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Instruments Used in Cesarean Section (C-Section) Surgery

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1. CUTTING & INCISION INSTRUMENTS

Scalpel Handle (No. 3 & No. 4) with Blades (No. 10 & No. 22)

• Used to make the initial skin incision (Pfannenstiel or midline) and the uterine incision.
• Blade No. 10 is used for skin; No. 22 for deeper layers.

Bandage / Uterine Scissors (Bandage Scissors)

• After the initial scalpel nick on the uterus, these scissors extend the uterine incision laterally to open the lower uterine segment safely.

Mayo Scissors (Curved & Straight)

• Heavy-duty scissors for cutting tough fascial layers, sutures, and scar tissue.
• Curved Mayo = tissue dissection; Straight Mayo = cutting sutures at the skin/fascia level.

Metzenbaum Scissors

• Lighter, finer scissors for delicate tissue dissection - used when opening the peritoneum and bladder flap.

Spencer Ligature Scissors (Suture Scissors)

• Dedicated scissors for cutting suture/ligature material during wound closure.

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2. GRASPING & HOLDING INSTRUMENTS (FORCEPS)

Sponge Holding Forceps (Ring Forceps / Foerster Forceps)

• Oval-ringed jaws to hold gauze sponges for skin preparation (painting the operative field with antiseptic) and for intraoperative sponging/mopping.

Allis Tissue Forceps

• Ratcheted clamp with interlocking teeth to grasp fascia, peritoneum, and uterine edges during incision and closure.

Littlewood Tissue Forceps

• Heavier grasping forcep for slippery or tough tissue - similar role to Allis but with stronger grip.

Artery Forceps (Mosquito / Crile Hemostatic Forceps)

• Straight and curved; used to clamp bleeding vessels and for hemostasis throughout the procedure.

Kocher Clamps (Straight Hemostatic Forceps)

• Single heavy tooth at the tip; clamp large tissue pedicles, the uterine edges, and the fallopian tube if needed.

Babcock Forceps

• Atraumatic, fenestrated jaws to grasp and elevate bowel or soft tubular structures gently.

Russian / Dressing Forceps (Thumb Forceps)

• Thumb-and-finger operated; used during suturing to hold tissue edges together and guide suture placement.

Tissue Forceps with Teeth (Adson / Toothed Forceps)

• Fine-tipped with small teeth for delicate grasping of skin and fascial edges during closure.

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3. RETRACTORS (Exposure)

Doyen Retractor (Bladder Retractor)

• A broad, curved, flat blade inserted to push the urinary bladder downward and away from the uterine incision site, protecting it from injury.
• Removed before delivery, reinserted after for closure visualization.

Langenbeck Retractors (Pair)

• Flat, L-shaped hand-held retractors used by assistants to hold the skin and subcutaneous edges apart during fascial and skin closure.

Morris Retractor / Balfour Retractor

• Larger self-retaining abdominal retractor for deeper exposure of the abdominal cavity.

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4. CLAMPING INSTRUMENTS

Backhaus Towel Clamps

• Small pointed clamps used to secure sterile drapes around the operative field, keeping them in place throughout the surgery.

Green-Armytage Forceps (Uterine Angle Forceps)

• Specifically designed to grasp and control the bleeding angles (corners) of the uterine incision after delivery of the baby. Essential for hemostasis at the uterine wound edges.

Heaney Clamps / Zeppelin Clamps

• Curved clamps for broader pedicle clamping during uterine closure or in case of extension.

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5. SUTURING INSTRUMENTS

Needle Holder (Heaney / Mayo-Hegar / Curved)

• The instrument held in the surgeon's hand to drive suture needles through tissue layers. The gold-ring handles (TC - tungsten carbide) shown in the image above are a common variety.
• Used extensively to close the uterus (2-layer closure), peritoneum, fascia, and skin.

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6. DELIVERY INSTRUMENTS

Outlet / Simpson / Wrigley Forceps (Obstetric Forceps)

• Used to guide and deliver the fetal head through the uterine incision, especially if the head is impacted in the pelvis.

Vacuum Extractor (Ventouse Cup) - optional

• An alternative to forceps for fetal head delivery through the uterine incision.

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7. MISCELLANEOUS / ACCESSORY INSTRUMENTS

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Summary: C-Section Instrument Categories at a Glance

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Source note: Instrument list compiled from Jalal Surgical C-section guide and the APGO Surgical Instruments module for OB/GYN.