Lacrimal instruments
(In this section, only instruments designed specifically for dacryocystorhinostomy are shown)

Rollet rugime for peeling the periosteum. This instrument has a sharp edge which is used to cut 
the periosteum and peel it to expose the lacrimal and ethmoid bone.

Traquair's periosteum elevator. After peeling back the periosteum with the roller to expose the lacrimal 
fossa, this instrument can be used to dislocate the lacrimo-maxillary suture. Once the suture is dislocated, osteotomy can commence with the bone punch. During the osteotomy, Traquair can be used from time to time to separate the nasal mucosa from the bone to avoid inadvertent tearing of the nasal mucosa.

Kerrison ronguers. This instrument is used to enlarge the osteotomy and it comes in different sizes and can be up-biting (as shown here) or down-biting. The blunt tip of the rongeur is placed against the nasal mucosa and rotated, dissecting the nasal mucosa from the underlying bone. In so doing, it allows the cutting edge to slip behind the bone without damaging the nasal mucosa.

Belz lacrimal rongeur. It is usually used to remove the spine of bone present between the nasal mucosa and the nasolacrimal duct. 

A set of lacrimal probes. During DCR, it helps to identify the exact location of the
lacrimal fundus and facilitate dissection of the lacrimal sac.

Werb's scissors, the angled tips allow cutting of the lacrimal sac to form flaps. It is also 
useful for cutting the nasal mucosa to create anterior and posterior flaps.

More instruments