Surgical Instrumentation: Essential Set and Handling Techniques

By Dr. Zubair Khalid, DVM, MS, PhD · 2026-08-11

Key Takeaways

• A standard veterinary surgical pack includes essential instruments for cutting (scalpel, Mayo/Metzenbaum scissors), grasping/clamping (hemostatic forceps, tissue forceps, Allis/Babcock forceps), and suturing (needle holders). Instrument selection is dictated by tissue type and procedure depth, with Mayo scissors for heavy fascia and Metzenbaum for delicate dissection.
• Mechanical principles like the box lock and ratchet mechanism in hemostatic forceps and needle holders are critical for precise jaw alignment and controlled tissue compression; over-engagement of the ratchet can damage tissue and instruments. Leverage is determined by instrument length, with longer tools offering greater reach and tremor dampening but less force amplification compared to shorter instruments.
• Proper instrument handling, including passing instruments by the handle and maintaining a consistent arrangement on the Mayo stand, is paramount for surgeon safety, sterile field integrity, and preventing intraoperative difficulties. Correct grip techniques, such as the pencil grip for fine dissection and palm grip for power, minimize fatigue and improve precision.
• Instrument care involves immediate post-operative cleaning with cool water and enzymatic cleaners, followed by thorough inspection, lubrication of hinges and box locks, and sterilization according to manufacturer instructions. Common failure modes include misaligned jaws, dull cutting edges, loose box locks, and retained debris, necessitating regular inspection and prompt repair or replacement.
• Instrument selection must consider species and patient size, with smaller instruments for small animals and longer, heavier instruments for large animals to accommodate tissue density and depth. Specialty procedures, such as ophthalmic or orthopedic surgery, require dedicated instrument sets with specific design characteristics for microsurgery or bone manipulation.

This reference article serves practicing veterinarians who select, handle, and maintain surgical instruments across general practice procedures. It defines the contents of a standard surgical pack, explains the mechanical principles underlying instrument design, and describes correct handling techniques that preserve instrument function and patient safety. The material applies to small animal, large animal, and mixed practice settings, with attention to how instrument choice varies by tissue type and procedure.

Instrumentation errors rank among the most preventable causes of intraoperative difficulty. A surgeon who understands why a needle holder is designed with a particular jaw pattern, or why scissors are classified by blade configuration, can select the correct tool without hesitation and recognize when an instrument has failed. This article provides that foundational knowledge.

At a Glance

Design Principles and Mechanical Function

Surgical instruments perform four basic functions: cutting, grasping, clamping, and retracting. Each instrument class embodies specific mechanical compromises between force transmission, tissue trauma, and operator control.

The Box Lock and Ratchet Mechanism

Hemostatic forceps and needle holders share a common mechanical architecture. The box lock joins the two halves and allows precise alignment of the jaws. The ratchet, positioned proximal to the box lock, maintains jaw closure without sustained operator effort. The ratchet has three engagement positions in most instruments, permitting graded compression. Over-tightening the ratchet crushes tissue and damages the instrument's alignment. The surgeon should engage only the number of ratchet clicks needed to control bleeding or hold suture.

Leverage and Force Transmission

Instrument length determines mechanical advantage. Longer instruments transmit less force to the tips for a given hand pressure but provide greater reach and tremor dampening. Short instruments amplify force but reduce precision. This trade-off explains why delicate procedures on superficial structures use short instruments while deep abdominal surgery requires longer tools. The fulcrum position, located at the box lock, means that jaw force exceeds hand force by a ratio determined by handle length relative to jaw length.

The Essential Surgical Pack

A general practice surgical pack contains instruments that address the majority of soft tissue, orthopedic, and dental procedures. The list below represents a consensus configuration adaptable to individual practice needs.

Cutting Instruments

The scalpel handle accepts disposable blades. The number 3 handle with a number 10 blade suits most skin incisions and soft tissue dissection. The number 15 blade, mounted on the same handle, provides finer control for small incisions and delicate work. The number 4 handle with a number 20 blade serves large animal surgery where thicker skin and heavier tissue require a larger blade.

