ABSTRACT
Surgical Instruments Like most surgeons do, I have assembled for my personal use (and I treasure) a custom tray of surgical instruments specifically for carotid surgery. Some of these instruments are standard favorites, while others have been specially designed or modified by the Scanlan Company of St. Paul, Minnesota. For a number of years I have marketed, with Scanlan, the Scanlan-Loftus® carotid set, a complete set of essential instrumentation for carotid procedures (A). In (B), we illustrate specifically four Scanlan-Loftus scissors; two types of Pott’s scissors to open the vessel (large and small, depending in the vessel size and degree of calcification), and also two sets of specially designed Metzenbaumtype scissors, again large and small, which I use for the dissection and exposure steps (large), and for fine work around the internal carotid or for plaque trimming in the CCA (small). In (C), I have illustrated the large and small “bulldog” clamps I use for closure of the internal and external carotid arteries. The large strong clamp occludes the ECA nicely to prevent backbleeding, while the smaller weaker clamp occludes the ICA without causing intimal damage. Finally, in (D), I show the simple Rummel-type tourniquet, handmade by the scrub nurse, which I use (with an encircling 0 silk tie) to occlude the CCA around a shunt tube if shunting is needed. If no shunt is required, the CCA is occluded throughout the case with a DeBakey-type cross-clamp only.
