Surgical instruments

A surgical instrument is a specially designed tool or device for performing specific actions of carrying out desired effects during a surgeryor operation, such as modifying biological tissue, or to provide access or viewing it. Along time, many different kinds of surgical instruments and tools have been invented, some of them of a more general character, others designed for a specific type of surgery. Accordingly, the nomenclature of surgical instruments follows certain patterns, such as a description of the action it performs (for example, scalpel, hemostat), the name of its inventor(s) (for example, the Kocher forceps), or a compound scientific name related to the kind of surgery (for example, tracheotome).

The expression surgical instrumentation is somewhat interchangeably used with surgical instruments, but its meaning in medical jargon is really the activity of providing assistance to a surgeon with the proper handling of surgical instruments during an operation, by a specialized professional, usually a nurse.

Classification

There are several classes of surgical instruments:

• Graspers, especially tweezersand forceps
• Clamps and occluders for blood vesselsand other organs
• Retractors, used to spread open skin, ribsand other tissue
• Distractors, positioners and stereotactic devices
• Mechanical cutters (scalpels, lancets, drill bits, rasps, trocars, etc.)
• Dilatorsand speculae, for access to narrow passages or incisions
• Suctiontips and tubes, for removal of bodily fluids
• Irrigation and injection needles, tips and tubes, for introducing fluid
• Powered devices, such as drills, dermatomes
• Scopes and probes, including fiber opticendoscopesand tactile probes
• Carriers and appliers for optical, electronic and mechanical devices
• Ultrasoundtissue disruptors, cryotomesand cutting laserguides
• Measurement devices, such as rulersand calipers

An important relative distinction, regarding surgical instruments, is the amount of bodily disruption or tissue traumathat their use might cause the patient. Terms relating to this issue are 'atraumatic' and minimally invasive. Minimally invasive systems are an important recent development in surgery. In the future, they devices will include many microscopic autonomous and directed devices.

History

Surgical instruments have been manufactured since the dawn of pre-history. Rough trephinesfor performing round craniotomieswere discovered in neolithicsites in many places. It is believed that they were used by shamansto release evil spirits and alleviate headachesand head traumascaused by war-inflicted wounds.

In the Antiquity, surgeonsand physiciansin Greeceand Romedeveloped many ingenious instruments manufactured from bronze, ironand silver, such as scalpels, lancets, curettes, tweezers, speculae, trephines, forceps, probes, dilators, tubes, surgical knifes, etc. They are still very well preserved in several medical museumsaround the world. Most of these instruments continued to be used in Medievaltimes, albeit with a better manufacturing technique.

In the Renaissanceand post-Renaissance era, new instruments were again invented and designed, in order to accompany the increased audacity of surgeons. Amputationsets originated in this period, due to the increased severity of war-inflicted wounds by shot, grapnel and cannon.

However, it was only with the discovery of anesthesiaand surgical asepsisthat new surgical instruments were invented to allow the penetration of the inner sanctum, or the previously forbidden body cavities, namely the skull, the thoraxand the abdomen. A veritable explosion of new tools occurred with the hundreds of new surgical procedures which were developed in the 19th centuryand first decades of the 20th century. New materiais, such as stainless steel, chrome, titaniumand vanadiumwere available for the manufacturing of these instruments. Precision instruments for microsurgeryin neurosurgery, ophthalmologyand otologywere possible and, in the second half of the 20th century, energy-based instruments were first developed, such as electrocauteries, ultrasound and electric scalpels, surgical tools for endoscopic surgery, and finally, surgical robots.

Historically, the development of a surgical instrument follows:

1. The surgeon uses a common tool and/or adapts it for use in an operation. Some ancient sources of such tools are weapons, butcher's tools, items used in ritualbody modification, cannibalismor torture, carpenter's, leatherworker's and metalworker's implements. (This process still continues, with tools coming out of automobileshops, aerospaceworkplaces, kitchens, etc.)
2. There is a period of transference and incremental improvement, generally focusing on materials, which must be nontoxicand durable. Bloodtends to corrode and the repeated washing and sterilizationof surgical instruments tends to quickly destroy many materials; other materials hold stains and bacteria.
3. There is a period of standardization.

However, in modern times, surgeons are also designing instruments from scratch. Also, governmental controls have modified the path of innovation somewhat.

Index of surgical instruments

Bibliography

• Wells, MP, Bradley, M: Surgical Instruments A Pocket Guide. W.B. Saunders, 1998.

External links

• Eponymous surgical instruments. WhoNamedIt.
• The Surgery of Ancient Rome. A Display of Surgical Instruments from Antiquity. University of Virginia Health System.
• Surgical instruments. University of Pennsylvania.
• Basic surgical instruments.
• Surgical instruments.

This article is licensed under the GNU Free Documentation License.
It uses material from the http://en.wikipedia.org/wiki/Surgical+instruments Wikipedia article Surgical instruments.