Virginia Beach surgical instruments

Proper care and maintenance is a must for surgical tools like safety scalpels in Virginia Beach. They need to be sterilized and disinfected before and after use. When it comes to instruments like scalpel, forceps, retractors etc. it is understandable that they will be used on vital body organs so you must ensure that they are completely germ free and disinfected before you end up using them. If the surgical instruments are cleaned and disinfected properly there is little to no chance of infections.

surgical scissor

Correct Use of disposable blades in Virginia Beach

Proper maintenance of these instruments are required in Virginia Beach, and it also increases the life span of the instruments. This results in reducing extra costs like repairs and replacements. Also you need to make sure that the instruments which are disposable are being disposed in a proper way as per the health regulations of Virginia Beach. You do not want them to get used by someone else. So ensure that all needles and other disposable surgical instruments are gathered and properly disposed off, since failure to do so will allow microorganisms to spread to and cause further diseases. These are some of the factors which everyone who uses operating room instruments must keep in mind; they will help in ensuring the safety of the patient as well as the other people in the Virginia Beach area. Hospitals have proper procedures for disposing off such medical devices as well.

Laprascopy With the Harmonic Scalpel

scalpel safety

Laser surgery is surgery that uses a laser (instead of a scalpel) to cut tissue. Examples include the use of a laser scalpel in otherwise conventional surgery, and soft-tissue laser surgery, in which the laser beam vaporizes soft tissue with high water content. Laser resurfacing is a technique in which covalent bonds of a material are dissolved by a laser, a technique invented by aesthetic plastic surgeon Thomas L Roberts, III using CO2 lasers in the 1990s. The CO2 (carbon dioxide) laser remains the gold standard for the soft tissue surgery because of the ease of simultaneous photo-thermal ablation and coagulation (and small blood capillary hemostasis).

Laser surgery is commonly used on the eye. Techniques used include LASIK, which is used to correct near and far-sightedness in vision, and photorefractive keratectomy, a procedure which permanently reshapes the cornea using an excimer laser to remove a small amount of tissue. Types of surgical lasers include carbon dioxide, argon, Nd:YAG laser, and Potassium titanyl phosphate.

  1. Photochemical effect: clinically referred to as photodynamic therapy. Photosensitizer (photophrin II) is administered which is taken up by the tumor tissue and later irradiated by laser light resulting in highly toxic substances with resultant necrosis of the tumor. Photodynamic therapy is used in palliation of oesophagial and bronchial carcinoma and ablation of mucosal cancers of Gastrointestinal tract and urinary bladder.
  2. Photoablative effect: Used in eye surgeries like band keratoplast, and endartectomy of peripheral blood vessels.
  3. Photothermal effect: this property is used for endoscopic control of bleeding e.g. Bleeding peptic ulcers, oesophagial varices
  4. Photomechanical effect: used in intraluminal lithotripsy

A range of lasers such as erbium, dye, and CO2 are used to treat various skin conditions including scars, vascular and pigmented lesions, and for photorejuvenation.

Various types of laser surgery are used to treat refractive error:

Lasers are also used to treat non-refractive conditions, such as:

Laser endarterectomy is a technique in which an entire atheromatous plaque in the artery is excised. Laser recanalization of blocked arteries. other applications include laser assisted angioplasties and laser assisted vascular anastomosis.

Lasers are used to treat several disorders in foot and ankle surgery. They are used to remove benign and malignant tumors, treat bunions, debride ulcers and burns, excise epidermal nevi, blue rubber bleb nevi, and keloids, and the removal of hypertrophic scars and tattoos.

A carbon dioxide laser (CO2) is used in surgery to treat onychocryptosis (ingrown nails), onychauxis (club nails), onychogryposis (rams horn nail), and onychomycosis (fungus nail).

  1. Peritoneum-Laser is used for adhesiolysis.
  2. Peptic ulcer disease and oesophageal varices - Laser photoablation is done.
  3. Coagulation of vascular malformations of stomach, duodenum and colon.
  4. Lasers can be effectively used to treat early gastric cancers provided they are less than 4 cm and without lymph node involvement. Lasers are also used in treating oral submucous fibrosis.
  5. Palliative laser therapy is given in advanced oesophageal cancers with obstruction of lumen. Recanalisation of the lumen is done which allows the patient to resume soft diet and maintain hydration.
  6. Ablative laser therapy is used in advanced colorectal cancers to relieve obstruction and to control bleeding.
  7. Laser surgery used in hemorrhoidectomy, and is a relatively popular and non-invasive method of hemorrhoid removal.
  8. Laser-assisted liver resections have been done using carbon dioxide and Nd:YAG lasers.
  9. Ablation of liver tumors can be achieved by selective photovaporization of the tumor.
  10. Endoscopic laser lithotripsy is a safer modality compared to electrohydraulic lithotripsy.

The CO2 laser is used in oral and dental surgery for virtually all soft-tissue procedures, such as gingivecomies, vestibuloplasties, frenectomies and operculectomies. The CO2 10,600 nm wavelength is safe around implants as it is reflected by titanium, and thus has been gaining popularity in the field of periodontology. The laser may also be effective in treating peri-implantitis.

Laser spine surgery first began seeing clinical use in the 1980s and was primarily used within discectomy to treat lumbar disc disease under the notion that heating a bulging disc vaporized enough tissue to relieve pressure on the nerves and help alleviate pain.

Since that time, laser spine surgery has become one of the most marketed forms of minimally invasive spine surgery, despite the fact that it has never been studied in a controlled clinical trial to determine its effectiveness apart from disc decompression. Evidence-based data surrounding the use of lasers in spine surgery is limited primarily due to the presence of a number of challenging factors including patient selection, operative indications in the type of laser used in the procedure. As a result, the official Blue Cross of Idaho position on laser disc surgery concluded:

"Evidence on decompression of the intervertebral disc using laser energy consists of observational studies. Given the variable natural history of back pain and the possibility of placebo effects with this treatment, observational studies are insufficient to permit conclusions concerning the effect of this technology on health outcomes."

The CO2 laser is also used in gynecology, genitourinary, general and thoracic surgery, otorhinolaryngology, orthopedic, and neurosurgery.

Surgical Staple after an Operation

A 40 watt CO2 laser scalpel with applications in ENT, gynecology, dermatology, oral surgery, and podiatry

A laser scalpel is a scalpel for surgery, cutting or ablating living biological tissue by the energy of laser light. The laser scalpel was invented in 1964. In soft tissue laser surgery, a laser beam ablates or vaporizes the soft tissue with high water content. Diode, Nd: and Er:YAG, and CO2 lasers are used most commonly in soft tissue surgery.

CO2 lasers are best for cutting soft tissue because their wavelength is most absorbed by water. The focused CO2 laser beam vaporizes tissue precisely, with little thermal damage to surrounding tissues (thermal coagulation zone is as little as 50 microns). The surgical outcome is thus safe and predictable. The CO2 laser is used in virtually all soft tissue procedures, including face lifts, tumor excision, and surgeries in the oral cavity. CO2 laser surgery is praised for minimized bleeding, less swelling and discomfort, reduced infection risk, and less procedure time, as compared to traditional scalpel surgery. Applications include oral surgery, periodontal surgery, oncological surgery, among many others.

In ophthalmology, excimer lasers are used for changing the shape of the cornea, procedures known as LASIK and LASEK.

Other surgical fields where the use of a laser scalpel is common are circumcision, neurosurgery and vascular surgery.

For research use in cell biology, special laser micro-scalpels can make cuts smaller than a single cell.

Laser lancets, e.g. Lasette or LaserDoc, are used as a less painful alternative for drawing small amounts (up to 100 µl) of capillary blood, e.g. for diabetic glucose tests. An adjustable-power flashlamp or diode pumped pulsed Er:YAG laser is typically used. A 150 mJ pulse (focused to 6 J/mm2) can vaporize a 0.025 mm2 of skin to 0.5 mm depth.

Today diode lasers, Nd:YAG and Er:YAG (and their variants, differing by pumping methods and host crystal type, e.g. Er,Cr:YSGG laser), and CO2 lasers are most commonly used, but possible benefits of using the vastly more expensive free electron lasers are being researched.


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Raleigh surgical instruments

Proper care and maintenance is a must for surgical tools like safety scalpels in Raleigh. They need to be sterilized and disinfected before and after use. When it comes to instruments like scalpel, forceps, retractors etc. it is understandable that they will be used on vital body organs so you must ensure that they are completely germ free and disinfected before you end up using them. If the surgical instruments are cleaned and disinfected properly there is little to no chance of infections.

safety retractable

Correct Use of microtome blades in Raleigh

Proper maintenance of these instruments are required in Raleigh, and it also increases the life span of the instruments. This results in reducing extra costs like repairs and replacements. Also you need to make sure that the instruments which are disposable are being disposed in a proper way as per the health regulations of Raleigh. You do not want them to get used by someone else. So ensure that all needles and other disposable surgical instruments are gathered and properly disposed off, since failure to do so will allow microorganisms to spread to and cause further diseases. These are some of the factors which everyone who uses operating room instruments must keep in mind; they will help in ensuring the safety of the patient as well as the other people in the Raleigh area. Hospitals have proper procedures for disposing off such medical devices as well.

Surgical Staple after an Operation

blade handle 34 surgical staples closing scalp following craniotomy

Surgical staples are specialized staples used in surgery in place of sutures to close skin wounds, connect or remove parts of the bowels or lungs. A more recent development, from the 1990s, uses clips instead of staples for some applications; this does not require the staple to penetrate.

Stapling is much faster than suturing by hand, and also more accurate and consistent. Staples are primarily used in bowel and lung surgery, because staple lines are more consistent and therefore less likely to leak blood, air or bowel contents. Still, several randomized controlled trials have shown no significant difference in bowel leakage after anastomoses performed either manually with suture by experienced surgeons, or after mechanical anastomoses with staples. In skin closure, dermal adhesives (skin glues) are also an increasingly common alternative.

