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. Over time, many different kinds of surgical instruments and tools have been invented. Some surgical instruments are designed for general use in surgery, while others are designed for a specific procedure or 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, atracheotome is a tool used to perform a tracheotomy). “Surgeon” redirects here. ... Biological tissue is a collection of interconnected cells that perform a similar function within an organism. ... A scalpel is a very sharp knife used for surgery, anatomical dissection, and various arts and crafts. ... Hemostats, curved and straight tip. ... Completed tracheotomy: 1 - Vocal cords 2 - Thyroid cartilage 3 - Cricoid cartilage 4 - Tracheal cartilages 5 - Balloon cuff A tracheotomy is a procedure performed by paramedics, emergency physicians and surgeons in order to secure an airway. ...

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. This article is about the occupation. ...

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History

Surgical instruments have been manufactured since the dawn of pre-history (millions of years ago). 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. A trephine () is a surgical instrument. ... 18th century French illustration of trepanation (Larger Version) Trepanation, also known as trephinning or trepanning, is a form of surgery where a hole is drilled or scraped into the skull, leaving the membrane around the brain intact. ... An array of Neolithic artifacts, including bracelets, axe heads, chisels, and polishing tools. ... The shaman is an intellectual and spiritual figure who is regarded as possessing power and influence on other peoples in the tribe and performs several functions, primarily that of a healer ( medicine man). The shaman provides medical care, and serves other community needs during crisis times, via supernatural means (means... A headache is a condition of mild to severe pain in the head; sometimes upper back or neck pain may also be interpreted as a headache. ... Head injury is a trauma to the head, that may or may not include injury to the brain (see also brain injury). ... For other uses, see War (disambiguation). ...

Surgeons and physicians in India used sophisticated surgical instruments since ancient times. Sushruta (circa 500 BC) was probably the most important surgeon in ancient history, often known as the "father of surgery". In his text Sushruta Samhita he described over 120 surgical instruments, 300 surgical procedures and classified human surgery in 8 categories. Surgeon may refer to: a practitioner of surgery the moniker of British electronic music producer and DJ, Anthony Child; see Surgeon (musician) This is a disambiguation page—a list of articles associated with the same title. ... The Doctor by Luke Fildes This article is about the term physician, one type of doctor; for other uses of the word doctor see Doctor. ... It has been suggested that this article or section be merged with Sushruta Samhita. ... Centuries: 7th century BC - 6th century BC - 5th century BC Decades: 550s BC - 540s BC - 530s BC - 520s BC - 510s BC - 500s BC - 490s BC - 480s BC - 470s BC - 460s BC - 450s BC Events and Trends 509 BC - Foundation of the Roman Republic 508 BC - Office of pontifex maximus created... “Ancient” redirects here. ... “Surgeon” redirects here. ...

In Antiquity, surgeons and physicians in Greece and Rome developed many ingenious instruments manufactured from bronze, iron and silver, such as scalpels, lancets, curettes, tweezers, specula, trephines, forceps, probes, dilators, tubes, surgical knives, etc. They are still very well preserved in several medical museums around the world. Most of these instruments continued to be used in Medieval times, albeit with a better manufacturing technique. Classical antiquity is a broad term for a long period of cultural history centered on the Mediterranean Sea, which begins roughly with the earliest-recorded Greek poetry of Homer (7th century BC), and continues through the rise of Christianity and the fall of the Western Roman Empire (5th century AD... This article does not cite any references or sources. ... Assorted ancient Bronze castings found as part of a cache, probably intended for recycling. ... For other uses, see Iron (disambiguation). ... This article is about the chemical element. ... A scalpel is a very sharp knife used for surgery, anatomical dissection, and various arts and crafts. ... Lancet may refer to: A lancet is a medical instrument, similar to a scalpel but with a double-edged blade. ... Noun A spoon-shaped surgical instrument for cleaning a diseased surface. ... This article does not cite any references or sources. ... A vaginal speculum, such as this Ricord-type speculum, is used to hold the vagina open for visual examinations, taking of samples, or surgery. ... Plastic forceps are intended to be disposable Forceps are a handheld, hinged instrument used for grasping and holding objects. ... Look up probe in Wiktionary, the free dictionary. ... The Middle Ages formed the middle period in a traditional schematic division of European history into three ages: the classical civilization of Antiquity, the Middle Ages, and modern times. ...

