Surgical Instruments

Question 1

What is the nurses responsibility with instruments?

Answer 1

Knowing

• name
• function
• how to handle

Question 2

What are most instruments made of?

Answer 2

Stainless steal
Titanium
Plated

Question 3

Benefits to stainless steel?

Answer 3

Resists corrosion, rush and tarnish

Question 4

3 finishes of stainless steel?

Answer 4

Anodized - dull/glare proof
Ebony - no glare/beam proof (used with lasers commonly)
Mirror - reflects light

Question 5

Benefits of titanium?

Answer 5

Inert
Non magnetic
Harder, lighter and stronger than stainless reel

Usually blue anodized

Question 6

Plated finishes?

Answer 6

Applied to any metal surface
Can chip/rupture
Difficult to keep from corroding

Question 7

4 categories of instruments?

Answer 7

Cutters
Clamps
Retractor
Other

Question 8

Types of cutters

Answer 8

Scalpel blade
Scissors 
Rongeurs 
Osteotomes 
Andenotomes 
Dermatones

Question 9

What do retractors do?

Answer 9

Hold back tissue

Can be hand help or self retaining

Question 10

Example of hand held retractor?

Answer 10

Army-navy

Deaver

Question 11

Example of self retaining retractor?

Answer 11

Have attached or interchangeable blades

Ex Balfour

Question 12

What falls under the “other” category of surgical instruments?

Answer 12

Probes
Suction tips
Smoke evacuation devices
Mallets

Question 13

Common components of scissors, hemostat, tonsil forceps and ring forceps all have in common?

Answer 13

Jaws 
Joint 
Shank
Ratchet 
Ring

Question 14

Types of joints?

Answer 14

Aseptic
Box lock
Screw

Question 15

Aseptic joint

Answer 15

Semi box

2 halves that make up instrument can be separated with dislocation of joint

Question 16

Box lock joint?

Answer 16

Most common

One arm passes through a slot in the other arm and the 2 halves are secured with a pin or rivet

Question 17

Screw joint?

Answer 17

2 halves that make up the instrument are aligned and secured with a screw

Question 18

6 considerations for picking sets?

Answer 18

Type of surgery 
Patient population ex. Peds
Needs of the surgeon
Weight of tray - cannot exceed 25lbs
Sterilization of contents
Weight of instruments

Question 19

Critical elements of knowing critical elements of instruments?

Answer 19

Critical elements: how to handle, how to use, name

Common language
Count process
Time spent in OR

Question 20

Specialty instruments?

Answer 20

Powered instruments
Laparoscopes
Endoscopes
Robotics

Question 21

What can instruments be powered by?

Answer 21

Air
Battery
Electricity

Question 22

What are Micro power powered instruments used for?

Answer 22

Used for drilling and sawing in small spaces

Question 23

What are Large power powered instruments used for?

Answer 23

Used on larger bones such as a knee/hip joint replacement

Question 24

Key considerations for powered instruments?

Answer 24

Power source is specific to the powered hand piece

Powered instruments are not immersible

The correct powered instrument is chosen for intended use

Question 25

What can laparoscopes do?

Answer 25

Can cut and coagulate Allow surgeon to reach surgical site thought tocars placed in small incisions * Minimally invasive

Question 26

Components of laparoscopic instruments?

Answer 26

``` Thin linear shafts with handles that connect to ESU 1. Grasper & 2. Laparoscope - contains light & CO2 ``` *tips are the key to instrument identification

Question 27

How do laparoscopes prevent injury?

Answer 27

They are insulated to prevent injury as electrical circuit travels down shaft - always inspect before use

Question 28

How are endoscopes classified?

Answer 28

On their bending ability Rigid Semi rigid Flexible

Question 29

Rigid endoscopes?

Answer 29

Not meant to bend Come in different sizes Common for lap chole and knee arthroplasty

Question 30

Endoscopes with channel vs without channel?

Answer 30

Channel: allow instruments to pass through Without: non operative, diagnostic

Question 31

Key considerations for endoscopes?

Answer 31

Light source required for use Internal glass or plates fibers can be damaged with rough handling The right scope is use for the surgery You may need more than one scope for the procedure

Question 32

How to hold endoscope to prevent damage?

Answer 32

Hold by eye piece and the neck of scope

Question 33

Robotic instruments?

Answer 33

Similar to laparoscopic - instruments are inserted into the robotic arms Video cart includes camera monitor abs light source

Question 34

What does the surgeon control in robotic surgery?

Answer 34

Instruments Scopes Cameras From the console of cart

Question 35

Key considerations for robotics?

Answer 35

Designed and engineered to replicate the surgeon’s movements 3D vision provides depth perception for precise location, control and use of the instruments Robotic instruments, camera and scopes are used for robotics only Instruments come in wide variety and are reposable -used and reprocessed before being discarded

Question 36

How are instruments cared for and handled?

Answer 36

With care Used correctly Effectively cleaned, decontaminated and sterilized

Question 37

Steps to handling instruments?

Answer 37

Organized in sterile field and handled with care in sterile field Choose right instrument for intended purposes to prevent damage and pt injury Use sterile water to clean instruments Transport instruments to decontamination area in closed container/cart ASAP after procedure

Question 38

Why can’t you wash instruments with NS?

Answer 38

Corrosive properties

Question 39

Inspection of instruments?

Answer 39

Done in OR and in sterilizing department - remove any damaged/broken instruments Preventative maintenance scheduled to ensure properly working Lubrication may be required as part of sterile processing to ensure operates smoothly