Autopsy Tools

Ed Uthman, MD
Diplomate, American Board of Pathology

I don't know how anyone can make a living by manufacturing and selling autopsy tools. They last forever, and no one ever steals them (instrument pilferage, which ran rampant before mandatory employee drug testing radically reduced the demand for roach clips, was never much of a problem in the morgue). Accordingly, most practicing prosectors today are using tools that were purchased decades ago by earlier generations of pathologists. For most of us, who learned how to actually do autopsies from uneducated and/or illiterate dieners, these tools are nameless implements that we employ empirically to do what we think they will do, whether they were originally designed to do so or not. Learning to use these instruments is a completely nonverbal process, which lends credence to the anthropological notion that tool-using by early hominids could have preceded the evolution of spoken language. The upshot is that, while some of the instruments shown below probably have proper eponymic designations, neither I nor any of the hundred-odd subscribers to the PATHO-L mailing list who have hit this site know what they are. If anyone reading this knows any synonyms for these tools, please e-mail me.

Enterotome

These large scissors are used for opening the intestines. The bulb-ended blade is inserted into the lumen (the hollow inside) of the gut, and the instrument is smoothly stripped down the length of the intestine. The blunt bulb keeps the internal blade from perforating the gut from the inside.

Skull chisel

After scoring the calvarium (the vault-like part of the skull that holds the brain) with the vibrating saw or hand saw, the chisel is used to gently finish the separation of the top of the calvarium from the lower skull, thus exposing the brain and its coverings (meninges).

Hagedorn needle

Also called the sailmaker's needle, this is a large needle with an eye for sewing up the body after the autopsy is finished. The stitching is similar to that used on the outer covering of baseballs. Heavy twine, which is much coarser than suture, is used for the procedure.

Rib cutters

These look like small pruning shears and are used to cut through the ribs prior to lifting off the chest plate. Some prosectors actually use pruning shears from a hardware store, which are much less expensive.

Scalpel

This differs from the surgeon's scalpel in having a longer handle for reaching deeper into body cavities. The disposable blade is usually a #22 size, which is the largest commonly available.

Toothed forceps

The teeth on these "pickups" lend strength in gripping heavy organs for removal. In surgical pathology, teeth are a liability in that they increase the risk of cross contamination between specimens, so untoothed forceps are used there.

Scissors

These are otherwise unremarkable scissors used for opening hollow organs (such as the gallbladder) and trimming off tissues. They can also be used for blunt dissection by means of an "opening" motion, rather than the more familiar "closing" motion used in cutting.

Bone saw

This hand saw is rarely used today, most often by pathologists who fear infection from aersols thrown up by the much more vigorous vibrating saw (see below). The hand saw can be used to saw through the skull, but it's very slow-going compared to the vibrating saw.

Hammer with hook

The hammer (perhaps the Beatles' inspiration for "Maxwell's silver hammer"?) is used with the chisel to separate the calvarium from the lower skull. The hook is handy to pull the calvarium away.

Breadknife

Also referred to simply as the "long knife," this is used to smoothly cut solid organs into slices for examination, display, and photography of the organs' cut surfaces. Particularly facile prosectors pride themselves on being able to do almost all of the soft tissue dissections (including stripping the gut from the mesentery and opening the heart chambers) with this large, unlikely-looking blade. The example shown here includes a disposable blade. Models with permanent, resharpenable blades are also available.

Vibrating saw

The vibrating saw, also referred to eponymously as the "Stryker saw," is the instrument of choice for most prosectors faced with removing the brain. The blade reciprocates rapidly with a small amplitude. This action prevents the saw from cutting soft tissues, notably the prosector's hand. The disadvantage of vibrating saws is that they throw up more potentially infectious aerosols than do hand saws.

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Originally posted 23 Feb 1999. Last revised 24 Feb 1999
Copyright © 1999,Ed Uthman, MD. Free for noncommercial use