Medieval breakthrough

One of the key players who made the real breakthrough in surgical instrumentation was Abu al-Qasim al-Zahrawi, known in the West as Abulcasis, and considered the "father of modern surgery". The first observation one must make at the outset is that Al-Zahrawi wrote his famous Al-Tasrif liman 'Ajiza 'an Al Ta'leef (written in 1000), translated as The Method of Medicine, and often referred to as Al-Tasrif, after long experience accumulated over fifty years of practising medicine. The book, therefore, was aimed to establish the rules of thumb in the practical medicine by emphasising the "do" and "don’t" in almost every issue encountered and the solutions/ treatments he provided or invented during this long experience. To complete his practical guide to solving various surgical problems, Al-Zahrawi ended this thirty volumes medical encyclopaedia with a treatise in which he introduces his famous collection of surgical tools exceeding a staggering total of 200 pieces. With its innovative title “On Surgery”, the treatise is considered the earliest elucidation compiled on the subject, which remained as the single best medieval source on the matter until modern times. In the words of Leclerc: “Al-Zahrawi remains a leading scholar who transformed surgery into an independent science based on the knowledge of anatomy. His illustration and drawing of the tools is an innovation that keeps his contribution alive, reflected in its continuous influence on the works of those who came after him” Abu al-Qasim Khalaf ibn al-Abbas Al-Zahrawi (936 - 1013), (Arabic: أبو القاسم بن خلف بن العباس الزهراوي) also known in the West as Abulcasis, was an Andalusian-Arab physician, and scientist. ... Al-Tasrif was an influential medieval treatise on medicine. ... Europe in 1000 The year 1000 of the Gregorian Calendar was the last year of the 10th century as well as the last year of the first millennium. ...

Additionally, Galen of Pergamum, one of the most profoung philosophers, surgeons, medical philologists and physicians of the ancient world, requested that his specialised surgical instruments be made of iron ore found only in a quarry in the Roman town of Noricum. Galen along with other early Arab doctors, pioneered the approach to medical instrumentation and his followers of the Medieval period manufactured their instruments based on Galen's early designs.

Hamidan, for example, listed a total of twenty six innovations that Al-Zahrawi introduced . One of such discoveries was his use of catgut for internal stitching, a method that still practised in most of today’s surgery. The catgut appears to be the only natural substance capable of dissolving and acceptable by the body. Catgut is the name applied to cord of great toughness and tenacity prepared from the intestines of sheep/goat, or occasionally from those of the hog, horse, mule, pig, and donkey. ...

Al-Zahrawi does not only illustrate the tool using clear hand drawn sketches but also provides detailed information on the material and how and when it is used. Much of these are illustrated in Spink and Lewis’s (1973) book, one of the best and most comprehensive work available. For example, in cauterisation he states that: “According to the opinion of the early (physicians) cauterisation using gold is better than when using iron. In our opinion the use of iron is quicker and more correct”. As he goes on to deal with particular instruments and their use he often gives a clear description of how it is applied in addition to an accompanying sketch.

A second example of such description is what he wrote about the scraper (majrad) tool and its use when turning a fistula into the nose. “Doctors give the name 'fistula' to what laymen call 'a quill'. When you have treated it with the cautery or with caustic according to the instructions given previously, and it is not healed, there is no clear method of treatment except to cut down on the tumour at its ripening and let out all the humidity or pus therein, till you reach the bone. When bone is reached and you see necrosis or blackness, scrape it with an instrument like this picture. It is called 'rough-head' and is made of Indian iron. Its head is round like a button 2 but is engraved with markings finely engraved, like those of a file or a rasp. Place it on the site of the diseased bone and spin it between your fingers, pressing down a little with your hand, till you are sure all the diseased bone has been scraped away. Do this several times. Then let the place be dressed with stanching and styptic remedies. And if the place heals and flesh is generated there and the flow of sanies is stayed and there is no return after leaving for forty days, and there is no swelling, and nothing emerges, you may know it is perfectly healed.”

