cm length.
Most injuries in minimally invasive surgery are associated with primary port insertion, leading to an unresolved debate on the benefits of various entry techniques (open, closed or direct entry). There is no evidence that any single technique is better in preventing major vascular or visceral complications, though there is a higher risk of failed entry with closed entry. The most recent Cochrane review concluded there is a lower risk of vascular injury with the direct entry in comparison to use of Veress needle.
These are used to create small passageways through the abdominal wall and are available in different textures (see Figure 1). Disposable and reusable trocars in various sizes are available and share the following common parts:
Sharp tips cut an entry path through the abdominal wall while blunt tips stretch the tissues apart to gain access to the peritoneal cavity.
Sleeve: is the working channel. Trocar sleeves or collars can have textures on the outer surface of the trocar that help it anchor to the abdominal wall. Some have an internal inflatable balloon at their tip and plastic/rubber ring to provide anchorage.
Valve: different valve systems prevent gas leaking from trocars and allow the insertion of instruments.
Side port: many trocars come with a side port that allows for gas insufflation or smoke evacuation.
The telescopes used in laparoscopy are available in sizes ranging from 2mm up to 12mm. The 10mm size is the one most commonly used in gynaecology. Similar to a hysteroscope, a laparoscope can come with an angle of view such as 0˚, 30˚ or 45˚. In an angled-view scope, the direction of vision points away from light source attachment. The 0˚ telescope offers a forward view corresponding to the natural approach and is preferred by most gynaecologists. It is useful if a less-experienced assistant is available. The 30˚ telescope can be rotated to enlarge field of view and can be advantageous for complicated cases. The 45˚ telescope is useful in single-incision laparoscopies, but is not commonly available. Every laparoscope has an engraved number by the eyepiece that specifies the viewing angle.
The commonest diameter for laparoscopic instruments is 5mm, though they range from 2–12mm. The narrower diameter (less than 5mm) instruments have less shaft rigidity and therefore are more flexible and more fragile than the wider versions. Standard instruments’ length ranges from 34–37cm. In bariatric patients or for single-site laparoscopy, 45cm-long instruments are useful.
Most laparoscopic instruments offer only four degrees of freedom of movement: in/out, up/down, left/right and rotation. In addition, certain devices called articulating/roticulating instruments offer angulation at their tips, which can be particularly useful in achieving triangulation while performing single-incision laparoscopy.
Graspers and scissors usually have an insulated sheath, a central working device, a handle and a rotating capability at the working end.
Ringed handles are similar to the conventional ring handle found on most needle holders used in open surgery. They can be in line or directed 90˚ in relation to the working axis. Some handles are in between these two:
a pistol handle allows integration of several functions; and
a co-axial handle is in the instrument axis.
The handles come with different types of ratchets that provide a locking mechanism.
Scissors with curved tips, analogous to Metzenbaum, are commonly used. Most endoscopic scissors can also be attached to the electrosurgical unit. Scissors are produced with variety of tips.
Grasper jaws (see Figure 2) are either are single action (one fixed jaw and one articulated jaw) or double action (both jaws articulated). Single-action jaws close with a stronger force ideally suited for an instrument such as a needle driver. Double action allows the jaws to open wider, so they are better suited as a dissection tool. Numerous grasper variants exist, with the inner side of the jaws having different surface properties, depending on the intended use:
Traumatic: deep serrations or toothed tip for secure grasping.
Atraumatic: finely serrated for gentle handling.
Equally, laparoscopic tenacula are also available with single-toothed and doubletoothed jaws.
Many styles of needle drivers are available and selection largely depends on surgeon’s preference. The jaws are either curved or straight. They commonly have a flat or finely serrated grasping surface, enabling them to grasp the needle in all directions. Certain needle-holders (termed self-righting) have a dome-shaped indentation inside their jaws that automatically orientates the needle in a perpendicular direction, thus making it easier to grasp the needle. However, if there is a need to load the needle at an oblique angle, the indentation can make it harder. The needle drivers also have various types of handles (such as finger grip, palm grip, pistol grip) as described previously.
Myoma screws are in the shape of a probe with a corkscrew tip. They are frequently used during myomectomy.