Scissors are classified by blade configuration. Mayo scissors have heavy blades with a blunt-blunt tip configuration and serve for cutting fascia, suture, and tough connective tissue. Metzenbaum scissors have longer, narrower blades with a blunt-blunt tip and are reserved for delicate dissection of loose connective tissue planes. Suture scissors, typically with a notch in one blade, cut suture material without damaging the needle. Operating scissors must never cut suture, as the suture material dulls the cutting edge.

Grasping and Clamping Instruments

Hemostatic forceps, also called artery forceps, clamp blood vessels and hold tissue. The Kelly forceps has transverse serrations along half its jaw length. The Crile forceps has serrations along the full jaw length. The mosquito forceps, smaller and finer, suits delicate vessels and small tissue bundles. Each pattern is available straight or curved, curved patterns improve visibility at depth.

Tissue forceps with teeth provide secure grasping without crushing. The Brown-Adson forceps has fine teeth at the tip and suits skin and subcutaneous tissue. The rat-toothed forceps provides firmer grip for heavier tissue. Thumb forceps without teeth, such as the DeBakey pattern, are atraumatic and suit vascular and intestinal work.

Allis tissue forceps have interlocking teeth and provide firm traction on tissue that will be excised. Babcock forceps have a flat, fenestrated jaw that grasps tubular structures such as intestine or uterus without crushing. Both instruments cause tissue trauma and should not be applied to tissue that will remain in the patient.

Needle Holders

The needle holder grips the suture needle during passage through tissue. The Mayo-Hegar pattern has cross-serrated jaws and suits general use. The Olsen-Hegar pattern incorporates scissors in the handle, allowing the surgeon to cut suture without changing instruments. Castroviejo needle holders have a spring-loaded handle and delicate jaws for fine ophthalmic and microvascular work. Tungsten carbide jaw inserts provide a firmer grip on the needle and reduce operator fatigue.

Retraction and Exposure Instruments

Self-retaining retractors maintain exposure without an assistant. The Gelpi retractor has sharp points and suits deep, narrow wounds. The Weitlaner retractor has blunt or sharp prongs and provides moderate retraction. The Balfour retractor, used in abdominal surgery, has adjustable blades and a bladder blade. Hand-held retractors, including the Army-Navy and Senn patterns, require an assistant but allow variable retraction force.

Handling Techniques

Correct instrument handling reduces fatigue, improves precision, and prevents accidental injury. The scalpel is held like a pencil for fine dissection or in the palm for sweeping incisions. Scissors are held with the thumb and ring finger in the rings, the index finger along the shaft for guidance. The needle holder is held with the thumb and ring finger, allowing the ratchet to be engaged by pronating the wrist.

Instruments are passed to the surgeon with the handle presented first and the working end directed away from the recipient. This convention prevents accidental puncture wounds and maintains the sterile field. The scrub nurse or assistant places instruments on the Mayo stand in a consistent arrangement so the surgeon can retrieve them without looking.

Instrument Care and Maintenance

Instrument longevity depends on immediate post-operative care. Blood and tissue debris are removed with cool water and enzymatic cleaner. Hot water coagulates protein and should be avoided. Instruments are disassembled when hinges permit, and box locks are brushed to remove debris. Ultrasonic cleaning reaches crevices that manual brushing misses.

Lubrication with instrument-grade oil protects hinges and prevents corrosion. Sterilization follows manufacturer instructions, autoclaving remains the standard for most instruments, but delicate patterns may require low-temperature sterilization. Instruments are inspected after cleaning for jaw alignment, cutting edge sharpness, and hinge function. Damaged instruments are removed from circulation and repaired or replaced.

