LARYNGOSCOPE

       A laryngoscope is an illuminating medical instrument used by healthcare providers to allow visualization of the pharynx and larynx of a patient. The pharynx is the area directly behind the nose and mouth, and the larynx is better known as the voice box. A laryngoscope is specially designed to fit into a patient's airway to allow for a procedure known as orotracheal intubation, in which a tube is inserted via the mouth into the trachea, or wind pipe, to deliver oxygen and medication and to permit deep suctioning.

There are two components to this instrument: the laryngoscope blade and the handle. The handle contains the batteries needed for illumination and the blade, which is inserted into the airway, has a bulb at the end of it from which a bright light shines during use. These blades are not sharp, and they do not cut the skin in any way. Laryngoscope blades come in different sizes, with 0 being the smallest and 4 being the largest. The size of the patient to be intubated determines the size of the blade that the healthcare provider will use.

The handle and blade of the typical laryngoscope are two separate pieces that have to be assembled before each use, but this can be accomplished in a matter of seconds, allowing doctors and paramedics to use this instrument in respiratory emergencies that require orotracheal intubation. A laryngoscope is not a large instrument; the handle is approximately the size of a door handle, and the blade is a little shorter than the handle. There are two types of laryngoscope blades: curved and straight. Both are inserted deep within a patient's airway. 

A straight blade is used to lift a leaf-shaped structure called the epiglottis, which serves to prevent food and foreign matter from entering the windpipe, and this type of blades generally is preferred when a pediatric patient must be intubated. A curved blade is preferred when an adult patient must be intubated. It is not the epiglottis that is lifted with a curved blade, which is inserted into another structure called the vallecula. Regardless of the type of blade used, the goal is the same, which is to allow visualization of the vocal cords through which the endotracheal tube can be passed into the trachea. The importance of viewing the vocal cords lies in the fact that it is vital that the doctor or paramedic performing orotracheal intubation ensures that he or she is placing the tube in the trachea and not the esophagus, the tube leading to the stomach.

GIGLI SAW

      A gigli saw is a simple medical tool that doctors have been using for centuries. Doctors use it to cut through bone. The saw is composed of a wire, two handles and a blade.

A gigli saw blade may have small, chain-style pieces that facilitate easy cutting when the user moves the handles. As the wire moves, the blade cuts through the bone. The style of the saw makes it useful for detailed surgical work. 

Although new technology has made a lot of traditional medical tools obsolete, doctors still use gigli saws. These tools are often used for cutting through the skull in brain surgery. This saw is also used to cut through other bones in other parts of the body.

Older gigli saw designs were used by doctors for amputations and other common surgeries. Some of these older saws are now medical antiques that may have collectible value. The handles of the older saws may be made of wood, or ivory. Modern saws are more likely to use synthetic materials. 

The stark visual image of the gigli saw and its unusual name make it a candidate for use in some macabre kinds of film and literature. Such a saw might also be part of a toolkit for medical students who are working on cadavers. Although the gigli saw is a tool of healing, some people may find it to be sinister in some contexts. 

In the range of modern saws available to surgeons, the gigli saw represents the unpowered variety. Other unpowered saws include hacksaws and similar designs. Doctors can also choose powered saw types like reciprocating saws. Sonic cutting saws provide a smooth result for today’s surgeries, and engineers are creating some new sonic saws that can also effectively cut tissue. 

One popular feature of the gigli saw is that it is ultra-portable. The saw takes up almost no space and travels easily. Doctors can get replacement blades, wires or handles as needed. The design of the gigli saw remains effective, and that may be one reason that doctors are still using it for a range of surgical tasks. Medical journals continue to mention some of the work that physicians are doing with simple tools like gigli saws, to help broaden the collective knowledge of the international medical community.

TROCARS

      A trocar is a surgical instrument with a sharp point which is used to create a hole in the body which can be used to introduce surgical tools. Trocars are most commonly attached to tubes known as cannulas, with surgical tools being passed down the cannula, through the trocar, and into the body. Trocars are widely used in laparoscopic surgery procedures. They are also utilized by the funeral industry, during the embalming process.

Although trocars are traditionally sharp, the blade can come in a number of styles, from the classic three pointed blade on a traditional trocar to a blunt blade on a non-bladed version of the instrument. Trocars can also be shielded, with small shields which click into place to prevent damage to a patient's internal organs after the trocar has been inserted. These devices are often designed to be single use, with the trocar discarded after use in a patient.

