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Use and Misuse of Instruments

Last Updated: September 27, 2018

Figure 1: Harvey Cushing demonstrated the appropriate use of his dissecting instrument during a subtemporal approach for avulsion of the Gasserian ganglion to treat trigeminal neuralgia (circa ~1909)(Courtesy of Cushing Brain Tumor Registry at Yale University).

The notion that a surgeon should operate by using instruments in the most comfortable manner should be challenged. The surgeon must recognize the correct methods for using the multitude of available microsurgical tools. It is most important that the methods and instruments chosen protect normal structures and handle the underlying pathology thoroughly and efficiently.  In the right hands, simple instruments lead to execution of complex and effective maneuvers. It is ultimately the handling of the instrument that defines surgical...