The optical properties of instrument materials affect intraoperative visualization. Metallic instruments produce high reflectivity with complete shadowing of underlying tissue, while silicone-tipped instruments produce moderate reflectivity with minimal shadowing, as demonstrated in intraoperative imaging research Ehlers et al., spectral domain OCT integrated with a surgical microscope. This consideration matters when selecting instruments for procedures performed under magnification or with intraoperative imaging.

Species and Procedure Considerations

Instrument selection varies with patient size and tissue characteriztics. Feline and small canine patients require smaller instruments, but the jaw length and blade curvature matter more than overall length. Equine and bovine surgery often requires longer instruments with heavier construction to accommodate thicker tissue and greater depth. Production animal practitioners may maintain separate packs for field surgery, where portability and durability take priority over delicacy.

Specialty procedures demand specialised instrumentation. Ophthalmic surgery requires fine forceps, scissors, and needle holders designed for microsurgery. Neurologic surgery requires rongeurs, periosteal elevators, and fine dissecting instruments. Orthopedic surgery requires bone holding forceps, drills, and implant insertion instruments. The general practice pack serves as the foundation upon which specialty instruments are added.

Robotic and minimally invasive platforms have introduced new instrument paradigms. Voice-controlled camera guidance and scaled-down instrument movement, as described in early robotic coronary surgery research Reichenspurner et al., voice-controlled ZEUS system for endoscopic coronary bypass, allow precise dissection in confined spaces. These systems remain specialised additions to the general practice armamentarium instead of replacements for conventional instruments.

Instrument Selection by Procedure

The core pack serves most soft tissue and orthopedic procedures in general practice, but specific interventions demand additions or substitutions. Ovariohysterectomy and castration require only the essential pack plus fine mosquito forceps for ovarian pedicle ligation. Intestinal resection and anastomosis add Doyen intestinal forceps, which are atraumatic and prevent luminal spillage during enterotomy closure. Thoracic procedures require Finochetto retractors, Satinsky vascular clamps, and long-handled needle holders to work within the pleural cavity. Orthopedic surgery replaces most soft tissue instruments with periosteal elevators, bone holding forceps, chisels, osteotomes, and a power drill system.

Dental and oral procedures require a separate dedicated set. Periodontal curettes, scalers, and extraction forceps should not be mixed with general surgical instruments because of the high bioburden of the oral cavity and the fine cutting edges that dull easily. Ophthalmic microsurgery similarly demands a dedicated microsurgical set with jeweler's forceps, Castroviejo needle holders, and corneal scissors. These instruments have tolerances that general instruments do not meet, and their tips deform with any misuse.

The choice between reusable and disposable instruments changes with caseload and sterilization capacity. Disposable scalpel blades, suture needles, and electrosurgical tips are standard. Disposable retractors and forceps suit low-volume practices or field settings where sterilization is unreliable. Reusable instruments amortize cost over many procedures but require rigorous cleaning and inspection between uses. The American College of Veterinary Surgeons animal health resources provide procedure-specific guidance on instrument requirements for common surgeries.

Handling Ergonomics and Grip

Correct grip minimizes surgeon fatigue and prevents instrument damage. The pencil grip suits scalpel handles and fine forceps, providing precision at the cost of force. The palm grip suits needle holders and scissors, transmitting power through the thenar eminence. The thumb-ring grip for needle holders and scissors should place the index finger along the instrument shaft to stabilize and guide the tip. This position improves control and reduces wrist strain during prolonged suturing.

Passing instruments follows a standard sequence. The scrub nurse presents the instrument with the working end oriented toward the surgeon and the handle toward the nurse's palm. The surgeon receives the instrument at the handle without reaching across the sterile field. Scalpels pass with the blade directed away from both parties, and sharp instruments pass in a kidney dish or on a Mayo stand to prevent glove puncture. Needles pass mounted in the needle holder, never loose.

Instrument exchange during surgery should follow a rhythm. The surgeon returns the used instrument to the scrub nurse's hand or the Mayo stand, then receives the next instrument. Dropped instruments are never retrieved from the floor, they are removed from the sterile field and replaced. The MSD Veterinary Manual professional edition notes that breaks in sterile technique, including instrument contamination, are a primary source of surgical site infection.

