There are several classes of surgical instruments such as graspers, 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, surgical scissors, etc.); dilators and specula for access to narrow passages or incisions; suction tips and tubes for removal of bodily fluids; sealing devices such as surgical staplers; 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; ultrasound tissue disruptors, cryotomes, and cutting laser guides; measurement devices, such as rulers and calipers; and many more. This chapter overviews surgical instruments for the operation theatre.
TopHistory
Surgical instruments have been designed and manufactured since the era of pre-history (Bonfils-Roberts, 1972). 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.
In the Antiquity, surgeons and physicians in Greece and Rome developed many ingenious instruments manufactured from bronze, iron and silver, such as scalpels, lancets, curettes, tweezers, speculae, trephines, forceps, probes, dilators, tubes, surgical knifes, 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 (“General Instrument Sourcebook”, 2006).
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.
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 materiais, 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.