High-Yield Image Based Questions on Surgical Instruments

Serrations 

Seen at Jaw/Blade · Transverse serrations -seen in Artery Forceps Longitudinal serrations -seen in Intestinal clamp Cross hatched serrations -seen in Needle holding forceps.

Towel Clips 

 Can be identified by: curved blade, Pointed tip · Used to fix towels/drapes · Used to fix suction tubes, catheters, diathermy cables, Laparoscopy cables.

Rampley's Sponge Holding Forceps 

Oval tip · Serrations for firm sponge grasp. – · There is presence of fenestration. · There is long blade and long shaft: During cleaning, other areas are not touched by the scrub surgeon.

Uses - To hold the forceps · Cleansing · In Open cholecystectomy to hold Fundus & Hartmann's pouch of GB · To swab an abscess cavity · Remove laminated membrane & daughter cyst in hydatid surgery.

Criss-Cross Serrations

For better grip of needle. · Central groove– minimal crushing effect, and no straightening of the curved needle · Handle to Blade ratio = 4:1 · Point of holding the needle- At junction anterior 2/3rd & posterior 1/3rd of needle holder Uses · Suturing of tissues · Ligation.

Doyen's Rib Raspatory / Coastal Elevator

It is also known as coastal elevator. · Polygonal handle – for better grip · End in curved fashion with sharp edges – to separate periosteum from under surface of rib.  To determine the side:  Handle should face laterally, Convexity of the hook should be upwards . Tip should face downward.

Kelly's Rectal Speculum (Protoscope) 

Length of proctoscope is – 10 cm · Length of Rigid sigmoidoscope - 25 cm · Length of Flexible sigmoidoscope - 60 cm · Length of Colonoscope- 160 cm.

Uses- Diagnostic · Hemorrhoids (IOC) (as it is non-palpable) · Rectal polyp · Rectal Ulcer · Carcinoma anal canal & Lower part of rectum · Localizing internal opening of fistula in- Ano Therapeutic · Sclerotherapy or banding of hemorrhoid · Polypectomy · Anal dilations.

Mayo's Vein Stripper

Used to strip varicose veins. · In long saphenous vein stripping should be done just below the knee joint to avoid injury of Saphenous nerve · In stripping of short saphenous system, careful dissection should be performed to avoid injury of Sural nerve · Gold standard treatment for Varicose veins – Endothermal ablation · In endothermal ablation 2 techniques are followed:  Endothermal laser ablation , Radiofrequency ablation.

Alli's Tissue Forceps 

 Long straight forceps blade - prevents crushing of the tissue · The gap in between the blades helps to accommodate the tissues / organ and thus there is no crushing effect. · Tip-Curved / angulated · Alternate teeth / groove at the end of tip - provides firm grip and prevents slippage of the tissue. · Should be applied over the inner aspect of skin & subcutaneous tissue.

Uses · Hold skin & S/C tissue flap for retraction-(excision of LN, Sebaceous cyst, lipoma) · Hold tough tissues - Fascia & aponeurosis approximation during suturing · During Thyroidectomy & Neck dissection. To hold the cut margins of skin · In Laparotomy-retract skin margins · In Bladder neck operations – hold the neck of bladder.

Babcock's Tissue Forceps 

Terminal part -curved · Fenestration to accommodate delicate structures · Non-traumatic instrument. · The space between the blades helps to accommodate the delicate structures such as bladder, bowel, ureter, appendix etc.

Uses · In Appendectomy-to hold the appendix · In Gastrectomy - to hold the cut margins · To hold Fallopian tube · To hold Ureter - during Pyelolithotomy & Ureter lithotomy · To hold Spermatic cord during hernia surgery · In Resection & Anastomoses-Hold the cut edges of Small intestine & Large intestine · In Suprapubic cystolithotomy-Used to hold cut edges of bladder.

Hope you found this blog helpful for your NEET SS General Surgery preparation. For more informative and interesting posts like these, keep reading PrepLadder’s blogs.