Not only the Al-Tasreef has exercised strong influence on later Muslim physicians but also became a reference book for most European medical schools and practitioners. It was first translated into Latin by Gherard of Cremona in the twelfth century to be followed by several other translations. Among the many European scholars to quote and cite from “Al-Tasreef” and many other Muslim medical works was the Frenchman Guy de Chauliac (d.1369) in his work “Chirurgia magna”. In fifteenth century Italian scholars rediscovered the works of Al-Zahrawi quoting his discoveries and remedies in their work. Among these one can refer to Mathieu de Gradibus who cited from Al-Zahrawi’s 27th treatise “Fi Tabai’a Al-Adwiyya and Aghdhiyya”. In the same period Arduinis de Passaro produced his book on the nature of poison “Liber de Venenis”, citing the work of Al-Zahrawi numerous occasions. Leclerc summarised the impact of Al-Tasreef admitting: “The translation (of Al-Tasreef) played a significant role in the development of Medieval surgery in Europe” The book constituted a central part of the medical curriculum in European countries for many centuries . A renowned French surgeon of the 14th century, Guy de Chauliac (1300-1368), was the physician for Pope Clement VI. In Avignon, France, he attended to the Pope and survived an infection of the Black Plague. ... Chirurgia magna (complete title: Inventarium sive chirurgia magna), completed in 1363, is a guide of surgery and practical medicine. ...

Sources:

Campell, D. (1974) ‘Arabian Medicine and its influence on the Middle Ages’, Philo press, Amesterdam. Hamidan Zohir (1993), ‘Abu-Al-Qassim Al-Zahrawi ; the Founder of Science of Surgery’, in Arabic, Dar Magallat Al-Thaqafa, Damascus. Lecrlerc Lucien (1877), ‘L’Histoire de la Medicine Arabe’, Paris, vol.1 p.456. Spink, M. S. and Lewis, G. L. (1973), ‘Albucasis On Surgery and Instruments’, The Wellcome Institute of the History of Medicine, London. Nasr Seyyed Hossein, (1976), ‘Islamic Science’, World of Islam Festival Publishing Company.

Renaissance and after

In the Renaissance and post-Renaissance era, new instruments were again invented and designed, in order to accompany the increased audacity of surgeons. Amputation sets originated in this period, due to the increased severity of war-inflicted wounds by shot, grapnel and cannon. The Renaissance (French for rebirth, or Rinascimento in Italian), was a cultural movement in Italy (and in Europe in general) that began in the late Middle Ages, and spanned roughly the 14th through the 17th century. ... Partial hand amputation Amputation is the removal of a body extremity by trauma or surgery. ...

However, it was only with the discovery of anesthesia and surgical asepsis that new surgical instruments were invented to allow the penetration of the inner sanctum, or the previously forbidden body cavities, namely the skull, the thorax and the abdomen. A veritable explosion of new tools occurred with the hundreds of new surgical procedures which were developed in the 19th century and first decades of the 20th century. New materials, such as stainless steel, chrome, titanium and vanadium were available for the manufacturing of these instruments. Precision instruments for microsurgery in neurosurgery, ophthalmology and otology were possible and, in the second half of the 20th century, energy-based instruments were first developed, such as electrocauteries, ultrasound and electric scalpels, surgical tools for endoscopic surgery, and finally, surgical robots. Anesthesia or anaesthesia (see spelling differences) has traditionally meant the condition of having the perception of pain and other sensations blocked. ... An antiseptic solution of Povidone-iodine applied to an abrasion Antiseptics (Greek αντί, against, and σηπτικός, putrefactive) are antimicrobial substances that are applied to living tissue/skin to reduce the possibility of infection, sepsis, or putrefaction. ... For other uses of Skull, see Skull (disambiguation). ... Diagram of a tsetse fly, showing the head, thorax and abdomen The thorax is a division of an animals body that lies between the head and the abdomen. ... The abdomen is a part of the body. ... Alternative meaning: Nineteenth Century (periodical) (18th century — 19th century — 20th century — more centuries) As a means of recording the passage of time, the 19th century was that century which lasted from 1801-1900 in the sense of the Gregorian calendar. ... (19th century - 20th century - 21st century - more centuries) Decades: 1900s 1910s 1920s 1930s 1940s 1950s 1960s 1970s 1980s 1990s As a means of recording the passage of time, the 20th century was that century which lasted from 1901–2000 in the sense of the Gregorian calendar (1900–1999... The 630 foot high, stainless-clad (type 304L) Gateway Arch defines St. ... Bright chrome is often used as a decorative feature on consumer products such as cars. ... General Name, symbol, number titanium, Ti, 22 Chemical series transition metals Group, period, block 4, 4, d Appearance silvery metallic Standard atomic weight 47. ... General Name, symbol, number vanadium, V, 23 Chemical series transition metals Group, period, block 5, 4, d Appearance silver-grey metal Standard atomic weight 50. ... Microsurgery is a type of surgery where an operation microscope is required in order to perform opératoire precision acts. ... Insertion of an electrode during neurosurgery for Parkinsons disease. ... This article is about the branch of medicine. ... Otology is a small, unknown but increasingly popular religion which consits of fellow OTers. ... Endoscopic images of a duodenal ulcer A flexible endoscope. ... Robotic surgery is the use of robots in performing surgery. ...