Staplers were originally developed to address the perceived problem of patency (security against stenosis or occlusion of the lumen) and tightness (security against leaks of blood or bowel contents) as well as easiness and quickness in performing the anastomosis. Leaks from poor suturing of bowel anastomoses was at that time a significant cause of post-surgical mortality. More recent studies have shown that with current suturing techniques there is no significant difference in outcome between hand sutured and mechanical anastomoses, but mechanical anastomoses are significantly quicker to perform.

The technique was pioneered by a Hungarian surgeon, Humor Hultl, known as the "father of surgical stapling". Hultl's prototype stapler of 1908 weighed eight pounds (3.6 kg), and required two hours to assemble and load. Many hours were spent trying to achieve a consistent staple line and reliably patent anastomoses.

The early instruments, by developers including Hultl, von Petz, Friedrich and Nakayama, were complex and cumbersome to use. The technology was refined in the 1950s in the Soviet Union, allowing for the first commercially produced re-usable stapling devices for creation of bowel and vascular anastomoses. Mark M. Ravitch, brought a sample of stapling device after attending a surgical conference in USSR, and introduced it to entrepreneur Leon C. Hirsch, who founded the United States Surgical Corporation in 1964 to manufacture surgical staplers under its Auto Suture brand. Until the late 1970s USSC had the market essentially to itself, but in 1977 Johnson & Johnson's Ethicon brand entered the market and today both are widely used, along with competitors from the Far East. USSC was bought by Tyco Healthcare in 1998, which became Covidien on June 29, 2007.

Safety and patency of mechanical (stapled) bowel anastomoses has been widely studied. It is generally the case in such studies that sutured anastomoses are either comparable or less prone to leakage. It is possible that this is the result of recent advances in suture technology, along with increasingly risk-conscious surgical practice. Certainly modern synthetic sutures are more predictable and less prone to infection than catgut, silk and linen, which were the main suture materials used up to the 1990s.

One key feature of intestinal staplers is that the edges of the stapler act as a haemostat, compressing the edges of the wound and closing blood vessels during the stapling process.

Laparoscopic cholecystectomy. Close-up demonstration of a surgical skin stapler.

The first commercial staplers were made of stainless steel with titanium staples loaded into reloadable staple cartridges.

Modern surgical staplers are either disposable and made of plastic, or reusable and made of stainless steel. Both types are generally loaded using disposable cartridges.

The staple line may be straight, curved or circular. Circular staplers are used for end-to-end anastomosis after bowel resection or, somewhat more controversially, in esophagogastric surgery. The instruments may be used in either open or laparoscopic surgery, different instruments are used for each application. Laparoscopic staplers are longer, thinner, and may be articulated to allow for access from a restricted number of trocar ports.

Some staplers incorporate a knife, to complete excision and anastomosis in a single operation. Staplers are used to close both internal and skin wounds. Skin staples are usually applied using a disposable stapler, and removed with a specialized staple remover. Staplers are also used in vertical banded gastroplasty surgery (popularly known as "stomach stapling").

Vascular stapler for reducing warm ischemia in organ transplantation. With this model each stapler end can be mounted on donor and recipient by independent surgical teams without care for reciprocal orientation, being the maximal possible vascular axis torsion ≤30°. Activating guide-wire is connected just immediately before firing (video)

While devices for circular end-to-end anastomosis of digestive tract are widely used, in spite of intensive research circular staplers for vascular anastomosis never had yet significant impact on standard hand (Carrel) suture technique. Apart from the different modality of coupling of vascular (everted) in respect to digestive (inverted) stumps, the main basic reason could be that, particularly for small vessels, the manuality and precision required just for positioning on vascular stumps and actioning any device cannot be significantly inferior to that required to carry out the standard hand suture, then making of little utility the use of any device. An exception to that however could be organ transplantation where these two phases, i.e.device positioning at the vascular stumps and device actioning, can be carried out in different time, by different surgical team, in safe conditions when the time required does not influence donor organ preservation, i.e. at the back table in cold ischemia condition for the donor organ and after native organ removal in the recipient. This is finalized to make as brief as possible the donor organ dangerous warm ischemia phase that can be contained in the couple of minutes or less necessary just to connect the device's ends and actioning the stapler.

Although most surgical staples are made of titanium, stainless steel is more often used in some skin staples and clips. Titanium produces less reaction with the immune system and, being non-ferrous, does not interfere significantly with MRI scanners, although some imaging artifacts may result. Synthetic absorbable (bioabsorbable) staples are also now becoming available, based on polyglycolic acid, as with many synthetic absorbable sutures.

Titanium staples are not suspected of causing nickel reactions because nickel is rarely if ever used in titanium alloys.

Where skin staples are used to seal a skin wound it will be necessary to remove the staples after an appropriate healing period, usually between 5 and 10 days, depending on the location of the wound and other factors. The skin staple remover is a small manual device which consists of a shoe or plate that is sufficiently narrow and thin to insert under the skin staple. The active part is a small blade that when hand-pressure is exerted it pushes down on the staple and pushes it through a slot in the shoe and deforms the staple into an 'M' shape to facilitate its removal, although in an emergency it is possible to remove them with a pair of artery forceps. Skin staple removers are manufactured in many shapes and forms, some disposable and some reusable.

History and Use of Scalpels in Surgery

The Harmonic scalpel is a surgical instrument used to simultaneously cut and cauterize tissue. Unlike Electrosurgery, the harmonic uses ultrasonic vibrations instead of electric current to cut and cauterize tissue.

The harmonic is superior to a Bovie in that it can cut through thicker tissue, creates less toxic surgical smoke, and may offer greater precision. The harmonic scalpel is not as easily maneuverable as the Bovie, and takes longer to cut and coagulate tissue. Additionally, while a Bovie can be used to coagulate bleeding tissue at any time, the Harmonic scalpel only coagulates as it cuts.

A Harmonic scalpel cuts via vibration. The scalpel surface itself cuts through tissue by vibrating in the range of 55,500 Hz. The high frequency vibration of tissue molecules generates stress and friction in tissue, which generates heat and causes protein denaturation. This technique causes minimal energy transfer to surrounding tissue, potentially limiting collateral damage. However, incidents have been reported where the active jaw has caused bowel perforation.


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Colorado Springs scalpel handle use

Proper care and maintenance is a must for surgical tools like safety scalpels in Colorado Springs. They need to be sterilized and disinfected before and after use. When it comes to instruments like scalpel, forceps, retractors etc. it is understandable that they will be used on vital body organs so you must ensure that they are completely germ free and disinfected before you end up using them. If the surgical instruments are cleaned and disinfected properly there is little to no chance of infections.

disposable scalpel and blade

Correct Use of ultrasonic scalpel in Colorado Springs

Proper maintenance of these instruments are required in Colorado Springs, and it also increases the life span of the instruments. This results in reducing extra costs like repairs and replacements. Also you need to make sure that the instruments which are disposable are being disposed in a proper way as per the health regulations of Colorado Springs. You do not want them to get used by someone else. So ensure that all needles and other disposable surgical instruments are gathered and properly disposed off, since failure to do so will allow microorganisms to spread to and cause further diseases. These are some of the factors which everyone who uses operating room instruments must keep in mind; they will help in ensuring the safety of the patient as well as the other people in the Colorado Springs area. Hospitals have proper procedures for disposing off such medical devices as well.

Use of a Laser Scalpel

surgical scissor

Hospitals can be scary sometimes but we can’t deny the fact that millions of lives are saved in these institutions every day. Being a doctor is definitely not an easy affair. Not only do these professionals have to become masters in understanding human biology but they also have to perfect their skills and capabilities of using various medical instruments. Can you think of a painter without the required paint brushes? Or a carpenter without his tools? Similarly, a doctor without his medical devices would be just like an audience on a show where, ideally, he should be performing on stage. No operation or diagnosis or procedure or even test can be carried out without necessary tools and equipment. It is important to know what these tools are and what their utilities are.

So if you are interested in medical tools and procedures and would like to understand how these are carried out, here is a list of the most basic medical instruments that you can find on an operating room. Hope this article helps you in your search for information.

# Scissors

The use of scissors as operating room instruments need not be highlighted or stated. No operation can be done without scissors. Scissors used in surgery come in two main types: Metzenbaum and Mayo scissors. Metzenbaum scissors are used in case of cutting or dissecting soft delicate tissues. Mayo scissors are preferred for cutting hard tissues such as joints. These scissors are used to cut thick tissues located in the breast and the muscles. Made up of stainless steel, these scissors are usually manufactured in variable lengths.

# Scalpel

Whether it is a major or a minor operation, a scalpel plays a very vital role in all of them. It is a knife that comes with stainless steel blades. Each and every surgery has its different needs but during every surgery, a correct incision is a must which cannot be carried out without a scalpel.

# Forceps

Forceps look like kitchen tongs. It allows the surgeon to hold and grasp the skin tissues firmly. Whether it is clamping the arteries or holding a part of intestine while operating, forceps can be relied upon. Also, this surgical instrument comes in a range of sizes so that the surgeon can choose one depending upon the need of the situation. The large ones are designed to hold a baby’s head and their main purpose is to safely get the baby out from the birth canal during a cesarean.

Of course there are other tools as well which will vary from surgery to surgery. They are manufactured with a wide variety of materials like platinum, stainless steel, tungsten carbide, chromium and other non-reactive and high strength metals. Designs and applications of medical devices have also evolved much over time. The more we advance into health care and medical science, the more new tools and equipment we will create for aiding surgeons in performing life saving procedures.

Laprascopy With the Harmonic Scalpel

The Harmonic scalpel is a surgical instrument used to simultaneously cut and cauterize tissue. Unlike Electrosurgery, the harmonic uses ultrasonic vibrations instead of electric current to cut and cauterize tissue.