Instrument Failure Modes and Prevention

Every instrument has predictable failure modes that the surgeon must recognize. Box lock instruments fail at the hinge, developing play that compromises clamping precision. Ratchet failure presents as slipping or incomplete engagement, often from corrosion or debris in the teeth. Needle holder jaws lose their insert pattern, causing needles to rotate during passage. Scissors dull at the cutting edge, first tearing instead of cutting, then failing to cut at all.

Forceps tips are the most vulnerable component. Rat-tooth forceps bend at the tooth junction, and Brown-Adson forceps lose their fine serrations with repeated autoclaving. Hemostatic forceps develop jaw misalignment when used to clamp tissue heavier than their design capacity. Using a Kelly clamp on a thick ovarian pedicle, for example, can permanently deform the jaws.

Prevention depends on matching the instrument to the tissue. Fine instruments handle delicate tissue only. Heavy instruments handle dense tissue and suture. Never use hemostats to hold suture needles, as this destroys the jaw alignment. Never use scissors to cut wire or pin material, as this chips the cutting edge. The WOAH terrestrial animal health code emphasizes that surgical standards, including instrument maintenance, directly affect animal welfare outcomes in both companion and production animal settings.

Cleaning and Sterilization Workflow

Instrument care begins at the operating table. Blood and tissue must not dry on instruments. The scrub nurse wipes instruments with a sterile saline-moistened sponge during the procedure, paying attention to box locks and ratchets. Instruments are then placed in a basin of cold water or enzymatic solution, never hot water, which coagulates protein and makes removal harder.

The cleaning sequence after surgery follows a fixed order. Gross soil removal occurs first, either manually or with an ultrasonic cleaner. Ultrasonic cleaning is preferred for hinged instruments because it reaches box locks and serrations that manual brushing misses. Instruments with lumens, such as suction tips and cannulas, require dedicated brush cleaning with the correct diameter brush. After cleaning, instruments are rinsed, dried, and inspected. Inspection checks jaw alignment, ratchet function, box lock tension, and the integrity of insulation on electrosurgical instruments.

Lubrication follows inspection. Instrument milk or a water-soluble lubricant is applied to hinges, box locks, and ratchets. Oil-based lubricants are contraindicated because they do not allow steam penetration during autoclaving. Lubricated instruments are then packaged for sterilization. Hinged instruments should be sterilized open, with the ratchet unlocked, to allow steam contact with all surfaces. Heavy instruments are placed on the bottom of the pack to prevent damage to lighter instruments.

Sterilization method depends on instrument composition and hospital capacity. Steam sterilization is standard for stainless steel instruments. Flash sterilization is reserved for dropped instruments during surgery and is not appropriate for routine processing. Cold chemical sterilization is used for heat-sensitive instruments such as some endoscopes and powered drills. Each method has specific cycle parameters that must be verified with biological indicators according to the practice's infection control protocol.

Documentation and Quality Assurance

Instrument tracking supports both patient safety and practice management. Each surgical pack should have a contents list that is verified before sterilization and after each use. Missing or damaged instruments are documented immediately, not at the next surgery. Practices that perform high volumes of surgery benefit from a numbered pack system with a log of sterilization cycles and biological indicator results.

Surgical records should note any instrument failure that affected the procedure. A needle holder that slipped during vascular ligation, a retractor that tore tissue, or a forceps that failed to hold are reportable events. These records support instrument replacement decisions and identify recurring problems with specific instruments or brands.

The American Veterinary Medical Association practice resources provide guidance on maintaining surgical standards in practice, including instrument management protocols. Regular audit of instrument inventory, sterilization records, and surgical complication rates identifies areas for improvement. Practices should review their instrument sets at least annually, replacing worn instruments and removing those that no longer serve a purpose in the current caseload.

