right|thumb|Various [[scalpels]]

A surgical instrument is a medical device used during surgery to perform specific actions, such as cutting, modifying tissue, or providing access for viewing. Over time, a broad spectrum of tools has been developed—some for general surgical use, others tailored to specialized procedures.

Classification systems help surgeons understand an instrument's function and appropriate usage. Innovation continues to drive the development of more precise, safer, and more effective instruments for modern surgery.

History

Surgical instruments have evolved alongside advances in medical science and surgical technique. Early tools were often adapted from everyday implements but were later refined for better precision and safety.

Two key milestones shaped modern surgical tools:

In the early 20th century, the advancement from antiseptic to aseptic surgery led to widespread adoption of sterilizers, sterile gauze, and cotton. Instrument handles transitioned from wood or ivory to metal, enabling effective sterilization. Simpler, one-piece designs improved safety and usability.

During World War II, hand surgery emerged as a subspecialty. Many of the tools developed for this purpose are still in use today, often named after their innovators.

Individual tools have diverse history development. Below is a brief history of the inventors and tools created for five commonly used surgical tools.

Scissors

  • Mayo scissors, developed by one of the Mayo brothers in the late 19th century, feature semi-blunt ends and either straight or curved blades—the former for superficial tissues, the latter for thicker tissue.
  • Metzenbaum scissors, designed by Myron Metzenbaum, are characterized by lighter construction and longer handles, suitable for delicate procedures like tonsillectomy (the surgical removal of the tonsils).
  • In 1904, King Gillette introduced a safety razor with disposable blades. A decade later, Morgan Parker patented a disposable scalpel blade that locked onto a metal handle—offering both durability and sterility.
  • In 1900, physician Joseph Rivière used electricity to treat a malignant hand ulcer. In 1907, Karl Franz Nagelschmidt applied diathermy to tumors and hemorrhoids.
  • William T. Bovie, working with Dr. Harvey Cushing, developed a device capable of cutting and coagulating tissue simultaneously, laying the foundation for modern electrosurgery. Around 1000 AD, Albucasis described specialized hooks for procedures like circumcision and tracheostomy.
  • In the 19th century, Eugène-Louis Doyen introduced self-retaining abdominal retractors to improve surgical exposure in gynecological and abdominal operations. This problem led to the establishment of forceps-assisted delivery in the 16th century by the Chamberlen family. The vascular atraumatic forceps (DeBakey) were widely used for grasping vascular tissue and causing minimal damage to the vessels. Originally, this notion of crushing did not exist and arterial catch forceps simply clamped vessels temporarily prior to ligature or cautery.
  • In 1867, Eugene Koeberle, who accidentally found arterial forceps with a catch closure came away spontaneously without the need for ligature, and invented “pince hémostatique,” which have pin and hole catches.
  • In 1882, the Kocher clamp was created by Emil Theodor Kocher, who significantly contributed to thyroidectomies (removal of all or a part of the thyroid gland) and decompressive craniotomy.

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, a tracheotomy is a tool used to perform a tracheotomy).

Classification

There are several classes of surgical instruments:

  • Graspers, such as forceps (non-locking forceps/ grasping forceps, thumb forceps, pick-ups)
  • Electrosurgery or diathermy is a modern technology that uses high frequency electrical current to fulgurate or "cut" tissue or coagulate blood.
  • LigaSure is a bipolar electrocautery device marketed by Medtronic that can fuse vessels up to 7mm in diameter in an efficient manner.
  • Argon plasma coagulation involves the application of gas discharges in argon.
  • Ultrasound surgery uses high-frequency and high-energy ultrasound wave devices (e.g. harmonic scalpel) to target and destroy tissue.

Terminology

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

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.

See also

  • Instruments used in general surgery
  • Medical instruments and implants

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References

  • Edgar R. McGuire Historical Medical Instrument Collection from the University at Buffalo Libraries

Bibliography

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