The harmonic is superior to a Bovie in that it can cut through thicker tissue, creates less toxic surgical smoke, and may offer greater precision. The harmonic scalpel is not as easily maneuverable as the Bovie, and takes longer to cut and coagulate tissue. Additionally, while a Bovie can be used to coagulate bleeding tissue at any time, the Harmonic scalpel only coagulates as it cuts.

A Harmonic scalpel cuts via vibration. The scalpel surface itself cuts through tissue by vibrating in the range of 55,500 Hz. The high frequency vibration of tissue molecules generates stress and friction in tissue, which generates heat and causes protein denaturation. This technique causes minimal energy transfer to surrounding tissue, potentially limiting collateral damage. However, incidents have been reported where the active jaw has caused bowel perforation.


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Long Beach scalpel handle use

Proper care and maintenance is a must for surgical tools like safety scalpels in Long Beach. They need to be sterilized and disinfected before and after use. When it comes to instruments like scalpel, forceps, retractors etc. it is understandable that they will be used on vital body organs so you must ensure that they are completely germ free and disinfected before you end up using them. If the surgical instruments are cleaned and disinfected properly there is little to no chance of infections.

scalpel handles and blades

Correct Use of surgical supplies in Long Beach

Proper maintenance of these instruments are required in Long Beach, and it also increases the life span of the instruments. This results in reducing extra costs like repairs and replacements. Also you need to make sure that the instruments which are disposable are being disposed in a proper way as per the health regulations of Long Beach. You do not want them to get used by someone else. So ensure that all needles and other disposable surgical instruments are gathered and properly disposed off, since failure to do so will allow microorganisms to spread to and cause further diseases. These are some of the factors which everyone who uses operating room instruments must keep in mind; they will help in ensuring the safety of the patient as well as the other people in the Long Beach area. Hospitals have proper procedures for disposing off such medical devices as well.

Proper Surgical Instruments

safety retractable 34 surgical staples closing scalp following craniotomy

Surgical staples are specialized staples used in surgery in place of sutures to close skin wounds, connect or remove parts of the bowels or lungs. A more recent development, from the 1990s, uses clips instead of staples for some applications; this does not require the staple to penetrate.

Stapling is much faster than suturing by hand, and also more accurate and consistent. Staples are primarily used in bowel and lung surgery, because staple lines are more consistent and therefore less likely to leak blood, air or bowel contents. Still, several randomized controlled trials have shown no significant difference in bowel leakage after anastomoses performed either manually with suture by experienced surgeons, or after mechanical anastomoses with staples. In skin closure, dermal adhesives (skin glues) are also an increasingly common alternative.

Staplers were originally developed to address the perceived problem of patency (security against stenosis or occlusion of the lumen) and tightness (security against leaks of blood or bowel contents) as well as easiness and quickness in performing the anastomosis. Leaks from poor suturing of bowel anastomoses was at that time a significant cause of post-surgical mortality. More recent studies have shown that with current suturing techniques there is no significant difference in outcome between hand sutured and mechanical anastomoses, but mechanical anastomoses are significantly quicker to perform.

The technique was pioneered by a Hungarian surgeon, Humor Hultl, known as the "father of surgical stapling". Hultl's prototype stapler of 1908 weighed eight pounds (3.6 kg), and required two hours to assemble and load. Many hours were spent trying to achieve a consistent staple line and reliably patent anastomoses.

The early instruments, by developers including Hultl, von Petz, Friedrich and Nakayama, were complex and cumbersome to use. The technology was refined in the 1950s in the Soviet Union, allowing for the first commercially produced re-usable stapling devices for creation of bowel and vascular anastomoses. Mark M. Ravitch, brought a sample of stapling device after attending a surgical conference in USSR, and introduced it to entrepreneur Leon C. Hirsch, who founded the United States Surgical Corporation in 1964 to manufacture surgical staplers under its Auto Suture brand. Until the late 1970s USSC had the market essentially to itself, but in 1977 Johnson & Johnson's Ethicon brand entered the market and today both are widely used, along with competitors from the Far East. USSC was bought by Tyco Healthcare in 1998, which became Covidien on June 29, 2007.

Safety and patency of mechanical (stapled) bowel anastomoses has been widely studied. It is generally the case in such studies that sutured anastomoses are either comparable or less prone to leakage. It is possible that this is the result of recent advances in suture technology, along with increasingly risk-conscious surgical practice. Certainly modern synthetic sutures are more predictable and less prone to infection than catgut, silk and linen, which were the main suture materials used up to the 1990s.

One key feature of intestinal staplers is that the edges of the stapler act as a haemostat, compressing the edges of the wound and closing blood vessels during the stapling process.

Laparoscopic cholecystectomy. Close-up demonstration of a surgical skin stapler.

The first commercial staplers were made of stainless steel with titanium staples loaded into reloadable staple cartridges.

Modern surgical staplers are either disposable and made of plastic, or reusable and made of stainless steel. Both types are generally loaded using disposable cartridges.

The staple line may be straight, curved or circular. Circular staplers are used for end-to-end anastomosis after bowel resection or, somewhat more controversially, in esophagogastric surgery. The instruments may be used in either open or laparoscopic surgery, different instruments are used for each application. Laparoscopic staplers are longer, thinner, and may be articulated to allow for access from a restricted number of trocar ports.

Some staplers incorporate a knife, to complete excision and anastomosis in a single operation. Staplers are used to close both internal and skin wounds. Skin staples are usually applied using a disposable stapler, and removed with a specialized staple remover. Staplers are also used in vertical banded gastroplasty surgery (popularly known as "stomach stapling").

Vascular stapler for reducing warm ischemia in organ transplantation. With this model each stapler end can be mounted on donor and recipient by independent surgical teams without care for reciprocal orientation, being the maximal possible vascular axis torsion ≤30°. Activating guide-wire is connected just immediately before firing (video)

While devices for circular end-to-end anastomosis of digestive tract are widely used, in spite of intensive research circular staplers for vascular anastomosis never had yet significant impact on standard hand (Carrel) suture technique. Apart from the different modality of coupling of vascular (everted) in respect to digestive (inverted) stumps, the main basic reason could be that, particularly for small vessels, the manuality and precision required just for positioning on vascular stumps and actioning any device cannot be significantly inferior to that required to carry out the standard hand suture, then making of little utility the use of any device. An exception to that however could be organ transplantation where these two phases, i.e.device positioning at the vascular stumps and device actioning, can be carried out in different time, by different surgical team, in safe conditions when the time required does not influence donor organ preservation, i.e. at the back table in cold ischemia condition for the donor organ and after native organ removal in the recipient. This is finalized to make as brief as possible the donor organ dangerous warm ischemia phase that can be contained in the couple of minutes or less necessary just to connect the device's ends and actioning the stapler.

Although most surgical staples are made of titanium, stainless steel is more often used in some skin staples and clips. Titanium produces less reaction with the immune system and, being non-ferrous, does not interfere significantly with MRI scanners, although some imaging artifacts may result. Synthetic absorbable (bioabsorbable) staples are also now becoming available, based on polyglycolic acid, as with many synthetic absorbable sutures.

Titanium staples are not suspected of causing nickel reactions because nickel is rarely if ever used in titanium alloys.

Where skin staples are used to seal a skin wound it will be necessary to remove the staples after an appropriate healing period, usually between 5 and 10 days, depending on the location of the wound and other factors. The skin staple remover is a small manual device which consists of a shoe or plate that is sufficiently narrow and thin to insert under the skin staple. The active part is a small blade that when hand-pressure is exerted it pushes down on the staple and pushes it through a slot in the shoe and deforms the staple into an 'M' shape to facilitate its removal, although in an emergency it is possible to remove them with a pair of artery forceps. Skin staple removers are manufactured in many shapes and forms, some disposable and some reusable.

Harmonic Scalpel Uses

Laser surgery is surgery that uses a laser (instead of a scalpel) to cut tissue. Examples include the use of a laser scalpel in otherwise conventional surgery, and soft-tissue laser surgery, in which the laser beam vaporizes soft tissue with high water content. Laser resurfacing is a technique in which covalent bonds of a material are dissolved by a laser, a technique invented by aesthetic plastic surgeon Thomas L Roberts, III using CO2 lasers in the 1990s. The CO2 (carbon dioxide) laser remains the gold standard for the soft tissue surgery because of the ease of simultaneous photo-thermal ablation and coagulation (and small blood capillary hemostasis).

Laser surgery is commonly used on the eye. Techniques used include LASIK, which is used to correct near and far-sightedness in vision, and photorefractive keratectomy, a procedure which permanently reshapes the cornea using an excimer laser to remove a small amount of tissue. Types of surgical lasers include carbon dioxide, argon, Nd:YAG laser, and Potassium titanyl phosphate.

  1. Photochemical effect: clinically referred to as photodynamic therapy. Photosensitizer (photophrin II) is administered which is taken up by the tumor tissue and later irradiated by laser light resulting in highly toxic substances with resultant necrosis of the tumor. Photodynamic therapy is used in palliation of oesophagial and bronchial carcinoma and ablation of mucosal cancers of Gastrointestinal tract and urinary bladder.
  2. Photoablative effect: Used in eye surgeries like band keratoplast, and endartectomy of peripheral blood vessels.
  3. Photothermal effect: this property is used for endoscopic control of bleeding e.g. Bleeding peptic ulcers, oesophagial varices
  4. Photomechanical effect: used in intraluminal lithotripsy

A range of lasers such as erbium, dye, and CO2 are used to treat various skin conditions including scars, vascular and pigmented lesions, and for photorejuvenation.

Various types of laser surgery are used to treat refractive error:

Lasers are also used to treat non-refractive conditions, such as:

Laser endarterectomy is a technique in which an entire atheromatous plaque in the artery is excised. Laser recanalization of blocked arteries. other applications include laser assisted angioplasties and laser assisted vascular anastomosis.