Decision Framework for Instrument Purchase

Instrument purchasing decisions balance cost, durability, and caseload. High-use instruments such as needle holders, hemostats, and scissors justify investment in premium brands. Low-use specialty instruments may be purchased from mid-range manufacturers without compromising outcomes. The table below summarizes the decision framework.

Instrument lifespan varies with use frequency and care quality. A needle holder in a high-volume practice may last two to three years with proper care. The same instrument in a low-volume practice may last a decade. The decision to repair or replace depends on the cost of repair relative to replacement and the instrument's role in the pack. Minor repairs such as screw replacement and sharpening are cost-effective. Major repairs such as box lock replacement often exceed the value of the instrument.

Recognized Complications and Early Detection

Instrument failure in the operating theatre rarely presents as sudden breakage. More often, it appears as progressive loss of function that the surgeon attributes to technique instead of hardware. The most common failure modes are ratchet slip, box lock loosening, jaw misalignment, and cutting edge dulling.

Ratchet slip is detected when a clamped vessel or tissue layer gradually opens during the procedure. The discriminating check is to close the ratchet on a single layer of surgical glove material and observe whether the jaws remain apposed under gentle traction. A ratchet that holds on glove material but slips on tissue has lost its interlocking surface geometry.

Box lock loosening presents as lateral play in the instrument when the jaws are closed. This permits shear forces at the tip, which crushes tissue instead of clamping it cleanly. The check is to hold the instrument closed and attempt to rotate the jaws against the shaft. Any appreciable movement indicates the box lock pin or mating surfaces have worn beyond acceptable tolerance.

Jaw misalignment in needle holders produces bent needles and erratic suture purchase. Close the instrument on a single sheet of paper and withdraw it, the perforation should be a clean circle. An elongated or torn hole indicates the jaws are meeting at an angle instead of in parallel.

Cutting edge dulling is the most insidious failure because it is gradual. Scissors that crush instead of cut create ragged wound edges and increased tissue trauma. The standard check is to cut a single layer of gauze or surgical glove material near the hinge. A sharp instrument produces a clean line with minimal pressure. Dull instruments require repeated strokes or tear the material.

Common Errors and Corrective Action

Less experienced clinicians most often err in instrument selection instead of manipulation. Using a needle holder to grasp tissue, employing hemostats as towel clamps, or cutting suture with Metzenbaum scissors all accelerate instrument wear and compromise the procedure. The corrective action is to return the instrument to its designated function and select the appropriate tool for each step.

Grip errors are equally common. Students frequently hold instruments with a full palmar grip, which reduces tactile feedback and increases tremor transmission. The correct pencil grip, with the instrument resting between thumb and index finger and the shaft stabilized against the middle finger, allows finer control. For needle holders, the grip should be positioned near the box lock, not at the distal end of the handles.

Ratchet closure errors occur when the clinician engages more clicks than necessary. Each additional click increases the force at the jaw tips and risks crushing delicate tissue. The corrective action is to close the ratchet only until the tissue is securely held, then verify by gentle traction.

A frequent error in instrument handling is failure to maintain the sterile field boundary. Instruments that extend beyond the draped edge or are passed over non-sterile surfaces must be considered contaminated. The corrective action is immediate removal and replacement, not repositioning.

Limitations of Current Evidence

The evidence base for veterinary surgical instrumentation is largely extrapolated from human surgery and biomechanical engineering studies. Direct comparative trials of different instrument brands, materials, or maintenance protocols in veterinary patients are scarce. Most recommendations on instrument lifespan, cleaning validation, and sterilization cycles derive from human operating theatre standards and manufacturer guidance.

Expert opinion differs on several practical points. The optimal frequency for instrument sharpening is contested, with some authorities recommending sharpening only when performance declines and others advocating scheduled maintenance. Similarly, the use of instrument milk or lubricants after cleaning is debated, particularly regarding residue build-up on box locks and ratchets over repeated cycles.

