Top Surgical Scissors for Precision and Efficiency in Every Procedure

Every little child has a fascination with scissors. There is something uniquely satisfying about using them first to cut paper, make intricate design holes on paper, then fabric, and then more difficult to cut material. It is a great pleasure to snip, shape, and create. They are often the first tool entrusted to children, thanks to their seemingly harmless design. A scissor’s blades tucked safely inside handles, so there are less chances of injuring oneself. Besides, their motion is easily manageable, and the purpose is clear: cutting!

It is but natural that the world of surgery, which is a fine art of cutting and healing; scissors are a fundamental tool.

In surgery, scissors are far more than playful tools. They are extensions of a surgeon’s skill, judgment, and finesse. Nearly every surgical procedure employs scissors at some point. 

While the first incision is often made with a knife, usually called a scalpel, it is the scissors that are frequently used to ‘open’ subcutaneous tissue, not by closing their blades, but by gently spreading them apart to dissect and delicately separate tissue layers, with precision.

For cutting sutures when the wound has healed, the scissors are the indispensable instrument.

These humble instruments, refined over centuries, are necessary tools in the operating theatre.

A Brief History of Scissors: From Ancient Egypt to Modern ORs

The earliest known scissors date back to 1500 BCE in ancient Egypt. These were single-piece, spring-type scissors made of bronze, where the two blades were connected at the handle by a thin, flexible strip of metal. Later, around 100 CE, the Romans developed the more modern cross-blade design with a central pivot, the fulcrum, allowing for smoother cutting action.

In India, particularly in Anjar, Gujarat, the tradition of crafting knives and scissors is centuries old. This village has produced generations of skilled artisans, known for their meticulous craftsmanship and high-quality steel implements. Even today, Anjar-made instruments are sought after for their durability and precision. Tailors proudly show their ‘Anjar’ scissors even in 2025 CE!

The Universality of Surgical Scissors

Scissors are used in:

• General surgery

• Neurosurgery

• Cardiothoracic surgery

• Plastic surgery

• Ophthalmic procedures

• Orthopaedic surgeries

• Obstetrics and gynaecology

• ENT surgeries

• Dermatological procedures

• Emergency trauma settings

• Laparoscopic and robotic surgery

No surgical specialty is exempt. Their applications include:

• Cutting skin, fascia, and muscle

• Dissecting soft tissues by opening the scissors

• Cutting sutures or bandages

• Holding or manipulating fine structures

• Assisting in needle placement

Anatomy of a Scissor: Simple Yet Sophisticated

Most surgical scissors operate on a single central fulcrum or pivot point. The components include:

• Handles: Controlled by fingers

• Blades: The cutting ends, straight or curved

• Tips: Can be sharp, blunt, or one of each

• Shaft: The length of the scissor determines the depth of access

The geometry of the blade (angle, sharpness, length) varies to suit specific tasks, offering surgeons nuanced control in different environments.

Types of Surgical Scissors

Let’s categorize surgical scissors based on their usage and design:

1. Suture Cutting Scissors

• Straight or slightly curved

• Often serrated to prevent slipping

• Used for cutting sutures cleanly and quickly

2. Fine-Pointed Scissors (e.g., Iris or Tenotomy)

• Used in ophthalmology, plastic surgery, paediatrics

• Ideal for delicate, small-scale work

3. Trauma Scissors / Bandage Scissors (e.g., Lister)

• Blunt lower tip to slide under bandages or clothes

• Strong enough to cut through clothing or gauze or clothes

• Often used in the Emergency Room to cut through clothes and expose wounds

4. Mayo Scissors

• Heavier build, used for cutting muscle or fascia

• Straight or curved

5. Metzenbaum Scissors

• Long and thin with a curved blade

• Excellent for delicate tissue dissection

6. Potts Scissors

• Angled tips for vascular and cardiac surgery
  
  

7. Jorgensen Scissors

• Gynaecologic surgeries, especially hysterectomies
  
  

8. Castroviejo Scissors

• Microsurgical work (neurosurgery, ophthalmology)
  
  

9. Needle Holder and Scissors Combo

• This hybrid instrument is used in minor surgeries

• Saves time by combining suture placement and cutting

10. Endoscopic/Laparoscopic Scissors

• Long shaft, narrow blades

• Some are electrocautery-enabled for cutting and sealing bleeders simultaneously

11. Utility and Disposable Scissors

• For use in wards, dressing rooms, and emergency care

• They are often disposable to reduce the risk of infection 

Self Sharpening 

Unlike knives, scissors have a unique self-sharpening mechanism built into their design. During each cut, the inner edges of the blades rub against one another at an angle. This consistent contact helps maintain a keen edge over time. As long as the scissor blades are properly aligned and tensioned, this rubbing action hones the cutting surfaces, preserving sharpness naturally. This is especially true for high-quality surgical scissors made from hardened steel or with tungsten carbide inserts. However, excessive use or cutting inappropriate materials can disrupt this self-sharpening effect, eventually requiring professional resharpening to restore optimal performance.