Historically, the development of a surgical instrument follows:

1. The surgeon uses a common tool and/or adapts it for use in an operation. Some ancient sources of such tools are weapons, butcher's tools, items used in ritual body modification, cannibalism or torture, carpenter's, leather worker's and metal worker's implements. (This process still continues, with tools coming out of automobile shops, aerospace workplaces, kitchens, etc.)
2. There is a period of transference and incremental improvement, generally focusing on materials, which must be nontoxic and durable. Blood tends to corrode and the repeated washing and sterilization of surgical instruments tends to quickly destroy many materials; other materials hold stains and bacteria.
3. There is a period of standardization.

However, in modern times, surgeons are also designing instruments from scratch. Also, governmental controls have modified the path of innovation somewhat. A weapon is a tool used to kill or incapacitate a person or animal, or destroy a military target. ... Butcher shop in Valencia A butcher is someone who prepares various meats and other related goods for sale. ... A ritual is a set of actions, performed mainly for their symbolic value, which is prescribed by a religion or by the traditions of a community. ... This article or section does not cite its references or sources. ... “Cannibal” redirects here. ... Torture, according to international law, is any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession, punishing him for an act he or a third person has... Carpenter at work in Tennessee, June 1942. ... Modern leather-working tools Leather is a material created through the tanning of hides and skins of animals, primarily cattlehide. ... This article does not cite any references or sources. ... “Car” and “Cars” redirect here. ... Look up aerospace in Wiktionary, the free dictionary. ... A kitchen is a room used for food preparation and sometimes entertainment. ... Toxic redirects here, but this is also the name of a song by Britney Spears; see Toxic (song) Look up toxic and toxicity in Wiktionary, the free dictionary. ... Human blood smear: a - erythrocytes; b - neutrophil; c - eosinophil; d - lymphocyte. ... Sterilization can mean: Sterilization (surgical procedure) - an operation which renders an animal or human unable to procreate Sterilization (microbiology) - the elimination of microbiological organisms It can also mean the death of sperm cells due to radiation. ... Phyla Actinobacteria Aquificae Chlamydiae Bacteroidetes/Chlorobi Chloroflexi Chrysiogenetes Cyanobacteria Deferribacteres Deinococcus-Thermus Dictyoglomi Fibrobacteres/Acidobacteria Firmicutes Fusobacteria Gemmatimonadetes Lentisphaerae Nitrospirae Planctomycetes Proteobacteria Spirochaetes Thermodesulfobacteria Thermomicrobia Thermotogae Verrucomicrobia Bacteria (singular: bacterium) are unicellular microorganisms. ... Standardization, in the context related to technologies and industries, is the process of establishing a technical standard among competing entities in a market, where this will bring benefits without hurting competition. ...

See also

• List of surgical instruments

This is a list of surgical instruments. ...

Bibliography

• Wells, MP, Bradley, M: Surgical Instruments A Pocket Guide. W.B. Saunders, 1998.

External links

Wikimedia Commons has media related to:

Category:Surgical instruments

• Eponymous surgical instruments. WhoNamedIt.
• The Surgery of Ancient Rome. A Display of Surgical Instruments from Antiquity. University of Virginia Health System.
• Surgical instruments. University of Pennsylvania.
• Basic surgical instruments.
• Surgical instruments.