History of Surgical Instruments

For a good understanding of the development of surgical instrumentation, try the online exhibit from the University of Virginia. It has some fantastic images of instruments that have clearly not changed a great deal over the centuries! www.med.virginia.edu/hs-library/historical/antiqua/instru.html

A surgical instrument is a specially designed tool or device for performing specific actions of carrying out desired effects during a surgery or operation, such as modifying biological tissue, or to provide access or viewing it. Along time, many different kinds of surgical instruments and tools have been invented, some of them of a more general character, others designed for a specific type of surgery. Accordingly, the nomenclature of surgical instruments follows certain patterns, such as a description of the action it performs (for example, scalpel, hemostat), the name of its inventor(s) (for example, the Kocher forceps), or a compound scientific name related to the kind of surgery (for example, tracheotome).

The expression surgical instrumentation is somewhat interchangeably used with surgical instruments, but its meaning in medical jargon is really the activity of providing assistance to a surgeon with the proper handling of surgical instruments during an operation, by a specialized professional, usually a nurse.

There are several classes of surgical instruments:

  • Graspers, especially tweezers and forceps
  • Clamps and occluders for blood vessels and other organs
  • Retractors, used to spread open skin, ribs and other tissue
  • Distractors, positioners and stereotactic devices
  • Mechanical cutters (scalpels, lancets, drill bits, rasps, trocars, etc.)
  • Dilators and speculae, for access to narrow passages or incisions
  • Suction tips and tubes, for removal of bodily fluids
  • Irrigation and injection needles, tips and tubes, for introducing fluid
  • Powered devices, such as drills, dermatomes
  • Scopes and probes, including fiber optic endoscopes and tactile probes
  • Carriers and appliers for optical, electronic and mechanical devices
  • Measurement devices, such as rulers and calipers

An important relative distinction, regarding surgical instruments, is the amount of bodily disruption or tissue trauma that their use might cause the patient. Terms relating to this issue are ‘atraumatic’ and minimally invasive. Minimally invasive systems are an important recent development in surgery. In the future, they devices will include many microscopic autonomous and directed devices.

Surgical instruments have been manufactured since the dawn of pre-history. Rough trephines for performing round craniotomies were discovered in neolithic sites in many places. It is believed that they were used by shamans to release evil spirits and alleviate headaches and head traumas caused by war-inflicted wounds.