The integration of advanced imaging into surgical microscopes, as demonstrated in ophthalmic procedures, has shown that instrument material affects visualization of underlying tissues. Metallic instruments produce high reflectivity with complete shadowing, while silicone-tipped instruments allow partial visualization of the tissue beneath. This finding has implications for microsurgery and minimally invasive procedures, but its relevance to routine general practice surgery remains uncertain.

Robotic and computer-assisted systems have been evaluated in experimental and clinical settings for endoscopic procedures. These systems allow scaled-down instrument movement and voice-controlled camera positioning, which may reduce tremor and improve precision. However, the evidence base in veterinary medicine is limited to experimental models and early clinical reports, and the cost and training requirements currently restrict their use to specialised referral centers.

Referral, Consultation, and Reporting

Referral to a surgical specialist is warranted when the required instrumentation exceeds the capacity of the general practice pack. Procedures requiring microvascular anastomosis, advanced minimally invasive access, or specialised retraction systems are best performed in facilities with appropriate equipment and trained personnel. The American College of Veterinary Surgeons provides resources on surgical conditions and expected outcomes that can guide referral decisions.

Specialist consultation is appropriate when instrument failure compromises a procedure intraoperatively and the clinician is uncertain whether the repair or the surgical outcome is adequate. A second opinion on tissue viability, anastomotic integrity, or wound closure can prevent postoperative complications.

Laboratory involvement may be required when instrument contamination is suspected or when sterilization validation fails. Biological indicators, such as spore tests, should be used to verify sterilizer function according to the manufacturer's instructions and local protocols. Positive indicators require immediate investigation and reprocessing of all instruments processed since the last valid test.

Regulatory reporting obligations vary by jurisdiction. Reportable events may include instrument breakage with retained fragments in a patient, sterilization failures that result in surgical site infection, or equipment malfunction that causes patient harm. The World Organization for Animal Health terrestrial animal health standards address disease surveillance and reporting obligations that may apply in production animal practice. Practitioners should consult their local veterinary board or regulatory authority for specific requirements.

Frequently Asked Questions

How Should I Prioritize Instrument Purchases When the Budget Is Limited?

Prioritize instruments that appear in nearly every procedure and that fail most often when quality is poor. Needle holders, scalpel handles, Mayo scissors, and hemostatic forceps should come first. Ratcheted instruments deserve special attention because a worn ratchet or box lock compromises hemostasis and needle driving. Buy the best quality you can afford for these items, and defer specialized retractors or procedure-specific tools until caseload justifies them. Consider refurbished instruments from reputable vendors for low-risk items such as towel clamps and dressing forceps. Track repair costs over 12 months. If you spend more than half the replacement value on repairs, replace the instrument. The American College of Veterinary Surgeons animal health resources provide procedure lists that help identify which instruments are genuinely required for common surgeries.

What Are Safe Substitutes When the Ideal Instrument Is Unavailable?

Substitution decisions should preserve tissue handling and sterility. When a dedicated needle holder is missing, use a Mayo-Hegar or Crile-Wood needle holder from another pack instead of hemostats, which damage needles and suture. For delicate ophthalmic or vascular work, use the finest forceps available, even if they are not the ideal pattern. A sterile cotton-tipped applicator can replace a malleable retractor for small exposures. Do not substitute a scalpel blade for a #11 blade in stab incisions. If the correct blade is absent, use a #15 blade with a controlled, short stab. Never substitute non-sterile items or instruments of unknown sterility. Document any substitution in the surgical record. When instruments are consistently missing, review pack contents against the procedure list and adjust the standard pack.

How Do Instrument Needs Differ Between Small Animal and Large Animal Practice?

Large animal surgery places greater demands on instrument strength and length. Bovine and equine procedures require longer instruments to reach deep body cavities, and heavier patterns withstand greater torque during manipulation of thick tissue. Ratchets and box locks must be robust because large animal tissues generate higher forces during retraction and clamping. Small animal microsurgery, by contrast, requires finer patterns with precise jaw alignment. The same principles of handling apply across species, but the mechanical limits of instruments differ. A fine mosquito hemostat that serves well in feline surgery will fail under equine tension. Select instruments rated for the tissue mass and force expected in your caseload. The MSD Veterinary Manual professional edition offers species-specific surgical guidance that includes instrument considerations for common procedures.

