Which of the following instruments are commonly used during a cesarean section?

A. Green amytage forceps

B. Shirodkars clamp

C. Doyens retractor

D. Scalpel with BP holder

E. Allis forceps

F. Cusco and Karman

1. A

   a, c, d, e

2. B

   b, c, d, f

3. C

   a, b, e, f

4. D

   a, c, e, f

Appeared in: INI-CET EXAM -2025

Explanation

• Green-Armytage forceps are specifically designed hemostatic forceps used to clamp the angles of the uterine incision during a C-section to control bleeding.
• Doyen's retractor is a large, broad abdominal retractor essential for retracting the urinary bladder inferiorly to protect it from injury during the uterine incision.
• A scalpel with a Bard-Parker (BP) handle is the fundamental cutting instrument used to make both the skin and uterine incisions.
• Allis forceps are used to securely grasp and hold dense tissues, such as the layers of the abdominal wall (fascia), while they are being incised or sutured.

Why Other Options Were Wrong

• Option B: This option includes Shirodkar's clamp (b) and Cusco/Karman instruments (f), which are not used in a standard cesarean section.
• Option C: This option includes Shirodkar's clamp (b) and Cusco/Karman instruments (f), which are incorrect for a cesarean section.
• Option D: This option includes Cusco and Karman instruments (f), which are used for vaginal and cervical procedures, not an abdominal C-section.

Related Visual

• Visual 1: Image - A tray of surgical instruments for a cesarean section, with labels pointing to the Green-Armytage forceps, Doyen's retractor, scalpel, and Allis forceps to help with visual identification.
• Visual 2: Diagram - A simplified illustration showing the placement of the Doyen's retractor to protect the bladder during a C-section.

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of surgical instruments used in a Cesarean Section as background academic context rather than a clinical decision trigger.
• Knowledge of surgical instruments is crucial for the scrub nurse and the entire surgical team to ensure the procedure is efficient and safe. Anticipating the surgeon's needs and providing the correct instrument promptly reduces operative time and potential complications.
• A 'What if?' scenario: If Green-Armytage forceps were unavailable, the surgeon might use multiple standard hemostats (like Kelly or Crile forceps) to control bleeding from the uterine angles, but this would be less efficient and might not provide as secure a clamp on the thick uterine muscle.
• Proper instrument counting before, during, and after the procedure is a critical patient safety measure to prevent retained surgical items, a serious but preventable complication.

How to Approach the Question

• First, read the question and the list of instruments carefully. The question asks for instruments used in a cesarean section.
• Analyze each instrument in the list (A-F) and recall or determine its primary function in obstetrics and gynecology.
• Identify instruments used for abdominal surgery (C-section) versus those used for vaginal or cervical procedures.
• Eliminate instruments not used in a C-section. For example, Shirodkar's clamp (cervical cerclage) and Cusco's speculum (vaginal exam) are incorrect.
• Review the remaining instruments (Green-Armytage, Doyen's, Scalpel, Allis) and confirm their roles in a C-section (hemostasis, retraction, incision, tissue grasping).
• Finally, select the option that contains only the correct instruments.

Concept Tested & Keywords

• Concept Tested: Identification of surgical instruments used in a Cesarean Section.
• Stem keywords: instruments, cesarean section
• Lead-in keywords: Which of the following

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