The suction irrigator is a multipurpose piece of equipment. Most use a trumpet valve but some have a sliding valve. The irrigation system can be powered by various mechanisms including pressure bag or a pump. Omentum, fallopian tube or bowel can get drawn into the suction probe and care must be taken to release the attached tissues gently.
The aspiration needle is a 16/22-gauge needle used for aspiration and injection of fluids.
There are two types of knot pushers available: the closed-end and the open-end knot pusher. Both have their advantages and disadvantages.
Energy sources include monopolar, bipolar, advanced bipolar, harmonic, combined and morcellator devices. Monopolar devices are commonly used in endometriosis resection and for incising the vaginal cuff during laparoscopic hysterectomy. Various types of monopolar hooks and spatula are available and most scissors have an attachment to connect monopolar lead.
Bipolar devices contain the continuous waveform electrical current between the jaws of the forceps and hence reduce the chances of damage to adjacent tissue. They achieve tissue sealing and haemostasis by thermal coagulation, though they lack the ability to cut. The classic bipolar device is the Kleppinger bipolar forceps. Several types of bipolar devices, many of them in form of graspers, are now available.
The surgical evolution of the energy devices, particularly with advanced bipolar features, has been the central point in exponential growth of laparoscopic procedures. The gain in popularity of these devices can be gauged by the fact that they are sometimes now used for open surgery and even vaginal surgery.
Bipolar devices (such as LigaSure™, Gyrus PKS™ and EnSeal®) provide haemostasis for vessels up to 7mm. They provide a low voltage, have an impedance-based feedback that modifies the energy delivered and tissue temperature is regulated to be below 100°C. The bipolar energy thus delivered denatures the collagen and elastin in vessel walls. Denatured tissue, tissue apposition and pressure seal the vessel walls in a process called coaptive coagulation. In comparison to the traditional bipolar instruments, these devices have reduced thermal spread, diminished charring and reduced sticking. However, some of these devices require a specialist electrosurgical unit and they are costly.
LigaSure (Covidien) provides a continuous bipolar waveform and has an integrated cutting mechanism. GyrusPK (Gyrus ACMI) delivers a pulsed bipolar waveform that allows tissue and device tip to cool during the energy off phase, but lacks the ability to cut. Enseal (Ethicon) has nanometre-sized conductive particles that direct the energy and control temperature between the jaws. Like LigaSure, it is multifunctional, with an I-Blade™ to cut the sealed tissue.
Harmonic devices have a piezoelectric crystal in their handpiece that converts the electrical energy into ultrasonic energy. This energy is delivered to the active blade at the tip of the instrument causing it to vibrate at 55 000Hz. The tip of the device cuts mechanically with a degree of collateral thermal coagulation used for haemostasis. There is no active current in the tissue. The advantage of harmonic devices is lower temperature (<80°C) as compared to other energy devices, hence reduced thermal spread and less charring. As a result of mechanical vibrations, in lower density tissue the intercellular water is vaporised at lower temperatures (<80°C) causing a ‘cavitation effect’ that can help in dissection by separating tissue layers. They are FDA approved for <5mm vessel sealing. Though harmonic devices operate at low temperatures, the active blade of the device becomes very hot and can remain so for some time. Care should be taken not to touch the vital structures with the jaws of the device for several seconds after activation.
Thunderbeat® (Olympus) combines both advanced bipolar electricity and ultrasonic energy in a single, multi-functional, handactivated instrument and can potentially reduce the surgical time.
Morcellators can be important tools for specimen removal during procedures, such as myomectomy, when a large amount of tissue is retrieved laparoscopically. Various types of morcellators are available on the market. The key safety maxim is to keep morcellator tip close to abdominal wall, to pull the tissue into the morcellator and not push the morcellator into the tissue. Morcellators require ports that are bigger than 5mm. Morcellation has recently been in news with a US Food and Drug Administration safety communication in swiftly followed by new and/or revised guidelines, including a joint statement by AGES and RANZCOG. To prevent tissue dissemination, power morcellation in an isolation bag has been proposed. Recently, an in-bag morcellation device (Alexis™ Contained Extraction System) has also been made available.
From new innovations in advanced energy to high-precision instrumentation, we offer a broad spectrum of laparoscopic instruments that enable minimally invasive surgery in a variety of specialties.
