Surgical Instruments

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 […]

A right upper lobectomy is twenty minutes in. The lobe needs to come anteriorly so the surgeon can reach the truncus anterior, and the assistant reaches for a grasper. Pick the wrong one and the lung tears along the staple line before the vessel is even looped. That is the job the Duval was designed

Every craniotomy tray in a well-equipped theatre has a pneumatic or electric craniotome on it. Every craniotomy tray that has ever been useful in a power cut, a field hospital, or a district facility three hours from a biomedical engineer also has a hand brace on it. The design dates to the early twentieth century

A pedicle sits deep at the base of the broad ligament. The right-angle clamp will not open wide enough to clear it, the assistant’s retractor is already at full stretch, and passing a tie behind the vessel by feel with a Mixter is starting to look like a way to tear something. This is the

William Walsham was a London surgeon writing in the 1890s. Morris Asch was a New York laryngologist of roughly the same era. Neither man ever saw the other’s instrument in use, and both patterns have survived essentially unchanged for well over a century — which tells you something about how well they solved the problem

The choledochotomy is open. Bile is welling up around the stay sutures, the cystic duct stump is ligated, and the intraoperative cholangiogram has shown a filling defect sitting just proximal to the ampulla. What comes off the tray next decides whether this becomes a clean ductal clearance or a twenty-minute wrestle that ends in a