Perlengkapan Instrumen Bedah

The basic instruments that every beginner surgeon should know are placed in four categories.

1.Cutting and Dissecting

2.Clamping and Occluding

3.Grasping and Holding

4.Retracting and Exposing

 

1. Cutting and Dissecting instruments

SCALPEL

Picture1

Knife handles:

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#7, #3, #4
(left to right)

7 handle with 15 blade (deep knife) – Used to cut deep, delicate tissue.

3 handle with 10 blade (inside knife) – Used to cut superficial tissue.

4 handle with 20 blade (skin knife) – Used to cut skin.

 

Scissors:

Picture3

straight Mayo, curved Mayo, Metzenbaum
(left to right)

Straight Mayo scissors – Used to cut suture and supplies. Also known as: Suture scissors.

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EX:  Straight Mayo scissors being used to cut suture.

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Curved Mayo scissors – Used to cut heavy tissue (fascia, muscle, uterus, breast).  Available in regular and long sizes

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Metzenbaum scissors – Used to cut delicate tissue.  Available in regular and long sizes.

Picture7

Suture scissor

Picture8

 

  1. Clamping and Occluding Instruments

Clamping and occluding instruments are used to compress blood vessels or hollow organs for hemostasis or to  prevent spillage of contents.

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A hemostat is used to clamp blood vessels or tag sutures.

Its jaws may be straight or curved. Other names: crile, snap or stat.

Picture10 hemostat

A mosquito is used to clamp small blood vessels. Its jaws may be straight or curved.

Picture11 hemostat, mosquito (left to right)

A Kelly is used to clamp larger vessels and tissue.

Available in short and long sizes. Other names: Rochester Pean.

Picture12 Kelly, hemostat, mosquito (left to right)

Pean Clamp

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A burlisher is used to clamp deep blood vessels. Burlishers have two closed finger rings. Burlishers with an open finger ring are called tonsil hemostats. Other names: Schnidt tonsil forcep, Adson forcep.

 

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A right angle is used to clamp hard-to-reach vessels and to place sutures behind or around a vessel. A right angle with a suture attached is called a “tie on a Passer”. Other names: Mixter.

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A hemoclip applier with hemoclips applies metal clips onto blood vessels and ducts which will remain occluded.

Picture17 hemoclip applier with hemoclips

  1. Grasping and Holding instruments

Grasping and holding instruments are used to hold tissue, drapes or sponges.

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An Allis is used to grasp tissue.  Available in short and long sizes.  A “Judd-Allis” holds intestinal tissue; a “heavy allis“holds breast tissue.

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A Babcock is used to grasp delicate tissue (intestine, fallopian tube, ovary).  Available in short and long sizes.

Picture20 Babcock

A Kocher is used to grasp heavy tissue. May also be used as a clamp. The jaws may be straight or curved. Other names: Ochsner.

Picture21 Kocher

A Foerster sponge stick is used to grasp sponges. Other names: sponge forcep.

Picture22 Foerster sponge stick

EX:  Sponge sticks holding a 4 X 4 and probang.

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A dissector is used to hold a peanut. EX:  Dissector holding a peanut.

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A Backhaus towel clip is used to hold towels and drapes in place. Other name: towel clip.

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large & small towel clips

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Pick ups, thumb forceps and tissue forceps are available in various lengths, with or without teeth, and smooth or serrated jaws.

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Russian tissue forceps are used to grasp tissue.

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Adson pick ups are either smooth: used to grasp delicate tissue; or with teeth: used to grasp the skin.  Other names: Dura forceps.

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DeBakey forceps are used to grasp delicate tissue, particularly in cardiovascular surgery.

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Thumb forceps are used to grasp tough tissue (fascia,breast). Forceps may either have many teeth or a single tooth. Single tooth forceps are also called “rat tooth forceps.”

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Mayo-Hegar needle holders are used to hold needles When suturing. They may also be placed in the sewing category. EX: Needle holder with suture.

Picture35Picture36

Mathieu needle holder

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  1. Retracting and Exposing instruments

Retracting and exposing instruments are used to hold back or retract organs or tissue to gain exposure to the operative site.They are either “self-retaining” (stay open on their own) or “manual” (held by hand).

When identifying retractors, look at the blade, not the handle.

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A Deaver retractor (manual) is used to retract deep abdominal or chest incisions.  Available in various widths.

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A Richardson retractor (manual) is used to retract deep abdominal or chest incisions.

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An Army-Navy retractor (manual) is used to retract shallow or superficial incisions.  Other names: USA, US Army.

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A goulet (manual) is used to retract shallow or superficial incisions.

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A malleable or ribbon retractor (manual) is used to retract deep wounds.  May be bent to various shapes.

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A Weitlaner retractor (self-retaining) is used to retract shallow incisions.

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A Gelpi retractor (self-retaining) is used to retract shallow incisions.

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A Balfour with bladder blade (self-retaining) is used to retract wound edges during deep abdominal procedures.

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