Designed hand-in-hand with our clinical partners, Aesculap instruments combine superior craftsmanship with modern design, making us the instrument of choice for minimally invasive surgery around the globe.
Our portfolio of laparoscopic instruments includes a comprehensive range of reusable, reposable and single-use instruments and trocars as well as ligation clip appliers, endoscopes and advanced energy solutions.
1McKernan JB, saye WB. Laparoscopic General Surgery and Med Assoc Ga. ; 79:157-159
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INTRODUCTION:
Laparoscopic surgery requires sophisticated and precisely calibrated instruments. The essential difference between instruments used in open surgery and people utilized for laparoscopic surgery would be that the latter are more complex in design and yet delicate in construction. Thus the laparoscopic instruments are more vulnerable to lodging of bioburden (micro-organisms and debris) within their crevices. Thus, the LI are difficult to clean, sterilize adequately and maintain as compared to their counterparts used in open surgery. Moreover, owing to their delicate design, gentlest methods have to be used for cleaning in addition to sterilization. Also, meticulous cleaning, maintenance in addition to sterilization are necessary so that not to compromise the safety from the patient, the surgeon or other operating room personnel. The rise in complexity of the laparoscopic procedures as also the emergence of resistant strains of bacteria, mycobacteria, fungi and viruses makes it imperative to effectively clean and disinfect instruments. Sterilization is the absolute elimination or destruction of forms of microbial life. It may be achieved with steam, gas or chemicals. However, disinfection is the relative removal of pathogenic organisms except spores.
Disinfection can be:
a) High level - where all life forms except the spores are destroyed,
b) Intermediate level - where some fungi, viruses and spores are spared, or
c) Low-level - where fungi, viruses, spores and mycobacteria remain undestroyed. For laparoscopic instruments ideally sterilization or at best higher level disinfection should be used.
CLEANING AND STERILIZATION
Optimal processing of LI involves several steps that reduce the risk of transmitting infection from used instruments along with other what to healthcare personnel.
They are
1) Dismantling,
2) Decontamination,
3) Precleaning,
4) Cleaning and rinsing,
5) Drying
6) Sterilization and
7) Storage. For proper processing, it is essential to perform the steps in correct order.
Most major hospitals have a Central Sterile Supplies Department where the instruments are transported in the operating room for processing. Even in hospitals or nursing homes that do not have an elaborate CSSD, the fundamental steps in processing of instruments can be followed provided a well-established protocol is in place, and designated personnel receive the responsibility for the same. Proper processing of instruments forms an intrinsic aspect of their care which should undoubtedly significantly help in increasing their life time and trouble-free service.
Dismantling
The look of LI should be so that they ought to allow easy dismantling. Instruments that can't be dismantled completely are prone to harbour blood / debris within the shafts and compromise safety of the patients in whom they are utilised subsequently
Decontamination
Decontamination is the procedure used to reduce bioburden on reusable medical devices. The procedure begins in the theatre itself using the nursing staff wiping off visible blood tissue and body fluids in the instruments with a damp sterile sponge. At the conclusion of this all soiled or contaminated instruments should be placed in a container containing a disinfectant solution such as 0.5% chlorine and allowing them to soak for Ten minutes.
The instruments shouldn't be left on this solution for longer period of time as they could get damaged. Once the instruments get to the CSSD, a purpose-built bath is used for decontamination of their decontamination just before proceeding using the next step in the cycle. Modifications of the standard cleaning processes have to clean rigid endoscopic instruments effectively. Instruments designed with an external gasket, an internal seal that does not totally occlude the internal space, or no gasket ought to be placed in the vertical position in enzymatic cleaning and rinsing solutions, instead of the standard horizontal position, so the air trapped within the instrument is permitted to escape and replaces using the solution. All solutions should be irrigated through cleaning ports of instruments. During the process of manual cleaning, special attention ought to be given to intricate and delicate operating mechanisms located at the distal end of many instruments. An ultrasonic cleaner will boost the cleaning of hard-to-reach places. At the end of decontamination, the instrument should be safe for handling without contact with blood-borne pathogens.
