General surgery is a multidimensional discipline with procedures that are targeted at different parts of the body (abdomen, breast, skin, soft tissues, etc.). During these General Surgery procedures, surgeons will use a variety of surgical instruments to help them perform the surgery safely and effectively and each instrument is specifically designed for a purpose. Instruments can cut, dissect, grip, and close the incision in the tissues and are used in every step of surgery.

This blog intends to provide information about common general surgery instruments, their designs, alternate forms, and uses clinically. Therefore, if you are looking for information as a surgical trainee or a nurse or are just curious about those shiny instruments, hopefully this guide will help inform you about these instruments.

1. Scissors: Cutting & Dissecting Instrumentation

Surgical scissors can be used to cut tissues, sutures, or dressings. Scissors are available in different lengths, blade shapes, and degrees of cutting edge based on their intended use.

a) Mayo Scissors

• Design: Mayo scissors are typically thick and strong with a short cutting surface. Mayo scissors are available in both straight and curved.

Intended Use:

1. Straight Mayo scissors are used to cut sutures and non-tissue items.
2. Curved Mayo scissors can be used to cut heavy tissues like fascia and muscle.

• Use: Commonly used in abdominal surgery or in dissection of deep structures.

b) Metzenbaum Scissors

• Design: Long handles with thinner blades compared to Mayo scissors.

Intended use: Used to cut and dissect fine tissues such as a soft structure or fat.

• Use: Significant for fine dissection in general or specific cases involving dissection of structures such as bowel or thoracic dissection.

2. Forceps: Grasping and Holding Surgery Instruments

Forceps are utilized to hold, grasp, or manipulate tissues, sutures, and other materials during surgical procedures. There are two types of forceps: thumb (non-locking) and clamp (locking). 

a)  Adson forceps

• Design: Short, flat-tipped forceps with or without teeth.
• Purpose: Used for holding delicate tissue while suturing or closing skin.
• Application: Used in plastic surgery and other minor procedures that require precision.

b)  Tissue forceps (toothed or non-toothed)

• Design: Long forceps with serrated or toothed ends to hold firmly.
• Purpose:

1. Toothed: To hold tough tissues such as fascia or skin. 
2. Non-toothed: To hold softer tissues such as intestines.

• Application: Used during retraction, during dissection, and during suturing.

c)  Allis forceps

• Design: Clamp instrument with interlocking teeth and ratchet handles. 
• Purpose: Used to hold firmly tissue that is being excised. 
• Application: Commonly used on fascia as well as tissue that can be removed.

d)  Babcock forceps

• Design: Rounded jaws with atraumatic features.
• Purpose: Gently grasp delicate tissue such as bowel, fallopian tubes, or the bladder. 
• Application: Ideal for handling soft tubular organs without causing damage.

3. Needle Holders: Suturing Devices 

Needle holders (also called needle drivers) are designed to hold the suturing needles while closing the incision. 

a) Mayo-Hegar Needle Holder

• Design: Sturdy needle driver—ratchet clamp. 
• Purpose: Keeps larger needles secure; presents substantial control for suturing.
• Application: The most frequently used needle holder used for general purposes. 

 b) Mathieu Needle Holder 

• Design: Spring-loaded handle with lock ratchet. 
• Purpose: Provides appropriate ergonomics; allows fast release of needle.
• Application: Commonly used in cardiac and microsurgery.

4. Retractors: Devices for Retracting/Exposure

Retractors are surgical instruments designed to retract tissues or organs for the best exposure or visibility for the surgeon.

a) Senn Retractor

• Design: Simple, small, double-ended instrument; one side is smooth, with rake-type features on the opposite end.
• Use: Skin and shallow tissue retraction.
• Application: Common in minor procedures and plastic surgery.

b) Deaver Retractor

• Design: Large blade with a curved blade, made for deep tissue retraction.
• Purpose: To retract the abdominal or thoracic wall for maximum exposure.
• Application: Common in surgeries of the open abdomen and pelvis.

c) Richardson Retractor

• Design: Rectangular-angled blade with a flat handle.
• Purpose: Maximum exposure of cavity deep within body.
• Application: useful in procedures in the abdomen.

d) Weitlaner Retractor (self-retainer)

• Design: Hinged arms/either blunt or sharp prongs; ratcheted.
• Purpose: It holds itself in place to keep the incision open.
• Application: primarily in orthopedic and spinal surgery.

5. Scalpels: Instruments for Incision

A scalpel is the simplest cutting instrument, used to make the original incision. 

a) No. 10 Blade 

• Design: Curved blade. 
• Use: For large incisions through skin and muscle. 
• Most common with: No. 3 handle.

b) No. 11 Blade 

• Design: Triangular point blade. 
• Use: Used for puncturing and precision cuts (e.g., drain incisions).

c) No. 15 Blade 

• Design: Small curved blade. 
• Use: For short, precise incisions. 
• Application: Used in facial, hand, or pediatric surgery.

6. Hemostatic Agents and Clamps: Control of Bleeding

 Hemostatic agents refer to surgical instruments that you use to control (stop) bleeding. Usually these agents will do so by clamping a bleeding blood vessel.

a) Mosquito Hemostats

•  Design: Small diameter, fine tip with a ratcheting lock. 
• Purpose: Control bleeding from small blood vessels. 
• Application: The initial clamping of bleeding minute blood vessels in superficial surgery.

 b) Kelly Hemostats 

• Design: Larger than mosquito hemostats. 
• Purpose: Clamping of medium-sized vessels or blunt dissection of tissue. 
• Application: Used more generally in abdominal/vascular surgery.

 c) Crile Hemostats 

• Design: Similar to Kelly hemostats; however, serration runs the length of the jaws. 
• Purpose: Multi-purpose clamp that can be used to control bleeding but can also be used to manipulate tissue.
•  Application: General or trauma surgery.

7. Suction Tips: Maintain Clear Surgical Field

Suction devices are used to clear blood, bodily fluids, and debris from the operative field.

a) Yankauer suction tip

• Design: Rigid, curved tube with a blunted end with a bulbous head and holes.
• Function: Suctioning for open surgical procedures.
• Indications: Typical for abdominal surgical procedures, thoracic surgical procedures, and orthopedic procedures.

b) Poole suction tip

• Configuration: Multi-holed (side holes).
• Function: Suctioning large amounts of fluid or tissue.
• Indications: Typical in abdominal surgical procedures, in areas with a large amount of pooled fluid.

Conclusion: Significance of General Surgery Instruments for Surgical Procedures

The skill of the surgeon, along with the quality and the suitability of the instrumentation involved in each case, will determine how successful any general surgery procedure will turn out to be. Each surgical instrument serves a different purpose, but the most simple of concepts, such as gently squeezing the bisecting tips of a pair of Babcock forceps versus the squeezing of a Kelly hemostat to apply full force distally, is completely understood! Even in the simplest of concepts, knowing the difference and usefulness of a variety of surgical instruments makes each operation even more efficient, safe, and precise.

At Hasni Surgical, we design multiple types of high-quality general surgery instruments, including scissors, forceps, retractors, needle holders, etc. Each instrument is made with medical-grade stainless steel, and dozens of different tests for durability, precision, and ergonomics are conducted on each instrument we sell. We hope to provide a viable and reliable assortment of high-quality surgical instruments for the surgeons of the world to depend on for excellence in surgical procedures.