A cesarean section instrument set is one of the most frequently used surgical trays in any hospital with an active obstetrics unit. Getting the configuration right matters for both patient safety and scrub technician efficiency — especially when C-section cases run back to back during high-volume shifts.
Complete C-Section Instrument Set Contents
A standard cesarean section set contains 40 to 55 instruments configured for the Pfannenstiel (lower transverse) approach. The list below reflects the most common configuration used in government and private hospitals across South Asia and the Middle East.
Retractors
- Doyen abdominal retractor — the defining instrument of the C-section set; the wide curved blade retracts the bladder and lower uterine segment to expose the uterine incision site safely
- Richardson retractors (large pair) — initial abdominal wall retraction during the Pfannenstiel exposure
- Langenbeck retractors (pair, 19 cm) — for wound edge retraction during uterine closure
Uterine Clamps and Hemostatic Forceps
- Green-Armytage uterine hemostatic forceps (6 to 8 pcs) — specifically designed for uterine incision bleeding control; straight jaws with multiple transverse serrations provide grip on the uterine muscle edge without cutting through
- Kocher clamps (6 pcs) — for cord clamping and broad ligament control
- Allis tissue forceps (4 pcs) — peritoneal and fascial layer handling during opening and closure
- Sponge-holding (ring) forceps (2 pcs) — swab counting and cavity packing with antiseptic gauze
Scissors
- Bandage scissors (Lister), 18 cm — for extending the uterine incision; the blunt lower blade protects the fetus from the scissor tip during lateral extension
- Mayo scissors, curved, 17 cm — fascia and heavy tissue cutting during opening
- Metzenbaum scissors, curved — uterine layer dissection and uterovesical space development
Needle Holders
- Mayo-Hegar needle holders (3 pcs, 18 cm, 20 cm, 23 cm) — uterine closure requires the longer 23 cm holder for deep placement on the posterior uterine wall
- Heaney needle holder, 23 cm — preferred by many OB/GYN surgeons for the first deep uterine layer
Tissue Forceps
- Adson tissue forceps (with and without teeth) — skin and subcutaneous closure
- Bonney tissue forceps, 18 cm — heavier fascial layer handling during opening and closure
- Russian tissue forceps, 18 cm — peritoneal closure
Supporting Instruments
- Yankauer suction cannula
- Backhaus towel clips (8 pcs)
- Scalpel handle No. 4 — for the Pfannenstiel skin incision
The Instrument That Most Generic Sets Get Wrong
Green-Armytage forceps are non-negotiable in a proper C-section set. Many low-cost generic sets substitute standard Kocher clamps at the uterine incision edges, which do not provide adequate grip on the uterine muscle and tend to slip under tension. A well-stocked C-section tray has at least 6 Green-Armytage forceps — 4 applied to the uterine incision immediately after delivery and 2 held in reserve for bleeding points along the lower segment.
Doyen blade depth matters too. A shallow blade under 6 cm does not adequately retract the bladder in patients with prior uterine scars, bladder adhesions, or a high-riding uterine segment. Our standard C-section sets include Doyen blades at both 7 cm and 8 cm depth, with the deeper blade included for use when standard retraction is insufficient.
Material and Quality Standards
All instruments in Fizza Surgical’s cesarean section sets are manufactured from 316L stainless steel and polished to Ra less than or equal to 0.4 micrometers. Sets are manufactured under ISO 13485:2016 and carry full CE marking documentation.
Custom and Combined Set Configurations
Some obstetrics departments run combined vaginal delivery and C-section trays. Others want a dedicated LSCS (Lower Segment Cesarean Section) tray with an increased Green-Armytage count and a second Doyen retractor for teaching cases. We configure sets to your instrument card with no design fee. Minimum 12 trays for custom configuration; no minimum for standard catalog sets.