Lasers are used to treat several disorders in foot and ankle surgery. They are used to remove benign and malignant tumors, treat bunions, debride ulcers and burns, excise epidermal nevi, blue rubber bleb nevi, and keloids, and the removal of hypertrophic scars and tattoos.

A carbon dioxide laser (CO2) is used in surgery to treat onychocryptosis (ingrown nails), onychauxis (club nails), onychogryposis (rams horn nail), and onychomycosis (fungus nail).

  1. Peritoneum-Laser is used for adhesiolysis.
  2. Peptic ulcer disease and oesophageal varices - Laser photoablation is done.
  3. Coagulation of vascular malformations of stomach, duodenum and colon.
  4. Lasers can be effectively used to treat early gastric cancers provided they are less than 4 cm and without lymph node involvement. Lasers are also used in treating oral submucous fibrosis.
  5. Palliative laser therapy is given in advanced oesophageal cancers with obstruction of lumen. Recanalisation of the lumen is done which allows the patient to resume soft diet and maintain hydration.
  6. Ablative laser therapy is used in advanced colorectal cancers to relieve obstruction and to control bleeding.
  7. Laser surgery used in hemorrhoidectomy, and is a relatively popular and non-invasive method of hemorrhoid removal.
  8. Laser-assisted liver resections have been done using carbon dioxide and Nd:YAG lasers.
  9. Ablation of liver tumors can be achieved by selective photovaporization of the tumor.
  10. Endoscopic laser lithotripsy is a safer modality compared to electrohydraulic lithotripsy.

The CO2 laser is used in oral and dental surgery for virtually all soft-tissue procedures, such as gingivecomies, vestibuloplasties, frenectomies and operculectomies. The CO2 10,600 nm wavelength is safe around implants as it is reflected by titanium, and thus has been gaining popularity in the field of periodontology. The laser may also be effective in treating peri-implantitis.

Laser spine surgery first began seeing clinical use in the 1980s and was primarily used within discectomy to treat lumbar disc disease under the notion that heating a bulging disc vaporized enough tissue to relieve pressure on the nerves and help alleviate pain.

Since that time, laser spine surgery has become one of the most marketed forms of minimally invasive spine surgery, despite the fact that it has never been studied in a controlled clinical trial to determine its effectiveness apart from disc decompression. Evidence-based data surrounding the use of lasers in spine surgery is limited primarily due to the presence of a number of challenging factors including patient selection, operative indications in the type of laser used in the procedure. As a result, the official Blue Cross of Idaho position on laser disc surgery concluded:

"Evidence on decompression of the intervertebral disc using laser energy consists of observational studies. Given the variable natural history of back pain and the possibility of placebo effects with this treatment, observational studies are insufficient to permit conclusions concerning the effect of this technology on health outcomes."

The CO2 laser is also used in gynecology, genitourinary, general and thoracic surgery, otorhinolaryngology, orthopedic, and neurosurgery.


http://medicalcutter.pro/usa/

Kansas City ultrasonic scalpel

Proper care and maintenance is a must for surgical tools like safety scalpels in Kansas City. They need to be sterilized and disinfected before and after use. When it comes to instruments like scalpel, forceps, retractors etc. it is understandable that they will be used on vital body organs so you must ensure that they are completely germ free and disinfected before you end up using them. If the surgical instruments are cleaned and disinfected properly there is little to no chance of infections.

10 blade vs scalpel

Correct Use of dissecting scissors in Kansas City

Proper maintenance of these instruments are required in Kansas City, and it also increases the life span of the instruments. This results in reducing extra costs like repairs and replacements. Also you need to make sure that the instruments which are disposable are being disposed in a proper way as per the health regulations of Kansas City. You do not want them to get used by someone else. So ensure that all needles and other disposable surgical instruments are gathered and properly disposed off, since failure to do so will allow microorganisms to spread to and cause further diseases. These are some of the factors which everyone who uses operating room instruments must keep in mind; they will help in ensuring the safety of the patient as well as the other people in the Kansas City area. Hospitals have proper procedures for disposing off such medical devices as well.

Most Common Operating Room Instruments

surgical instruments suppliers

Hospitals can be scary sometimes but we can’t deny the fact that millions of lives are saved in these institutions every day. Being a doctor is definitely not an easy affair. Not only do these professionals have to become masters in understanding human biology but they also have to perfect their skills and capabilities of using various medical instruments. Can you think of a painter without the required paint brushes? Or a carpenter without his tools? Similarly, a doctor without his medical devices would be just like an audience on a show where, ideally, he should be performing on stage. No operation or diagnosis or procedure or even test can be carried out without necessary tools and equipment. It is important to know what these tools are and what their utilities are.

So if you are interested in medical tools and procedures and would like to understand how these are carried out, here is a list of the most basic medical instruments that you can find on an operating room. Hope this article helps you in your search for information.

# Scissors

The use of scissors as operating room instruments need not be highlighted or stated. No operation can be done without scissors. Scissors used in surgery come in two main types: Metzenbaum and Mayo scissors. Metzenbaum scissors are used in case of cutting or dissecting soft delicate tissues. Mayo scissors are preferred for cutting hard tissues such as joints. These scissors are used to cut thick tissues located in the breast and the muscles. Made up of stainless steel, these scissors are usually manufactured in variable lengths.

# Scalpel

Whether it is a major or a minor operation, a scalpel plays a very vital role in all of them. It is a knife that comes with stainless steel blades. Each and every surgery has its different needs but during every surgery, a correct incision is a must which cannot be carried out without a scalpel.

# Forceps

Forceps look like kitchen tongs. It allows the surgeon to hold and grasp the skin tissues firmly. Whether it is clamping the arteries or holding a part of intestine while operating, forceps can be relied upon. Also, this surgical instrument comes in a range of sizes so that the surgeon can choose one depending upon the need of the situation. The large ones are designed to hold a baby’s head and their main purpose is to safely get the baby out from the birth canal during a cesarean.

Of course there are other tools as well which will vary from surgery to surgery. They are manufactured with a wide variety of materials like platinum, stainless steel, tungsten carbide, chromium and other non-reactive and high strength metals. Designs and applications of medical devices have also evolved much over time. The more we advance into health care and medical science, the more new tools and equipment we will create for aiding surgeons in performing life saving procedures.

Laser Surgery as a Scalpel

Hospitals can be scary sometimes but we can’t deny the fact that millions of lives are saved in these institutions every day. Being a doctor is definitely not an easy affair. Not only do these professionals have to become masters in understanding human biology but they also have to perfect their skills and capabilities of using various medical instruments. Can you think of a painter without the required paint brushes? Or a carpenter without his tools? Similarly, a doctor without his medical devices would be just like an audience on a show where, ideally, he should be performing on stage. No operation or diagnosis or procedure or even test can be carried out without necessary tools and equipment. It is important to know what these tools are and what their utilities are.

So if you are interested in medical tools and procedures and would like to understand how these are carried out, here is a list of the most basic medical instruments that you can find on an operating room. Hope this article helps you in your search for information.

# Scissors

The use of scissors as operating room instruments need not be highlighted or stated. No operation can be done without scissors. Scissors used in surgery come in two main types: Metzenbaum and Mayo scissors. Metzenbaum scissors are used in case of cutting or dissecting soft delicate tissues. Mayo scissors are preferred for cutting hard tissues such as joints. These scissors are used to cut thick tissues located in the breast and the muscles. Made up of stainless steel, these scissors are usually manufactured in variable lengths.

# Scalpel

Whether it is a major or a minor operation, a scalpel plays a very vital role in all of them. It is a knife that comes with stainless steel blades. Each and every surgery has its different needs but during every surgery, a correct incision is a must which cannot be carried out without a scalpel.

# Forceps

Forceps look like kitchen tongs. It allows the surgeon to hold and grasp the skin tissues firmly. Whether it is clamping the arteries or holding a part of intestine while operating, forceps can be relied upon. Also, this surgical instrument comes in a range of sizes so that the surgeon can choose one depending upon the need of the situation. The large ones are designed to hold a baby’s head and their main purpose is to safely get the baby out from the birth canal during a cesarean.

Of course there are other tools as well which will vary from surgery to surgery. They are manufactured with a wide variety of materials like platinum, stainless steel, tungsten carbide, chromium and other non-reactive and high strength metals. Designs and applications of medical devices have also evolved much over time. The more we advance into health care and medical science, the more new tools and equipment we will create for aiding surgeons in performing life saving procedures.


http://medicalcutter.pro/usa/

Mesa swann morton scalpel handle

Proper care and maintenance is a must for surgical tools like safety scalpels in Mesa. They need to be sterilized and disinfected before and after use. When it comes to instruments like scalpel, forceps, retractors etc. it is understandable that they will be used on vital body organs so you must ensure that they are completely germ free and disinfected before you end up using them. If the surgical instruments are cleaned and disinfected properly there is little to no chance of infections.

blade handle

Correct Use of surgical blade in Mesa

Proper maintenance of these instruments are required in Mesa, and it also increases the life span of the instruments. This results in reducing extra costs like repairs and replacements. Also you need to make sure that the instruments which are disposable are being disposed in a proper way as per the health regulations of Mesa. You do not want them to get used by someone else. So ensure that all needles and other disposable surgical instruments are gathered and properly disposed off, since failure to do so will allow microorganisms to spread to and cause further diseases. These are some of the factors which everyone who uses operating room instruments must keep in mind; they will help in ensuring the safety of the patient as well as the other people in the Mesa area. Hospitals have proper procedures for disposing off such medical devices as well.

Harmonic Scalpel Uses

blade handle 34 surgical staples closing scalp following craniotomy

Surgical staples are specialized staples used in surgery in place of sutures to close skin wounds, connect or remove parts of the bowels or lungs. A more recent development, from the 1990s, uses clips instead of staples for some applications; this does not require the staple to penetrate.

