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F. A. Davis Company
1915 Arch Street
Philadelphia, PA 19103
www.fadavis.com
Copyright © 2012 by F. A. Davis Company
Copyright © 2012 by F. A. Davis Company. All rights reserved. This product is protected by copyright. No part of it may be reproduced,
stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise,
without written permission from the publisher.
Printed in the United States of America
Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1
Senior Acquisitions Editor:Christa A. Fratantoro
Manager of Content Development:George W. Lang
Developmental Editor:Karen Williams
Art and Design Manager:Carolyn O’Brien
As new scientific information becomes available through basic and clinical research, recommended treatments and drug therapies undergo
changes. The author(s) and publisher have done everything possible to make this book accurate, up to date, and in accord with accepted
standards at the time of publication. The author(s), editors, and publisher are not responsible for errors or omissions or for consequences
from application of the book, and make no warranty, expressed or implied, in regard to the contents of the book. Any practice described
in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances
that may apply in each situation. The reader is advised always to check product information (package inserts) for changes and new
information regarding dose and contraindications before administering any drug. Caution is especially urged when using new or
infrequently ordered drugs.
ISBN: 978-0-8036-2545-7
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2545_FM_i-xvi 01/11/11 2:10 PM Page v
To the staff, students, anesthesia personnel, and surgeons in
operating rooms across the country
—your hard work makes the “miracle of modern
surgery” a reality for patients every day.
To the staff working in central sterile processing departments
across the country
—you provide an often-unheralded but critically
important service.
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PREFACE TO THE
SECOND EDITION
Feedback about the first edition, several more years of of the instruments, which is often the only way to differ-
teaching experience, and new advances in surgical pro- entiate between them. That inadequacy is the reason I
cedures led me to add three new features to this edition: decided to photograph and write this book. My goal was
(cid:129) A student-focused CD containing exercises and to show the whole instrument as well as a close-up of the
games that reinforce important concepts from tips to aid students and new operating room staff in
the book. Photo IDs, flashcards, practice Mayo identifying instruments. A description is included with
stand setups, and other activities are included. each instrument to further aid in identification and
Additional activities can be found on the book’s classification.
companion Davispluswebsite (http://davisplus. One of the most important methods used to identify
fadavis.com/). an instrument is to look at the tip. Is the jaw smooth or
(cid:129) A new “Second Look” feature that highlights sev- serrated? If it is serrated, do the serrations run horizon-
eral instruments with similar characteristics but tally or longitudinally? Does the jaw have teeth and what
small differences and points out the distinctive do the teeth look like? In this text, you will find close-up
features of each instrument. pictures of the jaws as well as a description and picture
(cid:129) Further separation of instruments according to of the whole instrument that will help you to differenti-
type. Minimally invasive surgery is here to stay, so ate one instrument from another. I photographed each
laparoscopic instruments now have their own instrument’s tip at an angle that I though best showed
chapter and arthroscopic and thoracoscopic what made it different from other similar instruments.
instruments now have their own sections. This This should help those new to the operating room envi-
edition also includes a new chapter on robotic ronment decide which instrument they are looking at.
instrumentation, something not included in As an instructor, I felt it was important to place instru-
previous texts. ments that look alike on the same page so that student
Whether you are a student, a new employee in the will be able to see the sometimes-subtle differences in
surgical suite or central sterile supply area, or a seasoned size or jaw serrations.
veteran wishing to review instrument names, I hope you It would be impossible to include in any text allof the
will find that this text and its CD are useful and valuable surgical instruments used in every type of surgical proce-
resources. dure. In this text, I have chosen to include the most
—Colleen Rutherford commonly used instruments and instrument types that
operating room personnel should be familiar with.
Instrument nicknames can vary from institution to
PREFACE TO THE FIRST EDITION institution, even from surgeon to surgeon. I have en-
deavored to include the instrument nickname (“alias”)
“Crile, Pean, Mosquito, Mixter” . . . To those who are new only if it is referred to this way on a large regional or na-
to the operating room environment, the number of in- tional basis. This text has been critiqued by reviewers
struments one has to learn can seem overwhelming. from different parts of the country to get feedback on
Learning is further complicated by the fact that many of whether an “alias” was common enough to be included.
the instruments look similar. The purpose of this text is to Instrument websites and catalogs were also consulted
help you differentiate among the common surgical in- for nickname information (see Acknowledgments).
struments. As an instructor for a Surgical Technology pro- This text is divided into chapters covering each
gram, I have seen students struggle to learn the surgical common specialty service, beginning with general sur-
instruments. The students (and I) felt the books that were gery instrumentation. You may see many of the gen-
available did not do an adequate job of showing the tips eral surgical instruments used in specialty surgical pro-
vii
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viii Preface to the Second Edition
cedures. In the interest of space, I have not repeated To assist educators in preparing their course materi-
those instruments in the specialty chapters unless I felt als, I have developed an electronic test bank and a
they were used so frequently that they warranted being searchable, digital image bank to accompany this text.
included. These ancillaries are provided on a CD-ROM and are
At the end of each section is a short “quiz” referred to made available to educators who adopt this book.
as a “Surgical Session.” These quizzes can be used by Whether you are a student, a new employee of the op-
students to reinforce their own learning, or if you are an erating room or central supply area, or are a seasoned
instructor, you may wish to assign these as in-class work veteran wishing to review instrument names, I hope you
or homework and discuss the answers in class. will find this text a useful and valuable resource.
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ACKNOWLEDGMENTS
No one writes a book alone. I would like to acknowl- Clark, Lynn Crispo, Shannon Dennis, Donna Dias, Lela
edge the following people and resources for their Holloran, Amy Ireland, Don King, and Brad Morrison. I
support of this project: appreciate your willingness to allow me into your ORs.
First, I would like to thank the team who worked To my family and friends: your support, caring, and
with me to make this book a reality. Christa Fratantoro advice mean more than I can say. You truly bring joy to
and George Lang of F. A. Davis Publishing Company: me on a daily basis. I am a very lucky woman to have all
your support and encouragement made this process of you in my life.
run smoothly. Karen Williams, developmental editor: I would also like to acknowledge the following surgi-
your thoughtful feedback and edits make this book a cal instrument company websites for helping me check
much better read for the audience. Jeff Adams and the facts that have gone into this book:
Steve Fowler of Jeff Adams Photography: your pa- http://www.surgicaltools.com
tience, sense of humor, and hard work during the http://www.codman.com
photo shoots resulted in beautiful pictures for the http://www.intuitivesurgical.com
book and a few laughs during the sessions. You proba- http://www.karlstorz.com
bly learned more about surgical instruments than you http://www.orsupply.com
ever wanted to know. http://www.miltex.com
I would like to recognize and thank the following
personnel at Concord Hospital for allowing me to pho-
tograph the setups that appear in Chapter 13: Holly
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