C-Section Instrument Reference Table (2026 Update)
The table below summarizes the core instruments in a standard Lower Segment Cesarean Section (LSCS) tray, with the role each plays and typical specifications. Use it as a quick procurement or count-sheet reference.
| Instrument | Role in the procedure | Typical spec |
|---|---|---|
| Doyen retractor | Retracts the bladder flap to expose the lower uterine segment | Blade width ~60 mm, AISI 410/420 |
| Green-Armytage forceps | Atraumatic hemostatic clamping of the uterine incision edges | Usually 6–8 per tray, 20 cm |
| Bladder retractor (Balfour/Doyen) | Deep retraction during uterine repair | Curved blade, self-retaining option |
| Mayo scissors (curved) | Dividing dense fascia and tough tissue | 17 cm, AISI 420 |
| Mayo-Hegar needle holder | Uterine and fascial closure with heavier suture | 18–20 cm, TC option |
| Sponge-holding (Foerster) forceps | Swabbing, prep, and delivery assistance | 24 cm, serrated or fenestrated |
| Allis / Babcock forceps | Grasping tissue and holding the peritoneal edge | 15–20 cm |
For a deeper look at the atraumatic uterine clamp central to this tray, see our forthcoming guide on Green-Armytage forceps, and compare the tissue-grasping options in our Allis vs Babcock comparison.
Category 1 Emergency Caesarean: What Changes on the Tray
An elective lower segment section and a Category 1 emergency use broadly the same instruments, but the way the tray is presented differs — and the difference costs minutes if nobody has planned for it.
The decision-to-delivery interval for a Category 1 section is conventionally targeted at 30 minutes, and much of that budget is consumed before the surgeon is scrubbed. The tray must therefore be usable in stages rather than laid out in full.
Staged Layout
Front-load the delivery instruments: scalpel with a No. 4 handle and 23 blade, a Doyen retractor, straight Mayo scissors, and two Green-Armytage forceps. Everything needed to open, deliver and clamp sits in the first row. Closure instruments — needle holders, tissue forceps, the additional Green-Armytages for the second layer — stay in the second row and are brought forward once the baby is out.
This matters because in a genuine emergency the scrub practitioner may be laying out while the surgeon is already incising. A tray organised for the sequence of the operation rather than for tidy presentation is measurably faster.
What to Add for the Emergency Set
- A second Doyen retractor. Bladder retraction plus an extra hand on a difficult delivery. Deep or impacted heads make this routine, not optional.
- Additional Green-Armytage forceps. Six rather than four. Lower segment bleeding after an emergency delivery is often brisker, and running short mid-haemostasis is avoidable. Our guide to Green-Armytage forceps in caesarean hemostasis covers placement technique.
- A heavy needle holder ready-loaded. Uterine closure with a 1 or 2 gauge suture on a heavy needle; having it mounted before delivery saves a step.
- Uterine packing material within reach. Not on the tray, but in the room and accounted for.
The Count Cannot Be Shortened
Under time pressure the instrument and swab count is the first thing people are tempted to compress. It should not be. Obstetric cases carry an elevated retained-swab risk precisely because of the urgency and the volume of blood-soaked material, and an emergency section is exactly the scenario in which a count is most likely to be needed and most likely to be rushed. Follow the standard protocol without abbreviation — see our guide to the surgical instrument count procedure.
Frequently Asked Questions
What instruments are in a cesarean section set?
A standard LSCS tray includes a Doyen bladder retractor, Green-Armytage hemostatic forceps, curved Mayo scissors, Mayo-Hegar needle holders, sponge-holding forceps, Allis or Babcock tissue forceps, and supporting clamps and dissectors. The Green-Armytage count and a second retractor are the parts departments most often customize.
What is the Doyen retractor used for in a C-section?
The Doyen retractor holds back the bladder flap after it is reflected off the lower uterine segment, giving the surgeon a clear field to make and repair the uterine incision. Its broad, curved blade is designed to protect the bladder throughout the procedure.
Why are Green-Armytage forceps important in cesarean delivery?
Green-Armytage forceps provide atraumatic hemostatic clamping of the uterine incision edges immediately after delivery, controlling bleeding from the well-vascularized lower segment without crushing the tissue. Adequate numbers on the tray directly affect how quickly hemostasis is achieved.
What steel are cesarean section instruments made from?
Reusable C-section instruments are forged from surgical stainless steel, typically AISI 410 or 420 for retractors and scissors, manufactured to ISO 7153-1 and passivated for corrosion resistance across repeated autoclave and CSSD cycles.
2026 update: demand for tungsten-carbide (TC) inserts on the Mayo-Hegar needle holders in obstetric trays continues to grow, as the harder TC jaws hold fine and heavy suture more securely and resist wear. Review the standards behind every set on our certifications page, or browse the full surgical instruments range.
Contact Fizza Surgical to request a C-section set catalog, sample tray, or procurement quote.
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