It has been said that "a good carpenter knows his tools." Similarly, skilled surgeons must know the applications and limitations of the instruments they regularly use. Novice surgeons usually select instruments according to the advice and habits of their surgical mentors. Personal experience modifies, and often limits, the selection of instruments eventually used by the advanced surgeon. The economic forces at work to standardize operative costs may further limit the choice of instrumentation.
Surgical instruments are, in many ways, simply extensions of the human hand. There is inevitably a "feel" for different instruments designed to accomplish the same purpose. This topic review is an effort to familiarize the reader with basic instrumentation for gynecologic surgery and advantages of individual instruments. The author has put forth some of his preferences for instrumentation based upon his experience, but is cognizant that satisfactory alternatives exist.
Surgical instruments used for laparotomy are discussed here. Instruments for laparoscopic surgery are discussed separately. (See "Instruments and devices used in laparoscopic surgery".)
The exposure and conduct of a surgical procedure depends upon use of cutting instruments that are properly chosen to accomplish a specific task.
Scalpel — The traditional surgical scalpel, available in a variety of sizes and shapes, is adequate for most gynecologic procedures. Disposable blades can be firmly attached to the scalpel handle using a needle holder.