What Records Should I Keep for Instrument Maintenance and Sterilization?

Maintain a log for each instrument set that records sterilization cycle dates, cycle parameters, and any repairs. Note the date of purchase and expected service life for high-use items. Record any instrument that fails inspection, including the nature of the failure and whether it was repaired or retired. Sterilization logs should include load contents, cycle type, exposure time, temperature, and chemical or biological indicator results. These records support troubleshooting when sterilization failures occur and provide documentation for quality assurance reviews. The American Veterinary Medical Association practice resources include guidance on practice management and quality assurance that applies to surgical instrument documentation. Keep records for at least the interval required by your regional veterinary board or accreditation body.

How Do I Explain an Instrument Failure or Sterilization Issue to a Supervisor or Client?

Describe the event factually, state what was done to protect the patient, and outline the corrective action. For a client, explain that a surgical instrument malfunction occurred, that the patient was monitored appropriately, and that the issue does not necessarily change the surgical outcome. Avoid speculation about cause until the investigation is complete. For a supervisor, provide the instrument identification, the nature of the failure, the sterilization history, and any patient impact. Recommend a specific corrective step, such as removing the instrument from service or reviewing the sterilization cycle. If a retained surgical item is suspected, disclose this promptly and follow your practice protocol for imaging and reporting. Professional communication guidelines from the American College of Veterinary Surgeons animal health resources emphasize clear, timely communication in surgical practice.

When Should I Retire an Instrument instead of Repair It?

Retire an instrument when repair cost approaches replacement cost, when the instrument has failed more than twice in the same mode, or when the failure compromises patient safety even after repair. Corrosion, pitting, or cracks in stainless steel cannot be reliably repaired. A needle holder with worn jaw inserts will continue to damage needles and suture regardless of adjustment. Box locks that wobble after repeated tightening will not hold alignment. Retire any instrument with visible cracks, bending, or loss of spring tension in scissors. Some instruments, such as towel clamps and forceps, can be repaired economically. Others, including most scissors and needle holders, are better replaced. Maintain a retirement log and remove retired instruments from the sterile field immediately to prevent accidental use.

Related Clinical & Scientific Guides

• Perioperative Antibiotic Prophylaxis: Timing and Selection
• Surgical Approaches to the Femur and Stifle
• Fracture Healing Assessment: Radiographic and Clinical Evaluation

References and Further Reading

• Integration of a spectral domain optical coherence tomography system into a surgical microscope for intraoperative imaging.. 2011.
• Use of the voice-controlled and computer-assisted surgical system ZEUS for endoscopic coronary artery bypass grafting.. 1999.
• Transoral robotic surgery (TORS): glottic microsurgery in a canine model.. 2006.
• Removal of epithelium in periodontal pockets following diode (980 nm) laser application in the animal model: an in vitro study.. 2004.
• Early experience with robotic technology for coronary artery surgery.. 1999.
• Single port sigmoidectomy in an experimental model with survival.. 2008.
• American College of Veterinary Surgeons Animal Health Resources. American College of Veterinary Surgeons.
• MSD Veterinary Manual, Professional Edition. MSD Veterinary Manual.
• American Veterinary Medical Association Practice Resources. American Veterinary Medical Association.

Related Articles

• Surgical Retractors and Exposure Techniques in Small Animals
• Surgical Biopsy Techniques: Incisional vs Excisional
• Surgical Draping Materials and Techniques for Contamination Control
• Surgical Oncology: Biopsy Techniques and Margin Assessment
• Surgical Scrub Techniques and Sterile Gowning Protocols

This article is educational professional reference material for veterinary audiences. It is not a substitute for veterinary diagnosis, individual clinical judgment, current product labeling, or applicable regulatory requirements.