VTNE Surgical Instruments: Complete Identification and Function Guide

VTNE surgical instrument identification rewards systematic study. If you can sort instruments into five functional categories - cutting, hemostatic, grasping, retraction, and suturing - and recognize each by a single identifying feature, you can answer almost any instrument question on the exam.

Cutting and Dissecting Instruments

• Scalpel handle (Bard-Parker): holds a disposable blade; a number 3 handle takes a number 10, 11, or 15 blade. The primary incision tool.
• Mayo scissors: heavy, blunt-tipped scissors for cutting dense tissue, fascia, and suture.
• Metzenbaum scissors: lighter and longer with a slim shaft for delicate tissue dissection.
• Suture removal scissors: have a hooked lower blade to slide under and cut sutures.
• Bandage scissors (Lister): a blunt lower tip protects skin while cutting bandages.

Hemostatic Instruments

Hemostats clamp blood vessels to control hemorrhage. Distinguish them by size and serration pattern.

• Mosquito (Halsted) hemostat: small with fully transverse serrations for tiny vessels.
• Crile hemostat: medium, fully serrated jaws for slightly larger vessels.
• Kelly hemostat: medium with serrations on the distal half of the jaws only.
• Carmalt forceps: large crushing clamp with longitudinal grooves and cross serrations at the tip.
• Rochester-Pean forceps: large, fully serrated clamp for large vessels and tissue pedicles.

Grasping and Tissue Instruments

• Adson tissue forceps: fine thumb forceps, often with delicate rat-tooth tips for skin.
• Brown-Adson forceps: multiple small teeth for an atraumatic grip on tissue.
• Allis tissue forceps: ratcheted with interlocking teeth to grasp tissue to be removed.
• Babcock forceps: fenestrated, rounded jaws for gentle handling of delicate or tubular tissue such as intestine.
• Backhaus towel clamp: curved, pointed tips with a ratchet to secure drapes to the patient.

Retraction Instruments

• Senn retractor: small handheld, double-ended with a rake on one end and a flat blade on the other.
• Army-Navy retractor: handheld, double-ended flat blades for moderate retraction.
• Gelpi retractor: self-retaining with single sharp points and a ratchet to hold tissue open.
• Weitlaner retractor: self-retaining with multiple rake-like prongs.
• Balfour retractor: self-retaining abdominal retractor with side blades and a center spoon.

Suturing Instruments

• Mayo-Hegar needle holder: ratcheted jaws to grasp and drive needles; no scissor blades.
• Olsen-Hegar needle holder: combines needle-driving jaws with built-in scissor blades to cut suture.
• Castroviejo needle holder: fine, spring-action holder for microsurgery and ophthalmic work.

Suture Material Types

Sterilization Methods

• Steam autoclave: 121 C (250 F) for at least 15 minutes at 15 psi. The standard for heat-stable instruments. A biological indicator with bacterial spores confirms a true sterilization cycle.
• Gas (ethylene oxide): low-temperature sterilization for heat- and moisture-sensitive items such as endoscopes and plastics. Requires aeration time before use.
• Cold sterilization: chemical immersion (for example glutaraldehyde) for items that cannot be autoclaved; technically high-level disinfection unless contact times are strictly followed.