Very few maneuvers in surgery are done without some sort of surgical instrument. Each step in a surgery-from initial incision to the final suture-is done using a surgical instrument. These surgical instruments can be very specialized. In fact several different surgical instruments can be used to do the very same thing. Some instruments have seemingly unlimited numbers of designs, for instance, surgical graspers.
As the name implies, surgical graspers allow the surgeon to grasp and hold on to things without touching them directly (i.e. with a gloved hand). One general design feature of surgical graspers includes a comfortable hand-grip so that it does not easily slip if one were to wet and slippery hands from blood or other fluids. Surgical graspers will also vary in length. This allows a surgeon to reach structures deep within the body without putting hand and forearm deep into the surgical field. Surgical graspers with long reaches allow for smaller surgical wounds since, rather than a hand going into the field, a thin instrument is all that needs to pass.
The business end of surgical graspers is where the true variability and assortment rest. The surgical graspers are called upon to hold skin, blood vessels, bones, and other human tissues. Some are delicate and others are hearty. Some tissues would be damaged by too much pressure while others would slip if they were not held securely.
In addition, surgical graspers may be used to hold other instruments or materials. Suture graspers must hold the suture needle and the suture thread intermittently. Surgical graspers are also used to introduce tubes, lines, and artificial devices. Since surgical graspers must hold both biological and surgical substances, the side of the surgical graspers that is actually grasping can look like just about anything.
In most cases surgical graspers with have two or three prongs that can grab and hold on to the target. The handles will be levered so that they provide just the right amount of pressure on the target but not too much to damage. This is another reason that the type of surgical grasper should be carefully selected based on the specific surgical task. For example, surgical graspers that would be used to suture blood vessels together would not be appropriate as suture graspers and vice versa.
One advancement that has greatly improved the delivery of medical and surgical care is the introduction of surgical graspers into laparoscopic and endoscopic devices. A laparoscope and an endoscope are thin tubes that enter the body through small incisions or bodily orifices, respectively. These devices allow doctors to see inside the body, but also to perform certain procedures.
Laparoscopic graspers may be introduced through a trocar or small portal in the body. The laparoscopic graspers are actually at the end of a very long, thin device that is controlled by special grips connected at the other end (outside of the body). The laparoscopic graspers can hold and move tissues and objects inside of the body while the surgeon views the action on a monitor. The monitor is getting images from the laparoscope inserted in a different trocar.
Endoscopic graspers are attached to the same tube as the endoscope. When the endoscope is advanced, for instance through the colon or the bronchus of the lung, the endoscopic graspers can be used to hold on to tissue and even perform a biopsy or excision in some cases.