Very few instruments in a modern tray predate anaesthesia. The grooved director does. It appears in surgical catalogues from the early nineteenth century in essentially the form we make today: a flat malleable blade with a channel running down its length, a bulbous probe at one end, a flattened tongue at the other. Two hundred […]

The airway has failed. Bag-mask ventilation is not moving chest, two intubation attempts have gone nowhere, and saturations are falling through the eighties. Someone opens the front-of-neck tray. Inside it, next to the scalpel and the bougie, sits a small single-prong instrument that most people in the room have never actually used on a living

A vestibular schwannoma has been debulked and the surgeon needs to find the plane between the tumour capsule and the flattened facial nerve. No instrument in the tray can be pushed. Everything has to be introduced closed, opened along a plane, and withdrawn without catching. That is the working definition of a dissector — and

Three different instruments carry Arbuthnot Lane’s name, and purchasing departments mix them up constantly. We have shipped replacement orders where a hospital asked for “Lane forceps” and meant a bone-holding clamp with a ratchet, then queried the invoice when a pair of spring-handled tissue forceps arrived. Both were correct against their own catalogue codes. Neither

A registrar is closing a thick, oedematous abdominal wall. The rectus sheath keeps sliding out of a pair of standard 1×2 toothed forceps, and every regrip leaves another puncture in fascia that is already friable. Somebody hands over a pair of Russian pattern forceps. The sheath stops slipping, and the punctures stop. That is the