Precleaning
Following the instruments reach the sterile supplies processing area, which is preferably a controlled environment, a pre-cleaning treatment with an enzymatic method is recommended. Numerous enzymatic products are available, viz. protease, lipase, amylase, which are effective in enhancing the cleansing process for difficult-to-clean instruments. These break up blood and other protein soil and facilitate cleaning. These enzymes are proteins, and must be removed by thorough cleaning.
Cleaning
Any instrument designed for autoclaving requires specialised cleaning just before sterilization. Users need to ensure that no residual, proteinaceous material or organic residue remains about the instrument surface. This is particularly important where the instrument has several small moving parts and crevices; build up of residues may eventually result in corrosive damage and pathogenic colonization (bioburden). Many hospitals adopt the technique of washing their instruments in soap scrubs. Although physical cleaning is partially effective, enzymatic and detergent based cleaners which dissolve and lift organic material from the surface of instruments are better suited to making certain instrument surfaces do understand of blood along with other body fluids and proteinaceous material before the sterilization process. For laparoscopic instruments this really is best completed using soft brushes that allow the inner surfaces from the instruments to be cleaned thoroughly.
Laparoscopic instruments are best rinsed in running water to ensure that all of the particulate matter in addition to residues of chemicals employed for contamination and cleaning are completely cleared from them. It is useful to possess “cleaning guns” with fine, pointed nozzles to wash theshafts from the laparoscopic hand instruments. The jet of water has the capacity to clean these instruments much better than rinsing them in stagnant water.
A method of cleaning that's growing in popularity is ultrasonic cleaning. This method is, by far, the most efficient and effective available today. Its simplicity of use and superior efficiency is quickly making ultrasonic cleaning the preferred choice. Actually, ultrasonic cleaning is 16 times better than hand-cleaning. The instruments are placed in the ultrasonic unit for 10-15 minutes and use a neutral pH solution. Attention should be directed at the next points during ultrasonic cleaning:
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Before placing into the ultrasonic unit, the instruments are cleaned of all visible debris.
It’s preferable to not mix instruments made of dissimilar metals (such as aluminum and stainless) in the same cycle.
It is important to ensure that the instruments have ample room. The ultrasonic cleaner shouldn't be overloaded.
As with all types of cleaning, all instruments ought to be opened so ratchets and box locks are fully subjected to the cleaning process.
Upon completion of the cycle, the instruments are removed immediately and rinsed.
Drying
The instruments should be dried at the end of the cleaning and rinsing cycle before they are packed for sterilization. This really is ideally achieved by using an air gun that blows all the water droplets off the surfaces of instruments or by using an oven. The second, however, may be available only in CSSD units.
Sterilization
The Centers for Disease Control (CDC) recommends that rigid laparoscopic instruments be sterile or, in the event that isn't feasible, they be high-level disinfected. There are three sterilization processes available to us - steam, ethylene oxide and peracetic acid. Because of product knowledge and proprietary design information, the instrument manufacturer may be the just one who can provide sterilization recommendations.
Steam sterilization
Steam sterilization in an autoclave is among the most typical forms of sterilization used in healthcare facilities. Autoclaving at 121 0C for 15minutes is ideal for all reusable metal instruments. It's effective, cheap and non-toxic. Laparoscopes may be sterilized by flash or vacuum steam sterilization. Before sterilization, all instruments that are insulated, all silicone tubing, and all sorts of cords ought to be doubly covered with a cloth to prevent connection with the hot metallic container. They are then put into the autoclave. Flash sterilization is carried out at 135 0C at 30 psi pressure for 60 minutes. This process requires post-vacuum and dry cycles. The instruments should rest on the sterilizer rack for 45 minutes to prevent water condensation about the lens all cords should be doubly wrapped in a cloth to avoid contact with the hot metallic container. They're then put into the autoclave. Flash sterilization is completed at 135 0C at 30 psi pressure for An hour. This method requires post-vacuum and dry cycles. The instruments should rest on a sterilizer rack for 45 minutes to prevent water condensation about the lens.
Gas sterilization
Using ethylene oxide (EO) would work for all disposable instruments, insulated hand instruments and tubings employed for gas, suction and irrigation. Endoscopic instruments may be sterilized with either cold or warm EO gas, with respect to the manufacturer’s instructions. With cold gas, the temperatures are set at 85 0C and also the instruments are subjected for 4 hours and 30 minutes. Aeration must then follow for 12 hours. Warm gas sterilization happens at 145 0C for 2 hour 30 minutes, followed by 8 hours aeration. The benefits of EO are how the items aren't damaged, it's non-corrosive to optics also it permeates porous material. Its main disadvantages are its cost, toxicity, the requirement for aeration and being a longer process.
