The following instrument is used in which surgery?

AIIMS Delhi NO- 2019

Medical Surgical Nursing

Easy

Appeared in: AIIMS Delhi NO- 2019

Explanation

The instrument depicted is a Lahey forceps, also known as a Lahey goiter clamp.
Its key features are long shanks, curved jaws with transverse serrations, and a ratchet lock, which are visible in the image.
This specific design is intended to securely grasp the firm and vascular tissue of the thyroid gland.
Therefore, its primary and specific use is during a thyroidectomy, the surgical removal of the thyroid gland.

Option B: Abdominal surgery involves a wide range of procedures on organs within the abdomen, requiring instruments like bowel clamps, laparotomy retractors, and general surgery tools. The Lahey forceps is not part of a standard abdominal surgery set.
Option C: Thoracotomy is a surgical incision into the chest wall. It requires specialized heavy-duty instruments such as rib spreaders (e.g., Finochietto retractor) and lung-grasping forceps, which are structurally very different from the instrument shown.
Option D: A Cesarean section is an obstetric procedure to deliver a baby. It uses specific instruments such as a bladder retractor, uterine clamps (e.g., Green-Armytage), and sometimes obstetric forceps for the baby. The Lahey forceps has no role in this surgery.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification and application of surgical instruments as background academic context rather than a clinical decision trigger.
For an operating room nurse, correctly identifying and anticipating the need for specific instruments like the Lahey forceps is crucial for the efficiency and safety of the surgical procedure.
Handing the surgeon the correct instrument at the right time minimizes delays and allows the surgeon to focus on the delicate dissection required in a thyroidectomy.
What if? If the surgeon was removing a lymph node from the neck (cervical lymphadenectomy) instead of the thyroid, they might request a more delicate clamp like an Allis or Babcock forceps, as the Lahey clamp's strong grip could crush the more fragile lymphoid tissue.

How to Approach the Question

First, carefully examine the image of the surgical instrument. Note its distinct features: the length, the shape of the jaws (curved), the pattern on the inner surface of the jaws (transverse serrations), and the type of handle (ratchet lock).
Based on these features, identify the instrument. This is a Lahey forceps or goiter clamp.
Recall the specific function of this instrument. The name 'goiter clamp' is a major clue, as a goiter is an enlargement of the thyroid gland.
Consider the options provided. A thyroidectomy is the surgical removal of the thyroid gland.
Match the instrument's function to the surgical procedures listed. The Lahey forceps is designed for grasping the thyroid, so it is used in a thyroidectomy.
Eliminate the other options by considering the types of instruments used in those surgeries (e.g., abdominal, thoracic, obstetric instruments).

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