The word “gastrectomy” hides three quite different operations, and the instrument tray changes with each. Before the set is built, the scrub team needs to know which one is on the board. Procedure What Is Removed Reconstruction Tray Emphasis Total gastrectomy Whole stomach Roux-en-Y oesophagojejunostomy Deep retraction, oesophageal access Subtotal (partial) gastrectomy Distal 60–80% Billroth […]

Few surgical fields are as unforgiving of a poorly chosen instrument as the male pelvis. The prostate sits in a bony funnel, wrapped by the dorsal venous complex in front and the neurovascular bundles on each side, with the rectum a millimetre behind. A radical prostatectomy asks the surgeon to remove the gland whole while

The first thing a scrub nurse learns about cranial surgery: the scalp bleeds more than almost any tissue in the body. Within ninety seconds of the skin incision, the surgeon expects Raney clips loaded and ready — a dozen of them, applied edge-to-edge along the flap before the field turns red. That is where a

In 1937, the London obstetrician Vivian Bartley Green-Armytage had a specific complaint about the lower segment cesarean section — then a relatively new alternative to the classical vertical incision. The cut edges of the uterine muscle bled briskly, retracted, and disappeared from view exactly when the surgeon needed to find them for closure. Standard hemostats