High level disinfection
When sterilization isn't available or feasible, high-level disinfection (HLD) is used for instrument processing. HLD eliminates bacteria, viruses, fungi, and parasites but doesn't reliably kill all bacterial endospores, which cause diseases such as tetanus, gas gangrene and atypical mycobacterial infections. HLD would work for items which will come in connection with broken skin or intact mucous membranes. The effectiveness of HLD depends on (a) the amount and kind of microorganisms, organic material (blood, other fluids, tissues), and other matter (for example dirt) present on the instrument or other item and (b) the quantity of protection them provides the microorganisms (such as if the item has grooves or the areas by which microorganisms can hide). Therefore it is important to decontaminate and thoroughly clean instruments along with other items before HLD.
Agents that are employed for HLD include 2% glutaraldehyde, 6% stabilized hydrogen peroxide and per acetic acid (acetic acid/hydrogen peroxide). Glutaraldehyde has got the benefits of having good biocidal activity, non-corrosive to optics and it is active in the presence of protein. Glutaraldehyde is irritating towards the skin, eyes, and respiratory system, especially at concentrations of 0.3 parts per million (ppm). The length of time that commercially available glutaraldehyde solutions may be used varies, usually from 14-30 days. It ought to be tested daily with the manufacturer’s test strip. Always stick to the manufacturer’s instructions regarding proper storage temperatures and expiration date. Solutions should be replaced any time they become cloudy. The efficiency of glutaraldehyde is influenced by the organic load, contact time and use pattern, concentration, physical configuration of instruments, temperature and pH. OSHA’s established maximum allowable exposure limit for glutaraldehyde is 0.2ppm. Fibreoptic light cords and telescopes have to be soaked in 2% glutaraldehyde not less than Ten minutes. Soaking should not exceed Twenty minutes. The endocamera could also disinfected by 10 minutes submersion in 2% glutaraldehyde. Care must be come to leave the plug end of the cord away from solution. Alternately, sterile drape over the camera and cord may be used. Soakage of other metallic instruments, including trocars, and hand instruments, has become recommended for An hour, to avoid infection with atypical mycobacterial infection. Formaldehyde, glutaraldehyde from phenolic derivatives, iodophors, hypochlorites, phenolics and quartery ammonium compounds are unpopular and it has been condemned. Formaldehyde is potentially cancercausing and very irritating to the skin, eyes, nose, and respiratory tract. Furthermore, its efficacy is found wanting, and for that reason, routine utilization of formaldehyde for sterilizing instruments and other items isn't recommended.
Newer methods of sterilization
Important for hospitals with high workload is the rapid turnaround times for instruments that can't be sterilized satisfactorily with steam or dry heat. One of the newer sterilizer system - STERRAD (Johnson & Johnson) - uses hydrogen peroxide vapor and low-temperature gas plasma to sterilize most devices quickly with no toxic residues. Usually, the process takes about 75 minutes for wrapped and dry instruments and devices. Within the chamber, a deep vacuum is drawn. Fifty-nine percent aqueous peroxide is vaporized into the chamber. The product will be enveloped within the peroxide vapor. Following a diffusion of the gaseous peroxide with the load, chamber pressure is reduced, permitting the generation of low-temperature gas plasma. Rf (RF) energy is put on the chamber via an RF amplifier, inducing the plasma state. Reactive species are generated in the peroxide on this state, reacting with materials and every other. When the high-energy species have reacted, they recombine to form water vapor, oxygen, along with other non-toxic byproducts. Upon completion of sterilization, instruments are dry for immediate use or sterile storage. Thus, recontamination risk is minimized, and given that they remain sterile until their next use, money and time is saved by avoiding reprocessing instruments when the case in canceled or delayed. This system occupies minimal space and requires no venting or water hookup. The only utility requirement is electrical hookup.