Stapling is much faster than suturing by hand, and also more accurate and consistent. Staples are primarily used in bowel and lung surgery, because staple lines are more consistent and therefore less likely to leak blood, air or bowel contents. Still, several randomized controlled trials have shown no significant difference in bowel leakage after anastomoses performed either manually with suture by experienced surgeons, or after mechanical anastomoses with staples. In skin closure, dermal adhesives (skin glues) are also an increasingly common alternative.

Staplers were originally developed to address the perceived problem of patency (security against stenosis or occlusion of the lumen) and tightness (security against leaks of blood or bowel contents) as well as easiness and quickness in performing the anastomosis. Leaks from poor suturing of bowel anastomoses was at that time a significant cause of post-surgical mortality. More recent studies have shown that with current suturing techniques there is no significant difference in outcome between hand sutured and mechanical anastomoses, but mechanical anastomoses are significantly quicker to perform.

The technique was pioneered by a Hungarian surgeon, Humor Hultl, known as the "father of surgical stapling". Hultl's prototype stapler of 1908 weighed eight pounds (3.6 kg), and required two hours to assemble and load. Many hours were spent trying to achieve a consistent staple line and reliably patent anastomoses.

The early instruments, by developers including Hultl, von Petz, Friedrich and Nakayama, were complex and cumbersome to use. The technology was refined in the 1950s in the Soviet Union, allowing for the first commercially produced re-usable stapling devices for creation of bowel and vascular anastomoses. Mark M. Ravitch, brought a sample of stapling device after attending a surgical conference in USSR, and introduced it to entrepreneur Leon C. Hirsch, who founded the United States Surgical Corporation in 1964 to manufacture surgical staplers under its Auto Suture brand. Until the late 1970s USSC had the market essentially to itself, but in 1977 Johnson & Johnson's Ethicon brand entered the market and today both are widely used, along with competitors from the Far East. USSC was bought by Tyco Healthcare in 1998, which became Covidien on June 29, 2007.

Safety and patency of mechanical (stapled) bowel anastomoses has been widely studied. It is generally the case in such studies that sutured anastomoses are either comparable or less prone to leakage. It is possible that this is the result of recent advances in suture technology, along with increasingly risk-conscious surgical practice. Certainly modern synthetic sutures are more predictable and less prone to infection than catgut, silk and linen, which were the main suture materials used up to the 1990s.

One key feature of intestinal staplers is that the edges of the stapler act as a haemostat, compressing the edges of the wound and closing blood vessels during the stapling process.

Laparoscopic cholecystectomy. Close-up demonstration of a surgical skin stapler.

The first commercial staplers were made of stainless steel with titanium staples loaded into reloadable staple cartridges.

Modern surgical staplers are either disposable and made of plastic, or reusable and made of stainless steel. Both types are generally loaded using disposable cartridges.

The staple line may be straight, curved or circular. Circular staplers are used for end-to-end anastomosis after bowel resection or, somewhat more controversially, in esophagogastric surgery. The instruments may be used in either open or laparoscopic surgery, different instruments are used for each application. Laparoscopic staplers are longer, thinner, and may be articulated to allow for access from a restricted number of trocar ports.

Some staplers incorporate a knife, to complete excision and anastomosis in a single operation. Staplers are used to close both internal and skin wounds. Skin staples are usually applied using a disposable stapler, and removed with a specialized staple remover. Staplers are also used in vertical banded gastroplasty surgery (popularly known as "stomach stapling").

Vascular stapler for reducing warm ischemia in organ transplantation. With this model each stapler end can be mounted on donor and recipient by independent surgical teams without care for reciprocal orientation, being the maximal possible vascular axis torsion ≤30°. Activating guide-wire is connected just immediately before firing (video)

While devices for circular end-to-end anastomosis of digestive tract are widely used, in spite of intensive research circular staplers for vascular anastomosis never had yet significant impact on standard hand (Carrel) suture technique. Apart from the different modality of coupling of vascular (everted) in respect to digestive (inverted) stumps, the main basic reason could be that, particularly for small vessels, the manuality and precision required just for positioning on vascular stumps and actioning any device cannot be significantly inferior to that required to carry out the standard hand suture, then making of little utility the use of any device. An exception to that however could be organ transplantation where these two phases, i.e.device positioning at the vascular stumps and device actioning, can be carried out in different time, by different surgical team, in safe conditions when the time required does not influence donor organ preservation, i.e. at the back table in cold ischemia condition for the donor organ and after native organ removal in the recipient. This is finalized to make as brief as possible the donor organ dangerous warm ischemia phase that can be contained in the couple of minutes or less necessary just to connect the device's ends and actioning the stapler.

Although most surgical staples are made of titanium, stainless steel is more often used in some skin staples and clips. Titanium produces less reaction with the immune system and, being non-ferrous, does not interfere significantly with MRI scanners, although some imaging artifacts may result. Synthetic absorbable (bioabsorbable) staples are also now becoming available, based on polyglycolic acid, as with many synthetic absorbable sutures.

Titanium staples are not suspected of causing nickel reactions because nickel is rarely if ever used in titanium alloys.

Where skin staples are used to seal a skin wound it will be necessary to remove the staples after an appropriate healing period, usually between 5 and 10 days, depending on the location of the wound and other factors. The skin staple remover is a small manual device which consists of a shoe or plate that is sufficiently narrow and thin to insert under the skin staple. The active part is a small blade that when hand-pressure is exerted it pushes down on the staple and pushes it through a slot in the shoe and deforms the staple into an 'M' shape to facilitate its removal, although in an emergency it is possible to remove them with a pair of artery forceps. Skin staple removers are manufactured in many shapes and forms, some disposable and some reusable.

Electrosurgery instead of a Scalpel Cut

Where can I locate the history of the surgical scalpel?

Ancient Egyptians used sharpened obsidian for surgery and embalming. I've never heard of using a piece of papyrus. One probably couldn't cut through flesh with papyrus, which is a grass.

Incidentally, I've also heard that plate glass blades are used on occasion in modern times, due to the incredible edge they can be given.

There seem to be glass knives made for cutting specimens for microscopy, tough diamond knives have replaced them for the more precise cuts.

Wikisurgery contains an unrivalled amount of operative information in the shape of unique operative scripts and images.

A scalpel may appear alarming at first.

This is a useful safety reaction and should mean that you will learn carefully and steadily.

A small minority of trainees develop an aggressive gung-ho tendency when holding a scalpel.

For fine work with a No 15 blade, hold the scalpel like a pen.

This is the correct way of holding a pen, using a tripod grip.

The three parts of the tripod are the side of the middle finger and the tips of the index and thumb.

Other ways of holding a pen, such as placing it between the sides of the thumb, index and ring finger, are unacceptable.

This grip enables the surgeon to:

Flex and extend the digits, so that the scalpel moves in and out during delicate dissections. Rotate the handle of the scalpel with the thumb, so the scalpel can cut small diameter curves.


The most usual grip with a No 10 or 22 blade is as if you are holding a table knife.

The handle rests in the palm of the hand.

The digits and hand are largely on top of the scalpel unlike with the pen grip.

This means that the scalpel can be held close to the surface of the tissues when cutting, without the digits and hand getting in the

way as in the pencil grip.

The grip is quite gentle.


For tougher tissues, such as the skin on the back, grip more firmly and place your index finger on the top of the handle rather than

on the side.

This will let you increase the downward pressure of the blade on the tissue.


For more delicate tissue, hold the handle between the thumb on one side and the four fingertips on the other.

The handle does not touch the hand.


Holding the scalpel in the fist or like a dagger is far too clumsy.


DO NOT dissect with the handle of the scalpel.

You will be concentrating on the site of dissection and may accidentally cut your assistant.

DO NOT hold the scalpel in your hand while using another instrument.

You may accidentally cut the patient as you concentrate on the dissection area.


ALWAYS pass the scalpel to someone else handle first.


Preferrably, place the scalpel in a dish for the scrub nurse to pick out.


DO NOT throw the scalpel down onto the bench (or onto the patient.)

The part of the blade that does the cutting is the curve and not the tip.

This means that you need to drag the curve of the blade across the tissue.

Scratching with the tip of the blade is a beginner's error.

A scalpel with a straight blade should be reserved for stab incisions such as for a drain tube.

You will feel the curved blade cutting into the tissue.

Go slowly and gently at first with repeated strokes in the same place, until you see how much the blade is cutting the tissue.


Brace your hands and fingers so that you make controlled movements without the blade suddenly slipping.


Press harder at the beginnings and ends of incisions to allow for the less efficient cutting action at the tip and the back of the blade.


http://medicalcutter.pro/usa/

Sacramento swann morton scalpel handle

Proper care and maintenance is a must for surgical tools like safety scalpels in Sacramento. They need to be sterilized and disinfected before and after use. When it comes to instruments like scalpel, forceps, retractors etc. it is understandable that they will be used on vital body organs so you must ensure that they are completely germ free and disinfected before you end up using them. If the surgical instruments are cleaned and disinfected properly there is little to no chance of infections.

10 blade vs scalpel

Correct Use of dermaplaning blades in Sacramento

Proper maintenance of these instruments are required in Sacramento, and it also increases the life span of the instruments. This results in reducing extra costs like repairs and replacements. Also you need to make sure that the instruments which are disposable are being disposed in a proper way as per the health regulations of Sacramento. You do not want them to get used by someone else. So ensure that all needles and other disposable surgical instruments are gathered and properly disposed off, since failure to do so will allow microorganisms to spread to and cause further diseases. These are some of the factors which everyone who uses operating room instruments must keep in mind; they will help in ensuring the safety of the patient as well as the other people in the Sacramento area. Hospitals have proper procedures for disposing off such medical devices as well.