Scissors with the fulcrum or pivot at one end

Whether these types of scissors may be called a scissor per se, is a good question. But they can be called scissors! Their main advantage is that more force can be applied at the cutting blade. Following are a few examples of surgical scissors with a fulcrum near the end, designed for precision and leverage in specific procedures:

1. Lister Bandage Scissors – Pivot at the end, with a blunt lower blade to safely cut bandages without skin injury.
   

2. Hook-Tip Scissors (e.g., LaGrange Enucleation Scissors) – Used in eye surgery, with a distal pivot for controlled cutting during procedures like enucleation.
   

3. Metzenbaum Dissecting Scissors (Long Variants) – Some extended versions have an offset pivot for deep-tissue dissection in thoracic or pelvic surgery.
   

4. Iris Scissors (Westcott Style) – Fine-tipped with a near-end pivot, ideal for delicate ophthalmic and microsurgery.
   

5. Potts-Smith Cardiovascular Scissors – Angled blades with a rear pivot for precise vessel cutting in cardiac surgery.
   
   

These designs enhance control and reduce hand fatigue in specialized surgical tasks.

Materials: What Are Surgical Scissors Made Of?

1. Stainless Steel (Surgical Grade)

• Corrosion-resistant

• Durable and easy to sterilize

• Affordable

2. Tungsten Carbide Inserts

• Harder than steel

• Edges stay sharper longer

• Usually added to blade edges only

3. Titanium

• Lightweight

• Non-magnetic (good for MRI and microsurgery)

• Corrosion-resistant

• Expensive

Pros and Cons:

• Stainless Steel: Reliable, cost-effective, but needs sharpening

• Tungsten Carbide: High performance but adds cost

• Titanium: Top-tier performance and longevity, but expensive

More Than Just Cutting

Though designed for cutting, surgical scissors often double as multi-purpose tools:

• Dissection: Separating tissue planes

• Spreading: Blunt tips are used to open spaces

• Needle holding: Especially in small procedures or field settings

• Tactile feedback: Experienced surgeons use pressure and resistance felt through the scissors to judge tissue consistency

Risks of Scissors: In and Out of the OR

In Everyday Life:

• Cuts and injuries from sharp tips

• Children misusing adult scissors

• Blunt scissors can lead to accidents due to added force

In Surgery:

• Accidental injury to nearby nerves, vessels, or organs

• Blunt blades lead to tissue crushing instead of cutting

• Instrument failure (e.g., loose pivot or poor alignment)

• Cross-contamination if not sterilized properly

• Improper use (e.g., using Metzenbaum for cutting sutures), causing rapid wear

Surgeons and nurses are trained to use each type of scissors appropriately to reduce these risks.

The Art and Science of Choosing the Right Scissors

The surgeon chooses based on:

• Procedure type

• Tissue involved

• Depth of field

• Hand feel and balance

• Personal preference and experience

A cardiac surgeon might reach for Potts scissors the way a plastic surgeon picks Iris scissors – each with confidence born from experience.

Handing the scissors to the surgeon during surgery when needed

In the realm of the operating room or theatre, every gesture matters. When handing a scissor to the surgeon, it must always be presented with the handles facing the surgeon, blades closed, and curved (if any) aligned correctly. This simple act, done smoothly and with care, shows respect for both the instrument and the hands that will wield it. Passing the scissors blades-first is not only unsafe—it’s a breach of trust and etiquette that may earn the assistant a flurry of unprintable @%$#*&^! Surgeon-speak vocabulary! A calm, correct handover keeps the mood steady and the team in perfect sync.

Conclusion: Indispensable Champions of the Surgical Table

From ancient Egypt to modern robotic surgery, scissors have evolved from basic tools to sophisticated surgical instruments. Their basic design remains familiar, yet their applications are as varied as human anatomy.

Scissors deserve far more respect than they get. Quietly resting in trays beside forceps and scalpels, they rarely make headlines. But to a surgeon, the right scissor at the right moment is not just helpful – it is essential.

Next time you hand a child a pair of safety scissors, think of the centuries of refinement behind those blades, and how those simple tools someday might become instruments of healing in the right hands.

Author’s Note: This blog aims to inform and fascinate both medical professionals and lay readers about the incredible diversity and utility of surgical scissors. From Gujarat’s blade-making artisans to titanium-bladed marvels, we owe much to this humble tool.