Storage
Items ought to be used or properly stored soon after sterilization or HLD so they do not become contaminated. Proper storage is as important as proper decontamination, cleaning, sterilization, or HLD. If items aren't stored properly, all of the effort and supplies used to properly process them will have been wasted, and the things is going to be contaminated. Specific instructions for proper storage rely on whether sterilization or HLD continues to be performed, the method used, and whether the items are wrapped or unwrapped.
The shelf-life of a wrapped item is suffering from numerous factors, including:
The kind of packing material used
The number of times those is handled
The number of people who handle the pack
The cleanliness, humidity, and temperature from the storage space
Whether the packs are stored on open or closed shelves
Whether dust covers (for example sealed plastic bags) are utilized
For optimal storage, sterile packs are put in closed cabinets in areas that aren't heavily trafficked, have moderate temperatures, and are dry or of low humidity. Under optimal storage conditions and with minimal handling, properly wrapped items can be considered sterile as long as they remain intact and dry. Storage time and the handling of sterile packs ought to be kept to a minimum, because the probability of contamination increases over time and with increased handling. When in doubt about the sterility of a pack, consider it to become contaminated and resterilize the item before use.
Recommended Laparoscopic Instruments for Surgeons:
Recommended Laparoscopic Instruments for Gynecologists
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Surgical scissors are vital in any operating room and are used for various cutting tasks during procedures. Different types of surgical scissors include:
Mayo scissors have straight blades with curved tips. They are ideal for cutting tough tissues like fascia or muscle and are commonly used in general surgery. They are also very strong and can cut sutures.2
Metzenbaum scissors have longer, thinner blades and delicate tips designed for the precise dissection of delicate tissues like blood vessels or nerves. They are frequently used in plastic surgery and ophthalmology.
Littauer scissors feature one sharp and one blunt blade. They are primarily used for removing sutures or dressings without harming the patient's skin.
Surgical scissors come in various blade designs and materials tailored to specific needs. Blades can be curved, straight, or angled and may have serrated or smooth edges for different cutting techniques. Common materials include stainless steel, tungsten carbide, or titanium for durability and corrosion resistance.
Proper handling and maintenance are crucial for the longevity and performance of surgical scissors. They should be cleaned with mild detergent and dried thoroughly after each use to prevent rust or contamination. Regular inspection and sharpening by a professional are also necessary.
Scalpels are precision instruments used for making incisions. They come in various sizes and shapes, each designed for specific types of surgery. Scalpels' sharpness and precision are crucial for minimizing tissue damage and ensuring clean cuts.
Surgical blades are identified by specific numbers that denote their size and shape. Surgeons commonly refer to these instruments by their blade numbers.3
Effective retraction requires proper technique and attention to detail. Key tips include:
Laparoscopic instruments are essential tools in minimally invasive surgeries. Unlike traditional open surgeries that require large incisions, laparoscopic procedures involve small incisions through which a laparoscope and specialized instruments are inserted. These instruments enable surgeons to perform precise movements and manipulations inside the body without extensive cutting.
For years, surgeons have used laparoscopic instruments with poor ergonomics, leading to increased neuromuscular and arthritic symptoms.4 A study found that 87% of surgeons performing minimally invasive surgery experience occupational injury symptoms.5 To address this, Snowden-Pencer Ergonomic Ring Handles were created to evenly distribute pressure across the hand, reducing fatigue and improving comfort during lengthy procedures.
Different types of laparoscopic instruments serve unique purposes during surgery. For example, a laparoscopic trocar creates access points for the laparoscope and other instruments. Other crucial tools include laparoscopic scissors, graspers, dissectors, and needle holders, each designed for specific tasks within the surgical field.
Laparoscopic surgical instruments are utilized in a variety of procedures, including gallbladder removal, hernia repair, appendectomy, and gastric bypass surgery. Surgeons use these instruments through small incisions while visualizing the surgical site with the laparoscope, which provides a high-definition view of internal organs and tissues.
Surgical clamps are indispensable tools to secure tissues, blood vessels, or other structures during surgical procedures. Different clamps serve specific functions, ensuring the success and safety of surgeries.
Hemostatic Clamps: Also known as artery forceps, hemostatic clamps help surgeons achieve hemostasis by clamping blood vessels, which can then be cauterized or tied off with sutures.6 These clamps feature serrated jaws for a firm grip and are constructed from durable materials, ensuring longevity and reliability in the operating room.