Types of Surgical Scalpel

scalpel blade holder

Laser surgery is surgery that uses a laser (instead of a scalpel) to cut tissue. Examples include the use of a laser scalpel in otherwise conventional surgery, and soft-tissue laser surgery, in which the laser beam vaporizes soft tissue with high water content. Laser resurfacing is a technique in which covalent bonds of a material are dissolved by a laser, a technique invented by aesthetic plastic surgeon Thomas L Roberts, III using CO2 lasers in the 1990s. The CO2 (carbon dioxide) laser remains the gold standard for the soft tissue surgery because of the ease of simultaneous photo-thermal ablation and coagulation (and small blood capillary hemostasis).

Laser surgery is commonly used on the eye. Techniques used include LASIK, which is used to correct near and far-sightedness in vision, and photorefractive keratectomy, a procedure which permanently reshapes the cornea using an excimer laser to remove a small amount of tissue. Types of surgical lasers include carbon dioxide, argon, Nd:YAG laser, and Potassium titanyl phosphate.

  1. Photochemical effect: clinically referred to as photodynamic therapy. Photosensitizer (photophrin II) is administered which is taken up by the tumor tissue and later irradiated by laser light resulting in highly toxic substances with resultant necrosis of the tumor. Photodynamic therapy is used in palliation of oesophagial and bronchial carcinoma and ablation of mucosal cancers of Gastrointestinal tract and urinary bladder.
  2. Photoablative effect: Used in eye surgeries like band keratoplast, and endartectomy of peripheral blood vessels.
  3. Photothermal effect: this property is used for endoscopic control of bleeding e.g. Bleeding peptic ulcers, oesophagial varices
  4. Photomechanical effect: used in intraluminal lithotripsy

A range of lasers such as erbium, dye, and CO2 are used to treat various skin conditions including scars, vascular and pigmented lesions, and for photorejuvenation.

Various types of laser surgery are used to treat refractive error:

Lasers are also used to treat non-refractive conditions, such as:

Laser endarterectomy is a technique in which an entire atheromatous plaque in the artery is excised. Laser recanalization of blocked arteries. other applications include laser assisted angioplasties and laser assisted vascular anastomosis.

Lasers are used to treat several disorders in foot and ankle surgery. They are used to remove benign and malignant tumors, treat bunions, debride ulcers and burns, excise epidermal nevi, blue rubber bleb nevi, and keloids, and the removal of hypertrophic scars and tattoos.

A carbon dioxide laser (CO2) is used in surgery to treat onychocryptosis (ingrown nails), onychauxis (club nails), onychogryposis (rams horn nail), and onychomycosis (fungus nail).

  1. Peritoneum-Laser is used for adhesiolysis.
  2. Peptic ulcer disease and oesophageal varices - Laser photoablation is done.
  3. Coagulation of vascular malformations of stomach, duodenum and colon.
  4. Lasers can be effectively used to treat early gastric cancers provided they are less than 4 cm and without lymph node involvement. Lasers are also used in treating oral submucous fibrosis.
  5. Palliative laser therapy is given in advanced oesophageal cancers with obstruction of lumen. Recanalisation of the lumen is done which allows the patient to resume soft diet and maintain hydration.
  6. Ablative laser therapy is used in advanced colorectal cancers to relieve obstruction and to control bleeding.
  7. Laser surgery used in hemorrhoidectomy, and is a relatively popular and non-invasive method of hemorrhoid removal.
  8. Laser-assisted liver resections have been done using carbon dioxide and Nd:YAG lasers.
  9. Ablation of liver tumors can be achieved by selective photovaporization of the tumor.
  10. Endoscopic laser lithotripsy is a safer modality compared to electrohydraulic lithotripsy.

The CO2 laser is used in oral and dental surgery for virtually all soft-tissue procedures, such as gingivecomies, vestibuloplasties, frenectomies and operculectomies. The CO2 10,600 nm wavelength is safe around implants as it is reflected by titanium, and thus has been gaining popularity in the field of periodontology. The laser may also be effective in treating peri-implantitis.

Laser spine surgery first began seeing clinical use in the 1980s and was primarily used within discectomy to treat lumbar disc disease under the notion that heating a bulging disc vaporized enough tissue to relieve pressure on the nerves and help alleviate pain.

Since that time, laser spine surgery has become one of the most marketed forms of minimally invasive spine surgery, despite the fact that it has never been studied in a controlled clinical trial to determine its effectiveness apart from disc decompression. Evidence-based data surrounding the use of lasers in spine surgery is limited primarily due to the presence of a number of challenging factors including patient selection, operative indications in the type of laser used in the procedure. As a result, the official Blue Cross of Idaho position on laser disc surgery concluded:

"Evidence on decompression of the intervertebral disc using laser energy consists of observational studies. Given the variable natural history of back pain and the possibility of placebo effects with this treatment, observational studies are insufficient to permit conclusions concerning the effect of this technology on health outcomes."

The CO2 laser is also used in gynecology, genitourinary, general and thoracic surgery, otorhinolaryngology, orthopedic, and neurosurgery.

Electrosurgery instead of a Scalpel Cut

The Harmonic scalpel is a surgical instrument used to simultaneously cut and cauterize tissue. Unlike Electrosurgery, the harmonic uses ultrasonic vibrations instead of electric current to cut and cauterize tissue.

The harmonic is superior to a Bovie in that it can cut through thicker tissue, creates less toxic surgical smoke, and may offer greater precision. The harmonic scalpel is not as easily maneuverable as the Bovie, and takes longer to cut and coagulate tissue. Additionally, while a Bovie can be used to coagulate bleeding tissue at any time, the Harmonic scalpel only coagulates as it cuts.

A Harmonic scalpel cuts via vibration. The scalpel surface itself cuts through tissue by vibrating in the range of 55,500 Hz. The high frequency vibration of tissue molecules generates stress and friction in tissue, which generates heat and causes protein denaturation. This technique causes minimal energy transfer to surrounding tissue, potentially limiting collateral damage. However, incidents have been reported where the active jaw has caused bowel perforation.


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Fresno swann morton scalpel handle

Proper care and maintenance is a must for surgical tools like safety scalpels in Fresno. They need to be sterilized and disinfected before and after use. When it comes to instruments like scalpel, forceps, retractors etc. it is understandable that they will be used on vital body organs so you must ensure that they are completely germ free and disinfected before you end up using them. If the surgical instruments are cleaned and disinfected properly there is little to no chance of infections.

10 blade vs scalpel

Correct Use of surgical blade in Fresno

Proper maintenance of these instruments are required in Fresno, and it also increases the life span of the instruments. This results in reducing extra costs like repairs and replacements. Also you need to make sure that the instruments which are disposable are being disposed in a proper way as per the health regulations of Fresno. You do not want them to get used by someone else. So ensure that all needles and other disposable surgical instruments are gathered and properly disposed off, since failure to do so will allow microorganisms to spread to and cause further diseases. These are some of the factors which everyone who uses operating room instruments must keep in mind; they will help in ensuring the safety of the patient as well as the other people in the Fresno area. Hospitals have proper procedures for disposing off such medical devices as well.

Laprascopy With the Harmonic Scalpel

scalpel safety

Surgery instruments must be kept in proper shape as they are vital towards carrying out an operation properly. Surgical instruments are designed to ensure that the surgeons can complete surgeries in an effective manner. Surgeries are mainly held to modify or remove any kind of body tissues. Surgical instruments also come in a variety of types designed to do separate things. They are categorized based on their usage. Also they are sometimes categorized according to the materials which which they are made.

Disposable and non disposable surgical instruments

The scalpel is one of the most common surgical instruments. These are used for incisions or thin cuts on the flesh to reach the inner organs. The retractors are used used to keep the cuts open so that the surgeons can reach in and go through with the operation. Forceps are another popular surgical instrument which is used for picking and holding tissues. When it comes to cutting tissues scissors are also used but these scissors are not the same as the household ones. These are much more precise and effective. All these instruments are made from hardened and tampered steel. After considering their composition they are labelled as reusable or not. There are also other surgical instruments which are made for just one time usage. These are destroyed after usage like the disposable surgical needles. Disposable surgical instruments are always sterilized the moment they are purchased in home and hospital departmental stores. These disposable tools are generally made from runner or plastic materials. Protective surgical gloves, twin bone nasal catheter, nasal oxygen catheter, oxygen mask, suction catheter, and trachea’s tony tubes are few examples of these types of instruments.

Why is sterilization of the instruments important?

Proper care and maintenance of surgical tools are a must. They need to be sterilized and disinfected before and after use. When it comes to instruments like scalpel, forceps, retractors etc. it is understandable that they will be used on vital body organs so you must ensure that they are completely germ free and disinfected before you end up using them. If the instruments are cleaned and disinfected properly there is little to no chance of infections. Proper maintenance of these instruments also increases the life span of the instruments. This results in reducing extra costs like repairs and replacements. Also you need to make sure that the instruments which are disposable are being disposed in a proper way. You do not want them to get used by someone else. So ensure that all needles and other disposable surgical instruments are gathered and properly disposed off, since failure to do so will allow microorganisms to spread to and cause further diseases. These are some of the factors which everyone who uses operating room instruments must keep in mind; they will help in ensuring the safety of the patient as well as the other people in the area. Hospitals need to have proper procedures for disposing off such medical devices as well.

Use of a Laser Scalpel

Where can I locate the history of the surgical scalpel?

Ancient Egyptians used sharpened obsidian for surgery and embalming. I've never heard of using a piece of papyrus. One probably couldn't cut through flesh with papyrus, which is a grass.

Incidentally, I've also heard that plate glass blades are used on occasion in modern times, due to the incredible edge they can be given.

There seem to be glass knives made for cutting specimens for microscopy, tough diamond knives have replaced them for the more precise cuts.

Wikisurgery contains an unrivalled amount of operative information in the shape of unique operative scripts and images.

A scalpel may appear alarming at first.

This is a useful safety reaction and should mean that you will learn carefully and steadily.

