| Small hemostatic forceps ([Fig. 195]) | 12 |
| Medium-sized forceps | 2 |
| Large forceps ([Fig. 196]) | 4 |
| Knife ([Fig. 197]) | 1 |
| Scissors—two pairs of long scissors, one straight and one curved on the flat. | |
| Pedicle-needles ([Fig. 198]) | 2 |
| Cyst-trocars ([Figs. 199] and [200]) | 2 |
| Straight, spear-pointed needles, 2½ inches in length,for closing the abdominal incision by the mass-suture. | |
| Curved needles for suturing within the abdomen.Fine straight and curved needles for the repair of intestinalinjuries. | |
| Large curved needles for catgut, etc. | |
| Abdominal retractors (blunt) | 2 |
| Needle-holder ([Fig. 201]) | 1 |
| Long dressing-forceps | 2 |
Three sizes of twisted silk are used for suture and ligature: heavy silk for ligature of the large arteries; medium silk for ligature of smaller vessels and for various suturing in the abdomen; fine silk for peritoneal and intestinal suture.
Fig. 198.—Pedicle-needle.
The silk should be as small as is consistent with secure ligature. The heavy silk is necessary for the ligature of pedicles in which a large amount of surrounding tissue is included with the artery.
Fig. 199.—Small curved trocar.
The silk is rolled on glass spools or on cores of gauze, contained in glass tubes plugged with cotton, and is then sterilized in the steam sterilizer by fractional sterilization. It is advisable always to use, for heavy ligature, silk of a uniform size, because the operator becomes accustomed to the strength of the silk and knows just how much strain it will bear. Silkworm-gut is the best material to use for suture of the abdominal incision in case the “through-and-through” or interrupted mass-suture is employed.
The silkworm-gut should be of the heaviest and the longest size. It may be sterilized by boiling with the instruments before the operation.