Towel Clamps: Towel clamps, or towel forceps, secure surgical drapes or towels to maintain a sterile field. Their ratcheted design allows for easy application and secure attachment. Our towel clamps are precision-crafted for optimal performance and ease of use.
Organ Holding Clamps: Designed to hold organs or tissues in place during surgery, organ holding clamps have a delicate yet sturdy construction to avoid tissue damage while providing a secure grip. These clamps offer maximum control and stability during delicate surgical maneuvers.
QuickRelease Kerrisons are specialized surgical instruments for precise bone cutting commonly used in spinal and neurosurgical procedures. They feature a unique quick-release mechanism for easy disassembly and cleaning, ensuring optimal hygiene and functionality. Made from high-quality materials, QuickRelease Kerrisons provide durability and reliability, enabling surgeons to perform delicate procedures accurately. Their ergonomic design reduces hand fatigue, enhancing the surgeon’s control and precision during operations. QuickRelease Kerrisons are essential tools for successful surgical outcomes and improved patient care.
Proper decontamination of complex instruments, including thoroughly cleaning all surfaces and lumens, is essential. Instruments should be decontaminated in an open position to ensure comprehensive cleaning. Furthermore, all modular or take-apart instruments must be disassembled during decontamination and sterilization. Before sterilization, instruments should be meticulously inspected for bioburden. Adherence to the manufacturer’s instructions for proper cleaning is imperative. Additionally, it is crucial to follow institutional policies and protocols and appropriate standards for decontamination and sterilization.
Additionally, instrument cleaning brushes help to support the manual cleaning and decontamination of surgical instruments. STERIS offers a wide range of general and channel cleaning brushes, including standard channel, toothbrush-style, pipe cleaner, lumen-guard brushes, and more.
Sterilization containers are essential in maintaining the sterility and safety of surgical instruments. Sterile containers are designed to withstand high temperatures and pressures during sterilization, ensuring that instruments remain contaminant-free. Made from durable materials like stainless steel or high-grade plastics, sterilization containers provide a secure environment that protects instruments from damage and contamination during storage and transport. Also, sterilization containers often feature filters and locking mechanisms to maintain sterility until the instruments are ready, thereby playing a crucial role in infection control and patient safety.
The Genesis sterilization containers are designed with hard-coat anodized aluminum to protect and maintain the sterility of your surgical instruments. They are offered in various sizes and with various baskets and accessories to help organize instrument set-up.
Surgical instrument protection products help to extend the life span of instruments. Instrument tip caps protect the delicate ends of surgical instruments from wear or damage during sterilization, transportation, and storage. Single-use instrument sleeves can be used to protect instruments, specifically hinged and non-hinged instruments, during sterilization.
As surgical instruments experience wear and tear over time, their performance can diminish, making maintenance and expert repair essential to extend their lifespan and ensure optimal functionality. STERIS offers surgical instrument repair services for manual instrumentation across service specialties, including stainless steel, laparoscopic, and microsurgical instruments. These services can prevent damage to surgical instruments and extend their lifespan. The comprehensive range of services, such as general maintenance, complex repairs, instrument inspection, testing, laparoscopic instrument services, and microsurgical instrument repairs, helps reduce costly repairs. Learn more about Surgical Instrument Repair: Ensuring Precision and Safety.
The significance of surgical instruments in healthcare cannot be overstated. Surgeons depend on these tools for precise movements, proper tissue manipulation, and minimizing trauma to surrounding structures. Using appropriate instruments improves surgical outcomes and patient safety.
The evolution of surgical instruments is truly remarkable. From essential tools, they have advanced to sophisticated instruments. Ongoing efforts to improve their design, materials, and functionality have created minimally invasive instruments, robotic-assisted surgical tools, and specialized instruments for specific procedures.
STERIS offers a broad range of surgical instruments to meet healthcare providers' unique needs. Our instruments are meticulously crafted to ensure precision and adhere to the highest quality standards.
Lena Fogle BSN, RN, CNOR
Senior Director Global Clinical Solutions, STERIS Healthcare
Lena is a seasoned healthcare leader with extensive experience leading complex perioperative environments as well as new program development, continuous process improvement, clinical outcomes, operational excellence, and stakeholder experience.
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