A small minority of trainees develop an aggressive gung-ho tendency when holding a scalpel.

For fine work with a No 15 blade, hold the scalpel like a pen.

This is the correct way of holding a pen, using a tripod grip.

The three parts of the tripod are the side of the middle finger and the tips of the index and thumb.

Other ways of holding a pen, such as placing it between the sides of the thumb, index and ring finger, are unacceptable.

This grip enables the surgeon to:

Flex and extend the digits, so that the scalpel moves in and out during delicate dissections. Rotate the handle of the scalpel with the thumb, so the scalpel can cut small diameter curves.


The most usual grip with a No 10 or 22 blade is as if you are holding a table knife.

The handle rests in the palm of the hand.

The digits and hand are largely on top of the scalpel unlike with the pen grip.

This means that the scalpel can be held close to the surface of the tissues when cutting, without the digits and hand getting in the

way as in the pencil grip.

The grip is quite gentle.


For tougher tissues, such as the skin on the back, grip more firmly and place your index finger on the top of the handle rather than

on the side.

This will let you increase the downward pressure of the blade on the tissue.


For more delicate tissue, hold the handle between the thumb on one side and the four fingertips on the other.

The handle does not touch the hand.


Holding the scalpel in the fist or like a dagger is far too clumsy.


DO NOT dissect with the handle of the scalpel.

You will be concentrating on the site of dissection and may accidentally cut your assistant.

DO NOT hold the scalpel in your hand while using another instrument.

You may accidentally cut the patient as you concentrate on the dissection area.


ALWAYS pass the scalpel to someone else handle first.


Preferrably, place the scalpel in a dish for the scrub nurse to pick out.


DO NOT throw the scalpel down onto the bench (or onto the patient.)

The part of the blade that does the cutting is the curve and not the tip.

This means that you need to drag the curve of the blade across the tissue.

Scratching with the tip of the blade is a beginner's error.

A scalpel with a straight blade should be reserved for stab incisions such as for a drain tube.

You will feel the curved blade cutting into the tissue.

Go slowly and gently at first with repeated strokes in the same place, until you see how much the blade is cutting the tissue.


Brace your hands and fingers so that you make controlled movements without the blade suddenly slipping.


Press harder at the beginnings and ends of incisions to allow for the less efficient cutting action at the tip and the back of the blade.


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Tucson surgical blade

Proper care and maintenance is a must for surgical tools like safety scalpels in Tucson. They need to be sterilized and disinfected before and after use. When it comes to instruments like scalpel, forceps, retractors etc. it is understandable that they will be used on vital body organs so you must ensure that they are completely germ free and disinfected before you end up using them. If the surgical instruments are cleaned and disinfected properly there is little to no chance of infections.

scalpel handles and blades

Correct Use of no 11 surgical blade in Tucson

Proper maintenance of these instruments are required in Tucson, and it also increases the life span of the instruments. This results in reducing extra costs like repairs and replacements. Also you need to make sure that the instruments which are disposable are being disposed in a proper way as per the health regulations of Tucson. You do not want them to get used by someone else. So ensure that all needles and other disposable surgical instruments are gathered and properly disposed off, since failure to do so will allow microorganisms to spread to and cause further diseases. These are some of the factors which everyone who uses operating room instruments must keep in mind; they will help in ensuring the safety of the patient as well as the other people in the Tucson area. Hospitals have proper procedures for disposing off such medical devices as well.

Electrosurgery instead of a Scalpel Cut

disposable surgical instruments

A scalpel, or lancet, is a small and extremely sharp bladed instrument used for surgery, anatomical dissection, and various arts and crafts (called a hobby knife). Scalpels may be single-use disposable or re-usable. Re-usable scalpels can have permanently attached blades that can be sharpened or, more commonly, removable single-use blades. Disposable scalpels usually have a plastic handle with an extensible blade (like a utility knife) and are used once, then the entire instrument is discarded. Scalpel blades are usually individually packed in sterile pouches but are also offered non-sterile. Double-edged scalpels are referred to as "lancets".

Scalpel blades are usually made of hardened and tempered steel, stainless steel, or high carbon steel; in addition, titanium, ceramic, diamond and even obsidian knives are not uncommon. For example, when performing surgery under MRI guidance, steel blades are unusable (the blades would be drawn to the magnets, or may cause image artifacts). Historically, the preferred material for surgical scalpels was silver, on account of its antimicrobial properties (although the mechanics were not understood at the time). Scalpel blades are also offered by select manufacturers with a zirconium nitride-coated edge to improve sharpness and edge retention. Others manufacture blades that are polymer-coated to enhance lubricity during a cut. Alternatives to scalpels in surgical applications include electrocautery and lasers.

Reusable handle (top) and disposable scalpels (bottom)

Surgical scalpels consist of two parts, a blade and a handle. The handles are often reusable, with the blades being replaceable. In medical applications, each blade is only used once (even if just for a single, small cut).

The handle is also known as a "B.P. handle", named after Charles Russell Bard and Morgan Parker, founders of the Bard-Parker Company. Morgan Parker patented the 2-piece scalpel design in 1915 and Bard-Parker developed a method of cold sterilization that would not dull the blades, as did the heat-based method that was previously used.

The handle of medical scalpels come in two basic types. The first is a flat handle used in the #3 and #4 handles. The #7 handle is more like a long writing pen, rounded at the front and flat at the back. A #4 handle is larger than a #3. Blades are manufactured with a corresponding fitment size so that they fit on only one size handle. The following table of blades is incomplete and some blades listed may work with handles not specified here.

Palmar grip

Also called the "dinner knife" grip. The handle is held with the second through fourth fingers and secured along the base of the thumb, with the index finger extended along the top rear of the blade and the thumb along the side of the handle. This grip is best for initial incisions and larger cuts.

Pencil grip

Best used for more accurate cuts with smaller blades. The scalpel is held with the tips of the first and second fingers and the tip of the thumb with the handle resting on the fleshy base of the index finger and thumb. Care should be taken not to allow the handle to rest too far along the index finger as this promotes an unstable grip and cramped fingers.

X-Acto knife

Graphical and model-making scalpels tend to have round handles, with textured grips (either knurled metal or soft plastic). These are often called by the name of the most well-known manufacturer of graphic arts blades, X-Acto knives. The blade is usually flat and straight, allowing it to be run easily against a straightedge to produce straight cuts.

There are many kinds of graphic arts blades; the most common around the graphic design studio is the #11 blade which is very similar to a #11 surgical blade (q.v.). Other blade shapes are used for wood carving, cutting leather and heavy fabric, etc.

Needlestick injury

In the last decade, a rising awareness of the dangers of sharps in a medical environment has led to the development of various methods of protecting healthcare workers from accidental cuts and puncture wounds. According to the Centers for Disease Control and Prevention, as many as 1,000 people each day are subject to accidental needle sticks and lacerations while providing medical care. Scalpel blade injuries are among the most frequent sharps injuries, second only to needlesticks. Scalpel injuries make up 7 percent to 8 percent of all sharps injuries.

"Scalpel Safety" is a term coined to inform users that there are choices available to them to ensure their protection from this common sharps injury.

Safety scalpels are becoming increasingly popular as their prices come down and also on account of legislation such as the Needle Stick Prevention Act. There are essentially two kinds of disposable safety scalpels offered by various manufacturers. They can be either classified as retractable blade or retractable sheath type. The retractable blade version made by companies such as OX Med Tech, DeRoyal, Jai Surgicals, and Swann Morton are more intuitive to use due to their similarities to a standard box-cutter. Retractable sheath versions have much stronger ergonomic feel for the doctors and are made by companies such as Aditya Dispomed, Aspen Surgical and Southmedic. A few companies have also started to offer a safety scalpel with a reusable metal handle. In such models, the blade is usually protected in a cartridge. Such systems usually require a custom handle and the price of blades and cartridges is considerably more than for conventional surgical blades.

However, CDC studies shows that up to 87% of active medical devices are not activated. Safety scalpels are active devices and therefore the risk of not activating is still significant. There is a study that indicated there were actually four times more injuries with safety scalpels than reusable scalpels.

There are various scalpel blade removers on the market that allows users to safely remove blades from the handle, instead of dangerously using fingers or forceps. In the medical field, when taking into account activation rates, the combination of a single-handed scalpel blade remover with a passing tray or a neutral zone was as safe and up to five times safer than a safety scalpel. Companies like Qlicksmart offers a single-handed scalpel blade remover that complies with regulatory requirements such as US Occupational Safety and Health Administration Standards.

The usage of both safety scalpels and a single-handed blade remover, combined with a hands-free passing technique, are potentially effective in reducing scalpel blade injuries. It is up to employers and scalpel users to consider and use safer and more effective scalpel safety measures when feasible.

History and Use of Scalpels in Surgery

34 surgical staples closing scalp following craniotomy

Surgical staples are specialized staples used in surgery in place of sutures to close skin wounds, connect or remove parts of the bowels or lungs. A more recent development, from the 1990s, uses clips instead of staples for some applications; this does not require the staple to penetrate.

Stapling is much faster than suturing by hand, and also more accurate and consistent. Staples are primarily used in bowel and lung surgery, because staple lines are more consistent and therefore less likely to leak blood, air or bowel contents. Still, several randomized controlled trials have shown no significant difference in bowel leakage after anastomoses performed either manually with suture by experienced surgeons, or after mechanical anastomoses with staples. In skin closure, dermal adhesives (skin glues) are also an increasingly common alternative.

Staplers were originally developed to address the perceived problem of patency (security against stenosis or occlusion of the lumen) and tightness (security against leaks of blood or bowel contents) as well as easiness and quickness in performing the anastomosis. Leaks from poor suturing of bowel anastomoses was at that time a significant cause of post-surgical mortality. More recent studies have shown that with current suturing techniques there is no significant difference in outcome between hand sutured and mechanical anastomoses, but mechanical anastomoses are significantly quicker to perform.