One use for the trocar in human and animal medicine is for aspiration. If a patient has a buildup of fluid or gas, a trocar can be quickly inserted and connected to an aspiration tube to remove the buildup. This can greatly increase comfort for the patient, acting as an emergency intervention to stabilize the patient until a doctor can determine what caused the buildup and address the problem. In laparoscopic surgery and surgical procedures on the veins and arteries, trocars are used as ports, creating a point of entry for tools used during the surgery. After the surgery is finished, the device is carefully removed and small stitches are put in place.

Trocars come in a range of sizes, designed for various applications. A surgical trocar may be quite large, to allow for the introduction of surgical tools, and the surgeon can usually select from several styles and sizes to find the most appropriate tool for a procedure. Various devices can also be attached to the instrument, such as aspiration machines, ports used for the delivery of medicine, and so forth.

In the embalming process used to prepare bodies for burial, the trocar is used to gain venous access for arterial embalming. Once the embalming is complete, another trocar connected to an aspiration machine is inserted into the abdomen to drain gas and fluids. This is designed to prevent bloating of the body, as the embalming process does not halt the process of decomposition, only slowing it considerably.

MOUTH GAG

      A mouth gag is any kind of device used to hold the mouth open or to keep the wearer from speaking. Mouth gags can vary widely in design and can be made of anything from rubber balls to stainless steel. They are used in dentistry and surgery in order to hold a patient's mouth open. A mouth gag may also be used in adult erotic play.

A mouth gag can assist in keeping a patient's mouth open if he has been sedated for painful dental work or surgery. It can also help patients who have difficulty keeping their mouth open for other reasons. When placed in the mouth, the mouth gag keeps the teeth apart while still allowing for a surgeon or dentist to work inside.

Dental mouth gags are usually made of stainless steel so that they can be easily cleaned and sterilized. They usually consist of a thick metal wire shaped into a rough oval, which is placed inside the mouth. Some other kinds of mouth gags resemble a pair of pliers, which can be locked in an open position to hold the mouth open on one side. 

A surgical mouth gag is used to keep a patient's mouth open while they are sedated and unconscious. Some surgical mouth gags come with built-in steel tongue depressors in order to hold a patient's tongue in place. This allows for the surgeon to have easier access to the throat. Surgical mouth gags are used during operations on adenoids, tonsils, and other surgeries which require access to the throat.

Mouth gags used in erotic play have a different purpose than those used in dentistry or surgery. Instead of holding the mouth open, they are used to keep the wearer from speaking clearly. Though they seldom are made well enough to keep someone from making noise, they can provide a powerful visual in games of power exchange. 

Erotic mouth gags are often made of materials that can be bitten into without harming the wearer. To this end, they often take the form of a soft rubber ball. The ball is held in the mouth by a strap that passes around the head. In some designs, the ball can be taken off the strap for easy sterilization. 

These gags can also take the form of simple strips of tape or cloth which go over the mouth or between the teeth. To further block the mouth, a piece of cloth might be stuffed inside the mouth before putting the gag over the wearer. This kind of simple gag can usually be defeated by movements of the tongue, which can push the fabric out of the way.

EAR SYRINGE

     An ear syringe is a medical device that is used to introduce or remove fluids from the ear. The design is also known as a bulb syringe and it can also be used in the nose. Ear syringes are available at many drug stores and they can also be obtained through a doctor's office. If a doctor prescribes a treatment that requires this device, one may be provided or packaged with the treatment for the convenience of the patient.

These devices consist of a rubber bulb attached to a short tube. They can be disposable or designed for multiple uses. By compressing the bulb to squeeze the air out, people create a pressure differential inside the syringe. When the tube is inserted into the ear or nose and the pressure is released, the syringe will suck up fluids, such as water and mucus. The same technique can be used when dipping the syringe into a fluid being used for treatment to fill it up.

A common reason to use an ear syringe is to clean out the ear. Syringing the ears after swimming, surfing, and engaging in other activities in the water can reduce the risks of inflammation and infection by keeping the ear as dry as possible. In addition, the syringe can be filled with a fluid solution to break up ear wax for the purpose of removing wax from the ears.

Care must be taken when squirting fluids into the ear with an ear syringe. Although the pressure is not very high, it can potentially damage the ear drum and cause hearing loss. It is also important to thoroughly syringe all of the fluid out afterward. The process can also be messy. People are usually advised to hold their heads over a towel to catch drips and overflow.

