Hysterectomy remains one of the most commonly performed major surgeries globally. The instrument set configuration changes considerably depending on surgical approach — total abdominal hysterectomy (TAH) requires a very different tray from a vaginal or laparoscopic-assisted case. This guide covers the open TAH configuration, which is the most widely used in hospital settings across Asia, Africa, and the Middle East.
Standard Hysterectomy Instrument Set — TAH Configuration
Retractors
- O’Sullivan-O’Connor self-retaining retractor — the primary retractor for open hysterectomy; the ring-and-blade design holds the abdominal wall open without a dedicated assistant throughout the procedure
- Deaver retractors (2 pcs, narrow and wide) — for bladder retraction during uterovesical space dissection and lateral pelvic exposure
- Richardson retractors (pair) — initial exposure before the self-retaining retractor is positioned
Pedicle Clamps — The Core of a Hysterectomy Set
Pedicle clamps define a hysterectomy set. These are not general-purpose clamps — they are long (20 to 24 cm), angled, and designed to clamp the broad ligament, uterine vessels, and vaginal angles without slipping under the tension applied during ligation and transection.
- Heaney clamps (8 pcs) — the standard curved pedicle clamp for the uterine artery, round ligament, and infundibulopelvic pedicles; available in single-tooth and serrated jaw patterns
- Masterson clamps (4 pcs) — straight jaw, used for the parametrium and vaginal angles where a straight approach is more controlled
- Zeppelin clamps (4 pcs) — a widely used alternative to Heaney in European and Middle Eastern hospitals; the angled jaw pattern provides controlled pedicle compression at the vaginal cuff level
- Kocher clamps (6 pcs) — for the round ligaments and ovarian pedicles
Long-Pattern Tissue Forceps
- Long Russian tissue forceps, 24 cm — atraumatic broad grip for pelvic tissue handling at depth
- Long Bonney tissue forceps, 23 cm — for deep pelvic fascial closure and peritoneal handling
- Long Adson-Brown forceps — fine tissue work at the vaginal cuff level during closure
Scissors
- Long curved Mayo scissors, 23 cm — pedicle transection and broad ligament cutting; the extra length reaches the deep pelvis without the surgeon’s hands obstructing the field
- Long Metzenbaum scissors, 23 cm — dissection of the uterovesical space and bladder reflection off the lower uterine segment
- Jorgensen scissors — for transecting the vaginal cuff; the deeply curved blades follow the vaginal vault angle and make a clean circumferential cut
Needle Holders
- Heaney needle holders (2 pcs, 23 cm and 25 cm) — essential for deep pedicle suturing where standard-length holders cannot reach without awkward angles
- Mayo-Hegar needle holders (2 pcs, 20 cm) — uterosacral and cardinal ligament suturing
Supporting Instruments
- Sponge-holding (ring) forceps, 24 cm — for abdominal packs and cavity swabs
- Backhaus towel clips (8 pcs)
- Yankauer suction handle
- Scalpel handles No. 3 and No. 4
Jaw Length in Pedicle Clamps — Why It Matters
A Heaney clamp with a standard 3.5 cm jaw covers the uterine artery pedicle in most patients. In overweight patients or those with large fibroids, the vessel bundle is wider and a 3.5 cm jaw may not include the complete pedicle — leaving exposed vessels that bleed after the clamp is released. Fizza Surgical offers Heaney clamps in both standard (3.5 cm jaw) and wide jaw (4.0 cm) configurations. We recommend including both in sets for teaching hospitals where patient body habitus varies widely.
Durability Standards
Pedicle clamps take significant mechanical stress — the ratchet mechanism locks under the pressure of clamped tissue, and repeated high-temperature autoclaving degrades box joints in lower-quality instruments. All Fizza Surgical hysterectomy set instruments are manufactured from 316L stainless steel with ratchet mechanisms tested to 5,000 open-close cycles. Needle holder jaws use tungsten carbide inserts for long-term grip performance.
Full ISO 13485:2016 certification and CE marking are standard on all sets.
Vaginal and LAVH Add-On Sets
We configure vaginal hysterectomy (VH) sets with Breisky vaginal retractors, Sims speculum, and Auvard weighted speculum. Laparoscopic-assisted vaginal hysterectomy (LAVH) sets with laparoscopic needle holders and trocar ports are also available. Contact us for those tray specifications or to request our full hysterectomy range catalog.
2026 Update: Tray Standardisation and Instrument Counts
Since this guide was first published, more of the hospitals we supply have moved from surgeon-specific trays to standardised TAH sets with a documented count sheet. The driver is reprocessing traceability rather than surgical preference — a fixed tray is auditable, and a tray that varies by surgeon is not.
Two practical consequences worth planning for. First, count sheets need to match the instrument’s catalogue description exactly, including jaw length and pattern name; “long clamp” is not a count-sheet entry. Second, standardisation raises instrument turnover, because the same tray now cycles through more cases per week. Where a set previously lasted several years on light rotation, budget for ratchet and jaw wear on a shorter horizon.
Our sets ship with a printed count sheet listing pattern, size, and quantity for each position. Ask for it at the quotation stage rather than after delivery.
Related Instrument Guides
Pedicle clamping is the step where a hysterectomy set earns its keep — our guide to Rochester-Carmalt forceps covers jaw geometry and the longitudinal serration pattern in detail. For adjacent procedures, see the D&C instrument set guide and our breakdown of sharp, blunt and ring curette types. The full OB/GYN surgical instruments guide covers the wider range.
Frequently Asked Questions
How many instruments are in a standard hysterectomy set?
A working TAH tray typically runs 60 to 90 pieces depending on whether retractor systems are counted individually. The variable is usually the self-retaining retractor: a Balfour with detachable blades adds several count-sheet lines that a fixed-frame system does not.
Why do pedicle clamps need long jaws?
The uterine vessels sit within a broad pedicle of tissue, and the clamp must occlude the full width in a single application. A short jaw forces a second bite, and the gap between two applications is where bleeding starts. Jaw length is a haemostasis specification, not a convenience one.
Are tungsten carbide inserts worth the extra cost on this set?
On needle holders, yes. TAH closure involves substantial suturing, and TC jaws hold their grip through far more cycles than plain stainless before the serrations polish smooth. The inserts are also replaceable, so a TC needle holder can be refurbished rather than discarded.
Can the same set be used for vaginal hysterectomy?
Only partially. A TAH tray lacks the Breisky vaginal retractors and Auvard weighted speculum that vaginal access requires, and its abdominal retractors are unused. Most departments run a separate VH tray rather than padding the abdominal set with instruments that stay wrapped.
What steel grade should these instruments be?
Martensitic stainless — AISI 410 or 420 — for clamps, scissors, and needle holders, hardened so serrations and edges survive repeated sterilization cycles. Correct passivation matters as much as the grade itself, since these instruments spend their lives cycling through moisture and heat.
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