The technique was pioneered by a Hungarian surgeon, Humor Hultl, known as the "father of surgical stapling". Hultl's prototype stapler of 1908 weighed eight pounds (3.6 kg), and required two hours to assemble and load. Many hours were spent trying to achieve a consistent staple line and reliably patent anastomoses.

The early instruments, by developers including Hultl, von Petz, Friedrich and Nakayama, were complex and cumbersome to use. The technology was refined in the 1950s in the Soviet Union, allowing for the first commercially produced re-usable stapling devices for creation of bowel and vascular anastomoses. Mark M. Ravitch, brought a sample of stapling device after attending a surgical conference in USSR, and introduced it to entrepreneur Leon C. Hirsch, who founded the United States Surgical Corporation in 1964 to manufacture surgical staplers under its Auto Suture brand. Until the late 1970s USSC had the market essentially to itself, but in 1977 Johnson & Johnson's Ethicon brand entered the market and today both are widely used, along with competitors from the Far East. USSC was bought by Tyco Healthcare in 1998, which became Covidien on June 29, 2007.

Safety and patency of mechanical (stapled) bowel anastomoses has been widely studied. It is generally the case in such studies that sutured anastomoses are either comparable or less prone to leakage. It is possible that this is the result of recent advances in suture technology, along with increasingly risk-conscious surgical practice. Certainly modern synthetic sutures are more predictable and less prone to infection than catgut, silk and linen, which were the main suture materials used up to the 1990s.

One key feature of intestinal staplers is that the edges of the stapler act as a haemostat, compressing the edges of the wound and closing blood vessels during the stapling process.

Laparoscopic cholecystectomy. Close-up demonstration of a surgical skin stapler.

The first commercial staplers were made of stainless steel with titanium staples loaded into reloadable staple cartridges.

Modern surgical staplers are either disposable and made of plastic, or reusable and made of stainless steel. Both types are generally loaded using disposable cartridges.

The staple line may be straight, curved or circular. Circular staplers are used for end-to-end anastomosis after bowel resection or, somewhat more controversially, in esophagogastric surgery. The instruments may be used in either open or laparoscopic surgery, different instruments are used for each application. Laparoscopic staplers are longer, thinner, and may be articulated to allow for access from a restricted number of trocar ports.

Some staplers incorporate a knife, to complete excision and anastomosis in a single operation. Staplers are used to close both internal and skin wounds. Skin staples are usually applied using a disposable stapler, and removed with a specialized staple remover. Staplers are also used in vertical banded gastroplasty surgery (popularly known as "stomach stapling").

Vascular stapler for reducing warm ischemia in organ transplantation. With this model each stapler end can be mounted on donor and recipient by independent surgical teams without care for reciprocal orientation, being the maximal possible vascular axis torsion ≤30°. Activating guide-wire is connected just immediately before firing (video)

While devices for circular end-to-end anastomosis of digestive tract are widely used, in spite of intensive research circular staplers for vascular anastomosis never had yet significant impact on standard hand (Carrel) suture technique. Apart from the different modality of coupling of vascular (everted) in respect to digestive (inverted) stumps, the main basic reason could be that, particularly for small vessels, the manuality and precision required just for positioning on vascular stumps and actioning any device cannot be significantly inferior to that required to carry out the standard hand suture, then making of little utility the use of any device. An exception to that however could be organ transplantation where these two phases, i.e.device positioning at the vascular stumps and device actioning, can be carried out in different time, by different surgical team, in safe conditions when the time required does not influence donor organ preservation, i.e. at the back table in cold ischemia condition for the donor organ and after native organ removal in the recipient. This is finalized to make as brief as possible the donor organ dangerous warm ischemia phase that can be contained in the couple of minutes or less necessary just to connect the device's ends and actioning the stapler.

Although most surgical staples are made of titanium, stainless steel is more often used in some skin staples and clips. Titanium produces less reaction with the immune system and, being non-ferrous, does not interfere significantly with MRI scanners, although some imaging artifacts may result. Synthetic absorbable (bioabsorbable) staples are also now becoming available, based on polyglycolic acid, as with many synthetic absorbable sutures.

Titanium staples are not suspected of causing nickel reactions because nickel is rarely if ever used in titanium alloys.

Where skin staples are used to seal a skin wound it will be necessary to remove the staples after an appropriate healing period, usually between 5 and 10 days, depending on the location of the wound and other factors. The skin staple remover is a small manual device which consists of a shoe or plate that is sufficiently narrow and thin to insert under the skin staple. The active part is a small blade that when hand-pressure is exerted it pushes down on the staple and pushes it through a slot in the shoe and deforms the staple into an 'M' shape to facilitate its removal, although in an emergency it is possible to remove them with a pair of artery forceps. Skin staple removers are manufactured in many shapes and forms, some disposable and some reusable.


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Albuquerque microtome blades

Proper care and maintenance is a must for surgical tools like safety scalpels in Albuquerque. They need to be sterilized and disinfected before and after use. When it comes to instruments like scalpel, forceps, retractors etc. it is understandable that they will be used on vital body organs so you must ensure that they are completely germ free and disinfected before you end up using them. If the surgical instruments are cleaned and disinfected properly there is little to no chance of infections.

blade handle

Correct Use of scalpel handle use in Albuquerque

Proper maintenance of these instruments are required in Albuquerque, and it also increases the life span of the instruments. This results in reducing extra costs like repairs and replacements. Also you need to make sure that the instruments which are disposable are being disposed in a proper way as per the health regulations of Albuquerque. You do not want them to get used by someone else. So ensure that all needles and other disposable surgical instruments are gathered and properly disposed off, since failure to do so will allow microorganisms to spread to and cause further diseases. These are some of the factors which everyone who uses operating room instruments must keep in mind; they will help in ensuring the safety of the patient as well as the other people in the Albuquerque area. Hospitals have proper procedures for disposing off such medical devices as well.

Proper Surgical Instruments

scalpel blade holder Where can I locate the history of the surgical scalpel?

Ancient Egyptians used sharpened obsidian for surgery and embalming. I've never heard of using a piece of papyrus. One probably couldn't cut through flesh with papyrus, which is a grass.

Incidentally, I've also heard that plate glass blades are used on occasion in modern times, due to the incredible edge they can be given.

There seem to be glass knives made for cutting specimens for microscopy, tough diamond knives have replaced them for the more precise cuts.

Wikisurgery contains an unrivalled amount of operative information in the shape of unique operative scripts and images.

A scalpel may appear alarming at first.

This is a useful safety reaction and should mean that you will learn carefully and steadily.

A small minority of trainees develop an aggressive gung-ho tendency when holding a scalpel.

For fine work with a No 15 blade, hold the scalpel like a pen.

This is the correct way of holding a pen, using a tripod grip.

The three parts of the tripod are the side of the middle finger and the tips of the index and thumb.

Other ways of holding a pen, such as placing it between the sides of the thumb, index and ring finger, are unacceptable.

This grip enables the surgeon to:

Flex and extend the digits, so that the scalpel moves in and out during delicate dissections. Rotate the handle of the scalpel with the thumb, so the scalpel can cut small diameter curves.


The most usual grip with a No 10 or 22 blade is as if you are holding a table knife.

The handle rests in the palm of the hand.

The digits and hand are largely on top of the scalpel unlike with the pen grip.

This means that the scalpel can be held close to the surface of the tissues when cutting, without the digits and hand getting in the

way as in the pencil grip.

The grip is quite gentle.


For tougher tissues, such as the skin on the back, grip more firmly and place your index finger on the top of the handle rather than

on the side.

This will let you increase the downward pressure of the blade on the tissue.


For more delicate tissue, hold the handle between the thumb on one side and the four fingertips on the other.

The handle does not touch the hand.


Holding the scalpel in the fist or like a dagger is far too clumsy.


DO NOT dissect with the handle of the scalpel.

You will be concentrating on the site of dissection and may accidentally cut your assistant.

DO NOT hold the scalpel in your hand while using another instrument.

You may accidentally cut the patient as you concentrate on the dissection area.


ALWAYS pass the scalpel to someone else handle first.


Preferrably, place the scalpel in a dish for the scrub nurse to pick out.


DO NOT throw the scalpel down onto the bench (or onto the patient.)

The part of the blade that does the cutting is the curve and not the tip.

This means that you need to drag the curve of the blade across the tissue.

Scratching with the tip of the blade is a beginner's error.

A scalpel with a straight blade should be reserved for stab incisions such as for a drain tube.

You will feel the curved blade cutting into the tissue.

Go slowly and gently at first with repeated strokes in the same place, until you see how much the blade is cutting the tissue.


Brace your hands and fingers so that you make controlled movements without the blade suddenly slipping.


Press harder at the beginnings and ends of incisions to allow for the less efficient cutting action at the tip and the back of the blade.

Laser Surgery as a Scalpel

The Harmonic scalpel is a surgical instrument used to simultaneously cut and cauterize tissue. Unlike Electrosurgery, the harmonic uses ultrasonic vibrations instead of electric current to cut and cauterize tissue.

The harmonic is superior to a Bovie in that it can cut through thicker tissue, creates less toxic surgical smoke, and may offer greater precision. The harmonic scalpel is not as easily maneuverable as the Bovie, and takes longer to cut and coagulate tissue. Additionally, while a Bovie can be used to coagulate bleeding tissue at any time, the Harmonic scalpel only coagulates as it cuts.

A Harmonic scalpel cuts via vibration. The scalpel surface itself cuts through tissue by vibrating in the range of 55,500 Hz. The high frequency vibration of tissue molecules generates stress and friction in tissue, which generates heat and causes protein denaturation. This technique causes minimal energy transfer to surrounding tissue, potentially limiting collateral damage. However, incidents have been reported where the active jaw has caused bowel perforation.


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