If an ear syringe is going to be reused, it needs to be cleaned after each use. It may also be advisable to limit use to a single person to reduce the risk of spreading infections. Cleaning is accomplished by filling the syringe with an antibacterial solution, such as a blend of alcohol and water or hydrogen peroxide and water and then squeezing the fluid out to flush the ear syringe.

Ears should not be flushed if there is a foreign body inside, if someone cannot hear from the affected ear, or if the ear is painful. Instead, a doctor should be consulted to clean and examine the ear.

ATRAUMATIC / DEBAKEY Froceps

      Debakey forceps are a type of surgical forceps used to hold vascular vessels and tissue. They are specifically known for being atraumatic, or non-damaging. They are capable of holding soft tissues, blood vessels, and other delicate body parts without causing harm. By squeezing the blades, surgeons are able to capture tissues between the blunt tips and hold them in order to perform surgical operations or hold the tissues out of harm's way. A common nickname for Debakey forceps is magics or magic forceps.

Often resembling standard tweezers in design, Debakey forceps are one of the most widely used pieces of surgical equipment, especially in cardiovascular surgery. The blades consist of two flat pieces of metal connected at one end so that the blades point away slightly from each other in a narrow A-shape. Squeezing the blades together creates spring tension so that the tips can grip. Debakey forceps usually require a specific spring tension to allow for easy opening and closing without undue force that could damage sensitive tissues.

The blades will either taper gradually down to a thin, straight tip or truncate with the slender cylindrical tip attached. Most have ridged blades to provide traction for gripping. The tips have a very specific design — the interior surface of the slim, blunt-ended tips features microscopic teeth designed to fit together on closing. These teeth grip blood vessels or other tissues with enough friction to provide a firm hold without damaging them. 

The forceps are generally crafted from stainless steel or other surgically-safe, easily-sanitized material. Straight forceps average 4.75 inches (12 cm) in length, but can be up to 9.5 inches (24 cm) long. Depending on the use, such as intestinal forceps, the design may vary to include different sizes or even curved blades. Many forceps also use hybrid designs pairing Debakey dips with other models, such as the Debakey-Satinsky forceps or the Allis-Debakey forceps. These can be paired with forceps clamps to grip delicate tissues during suturing and other procedures.

Debakey forceps are named after Michael E. Debakey, a pioneer in medical science and development. He made several groundbreaking discoveries in surgical medicine, including techniques in blood vessel grafting, replacement, and repair. He also invented devices such as the roller pump, the first successful external heart pump — and of course, the Debakey forceps, which were originally designed for vascular surgery. Debakey also introduced the practice of video-recording surgical procedures.

MAGILL Forceps

      Designed by the physician Sir Ivan Whiteside Magill in the 1920s, Magill forceps are one of several tools that aided in the development of modern anesthesia. The tool combines long forceps with an angled handle, which keeps the hand out of the line of vision when a physician is inserting or removing tubes from the trachea or esophagus. Magill forceps also are used to remove small objects from the throat or mouth.

Also known as Magill’s forceps, Magill forceps come in several standard sizes. In addition to a 9.5-inch (24-cm) size used for adults, there’s also a 7.5-inch (19-cm) size for use on children. An extra-small size of 6 inches (16 cm) is used for babies. These various lengths allow physicians to use the proper length of instrument depending on the patient’s size. Like many medical tools that are inserted into the body to perform a task, Magill forceps are made of stainless steel, which makes them easy to clean and sterilize.

The history of Magill forceps goes back to World War I. Born in 1888 in Ireland, Magill developed his approach to anesthesia after seeing accidental battlefield deaths caused by anesthesia overdosing. At that time, patients were anesthetized using a rag soaked with chloroform. The chances of overdose were great with this inexact administration.

Magill recognized a need for equipment inserted into patients' throats so they could be anesthetized continuously and safely throughout surgery. On his way to achieving this goal, Magill developed many tools, including tubing for the throat and nose, the Magill forceps for inserting and removing the tubing and a rudimentary breathing system that eventually evolved into modern-day anesthesiology systems.

With their curved handle and ease of operation, Magill forceps soon became useful for removing objects from the airways. They have been used in emergency rooms and critical-care centers to extract small toys or toy pieces swallowed by children. Medical literature has recorded the use of Magill forceps to retrieve something as small as a safety pin from the upper esophagus of a child.

Magill forceps also have been used to insert throat packs prior to oral surgery. Made of a porous, sponge-like material, throat packs are used to absorb blood and other fluids and keep them from entering airways. An oral surgeon can use these forceps to guide a throat pack into place and, if need be, to help remove it.