Wednesday 15th November, 2023

The secret to super surgery – instruments!

There is a secret to performing great surgeryhaving decent instruments! There it is, the secret is out!


One of our pet hates at MSM Vets is blunt, old, or poor-quality needle holders, which are just plain dangerous when it comes to performing instrument ties. It really isn’t clear why our profession sees this instrument as a heritable item because your children will certainly not need them! When they are worn out and beyond repair just get rid of them.


A good investment


This is an area well worth investing more in and tungsten carbide Olsen-Hegar with replaceable faces are a joy to use. Get yourself a large and smaller pair – the larger for 3-4 metric and smaller for 1-2 metric – and you will notice a massive difference in your suturing accuracy.


Cheap instruments have less finishing to them and can have sharp burrs that damage suture material which can easily cause catastrophe. This is doubly important when training surgeons as this can destroy confidence.


We also understand from human surgery reports that Gillies are thought to promote hand strain as well, so be mindful when making your choice.


Inexpensive option


DeBakey forceps are an excellent instrument and these inexpensive beauties can transform your fine surgery by giving you atraumatic grip. The parallel lines of fine points do not crush the tissue – they were designed for vascular surgery in humans – and make manipulation of fragile tissues effortless.


In contrast, the skin and thicker tissues need a more coarse pattern and while we like Adson-Brown or rat tooth forceps are perfectly acceptable. Try to avoid forceps that are made of really thin metal that bends too much, it makes you squeeze really hard which causes more trauma. 


A lot of people are fearful of using rat tooth forceps and address skin and muscle issues with dressing forceps but they crush rather than pierce, which is a lot more damaging to vascularity. Rat tooth forceps on viscera are a bit coarse though, which is where the likes of DeBakey can be an advantage.


Shedding light on the situation


You can’t dissect if you can’t see! So, once you have decent lighting, something you should never skimp on, you need retraction. Mini Gelpis are lovely. Best used in pairs, they allow a grid pattern to dissect down to deep structures – a process essential for glandular work.

When it comes to the tools of your trade, come and join us on the dark side and become an instrument dork – it’s the future!

Posted by Rhea Alton