Jarrod Shapiro, DPM
Practice Perfect Editor
Assistant Professor,
Dept. of Podiatric Medicine,
Surgery & Biomechanics
College of Podiatric Medicine
Western University of
Health Sciences,
St, Pomona, CA

What’s That Instrument Called?

When I was a student and resident, I dutifully learned the names of all the surgical instruments needed to perform foot and ankle surgery (among many others). Without any thought to why our instruments are named as they are, I blindly went through my training and very early practice years without a consideration for why a Freer elevator was named as it was, or why a Weitlaner retractor was called a Weitlaner. As it turns out, when we are in the OR, we are surrounded by ghosts of the past who left their names indelibly on our collective operative unconscious. So, here’s a quick description of some of our more common OR instruments.

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Weitlaner retractor - Do you call this one a "wheatlander" or "wheetie"? You might be surprised to know this instrument is correctly pronounced "VIGHT - lahn - er" after Franz Weitlaner a physician born in 1872 in Welsburg, Italy. In 1905, he published the first description of his retractor, which was modeled after the Broz wound-dilator (looked similar but had a screw mechanism rather than the ratchet type we use today). What I find ironic is that Dr Weitlaner asked for no monetary compensation, exchanging money for naming rights. And today no one pronounces it correctly! Lister scissors (AKA bandage scissors) - This instrument, carried in the pockets of almost all podiatric students, residents, and many attendings, is named after the famous Joseph Lister (1827-1912) who popularized the antiseptic method that we use today. You may be interested to know that the original antiseptic method was done using carbolic acid, what we call phenol and use for nail procedures. Surgeons would wash their hands in a dilute phenol solution and walk through a mist of the substance. To realize how connected the world is, you just need to know that William Halstead’s nurse (later his wife) contracted a severe dermatitis from using carbolic acid, which led Dr. Halstead to create the rubber glove. It wasn’t to protect the patient, but rather the staff! Interestingly, Dr. Lister also introduced absorbable cat gut sutures into medical use. Allis forceps - This forcep was the creation of Dr. Oscar Huntington Allis (1826-1921) who originally created this instrument to handle the ends of intestines during surgical anastomosis. Our contemporary use of this instrument in foot and ankle surgery is an excellent example of coopting something for a new purpose. Bard Parker Scalpel Handle - Ever wonder why we call this handle by its name? Morgan Parker was the nephew of a physician who was frustrated using the then common straight-edged disposable blades invented by King Gillette (of Gillette razor company fame) in 1905. To help his uncle, Parker created the 2-piece scalpel in 1915, allowing for blade replacement. Parker was then encouraged by the American College of Surgeons to mass produce his instrument, so in classic style, he opened the telephone book (no Google back then, of course) to the first medical supply company he saw: the Bard Company. The Bard Parker company was born! Think about that the next time you make an incision. Freer elevator - Did you know it’s not pronounced "free-er" but rather "freer" (long E, one syllable)? This instrument is not named based on its ability to "free" anything, but rather after Otto Tiger Freer (1857-1932) a Chicago surgeon who created this elevator to correct deflections of the nasal septum. When an instrument is this useful, it can’t stay in the ENT arena for long! Kocher forceps - This highly useful instrument was invented by Theodor Kocher (1841-1917), a then internationally famous Swiss surgeon who pioneered thyroid surgery. His forceps came in handy when handling the thyroid and associated tissues. Incredibly, he is the first of only two surgeons in history to receive the Nobel prize. I’ll leave it up to you to find the other one. Mayo scissors - This most famous of instruments was created by the Mayo brothers, William Charles Mayo (1861-1939) and Charles Horace Mayo (1865-1939). No one knows which brother actually invented the scissors. The Mayo’s father was a physician and both brothers followed suit. In 1883, a tornado swept through Rochester, Minnesota, damaging the town. The Mayo brothers collaborated with a group of nuns from a local convent to provide medical care to the town. As a result, the nuns raised money for a hospital and asked the Mayos to be their surgeons, and the Mayo Clinic was born We really do stand on the shoulders of giants. Next time you go into the OR, think about all the men and women who contributed to our current techniques and technologies. It’s hard to appreciate history while it’s occurring, but take just a second and consider. I wonder: in a hundred years, will anyone know who invented the Weinraub retractor?