Tenotomy Scissors (Stevens / Westcott / Jameson / Knapp / Castroviejo)
Fine scissors for delicate cutting and dissection, available in different blade, tip and handle patterns. Stevens tenotomy models are used in several surgical specialties; they may be useful in a suitably exposed GU field, but no reviewed source establishes a universal reconstructive-urology tray default.[1][4][5] Westcott and Castroviejo patterns offer different fine-tool geometries.[1][4][5]
Where Tenotomy Scissors Sit
Between iris scissors and Metzenbaum scissors on the fine-dissection axis:
| Scissor | Length | Tip | Best fit |
|---|---|---|---|
| Iris | Model-specific | Sharp/sharp, sharp/blunt or blunt/blunt | Fine exposed tissue, by model |
| Tenotomy (Stevens) | 11–11.5 cm in checked models | Pointed or blunt; straight or curved | Fine tissue dissection or suture cutting when permitted by the model IFU |
| Westcott | 11.4 cm in one Aspen model | Check chosen tip; spring-action pattern | Ophthalmic delicate work; selected other fine work |
| Metzenbaum | Model-specific | Model-specific | Larger soft-tissue planes, by model |
| Castroviejo / micro | Model-specific | Ultra-fine variants | Microsurgical layers when actual scale fits |
Stevens-pattern blades can be straight or curved, pointed or blunt. For example, FCI lists all four combinations, while DTR's named single-use Stevens models permit delicate tissue dissection and tissue or suture cutting.[1][4]
Reconstructive-Urology and Urogyn Uses
Stevens tenotomy — selected fine GU work
- Hypospadias and distal-urethral reconstruction. Selected fine dissection of glanular wings, urethral plate and inner-prepuce flaps during TIP / TIPU / Mathieu / onlay-island-flap; choose the actual tip and dissection plane under direct vision.
- Glansplasty and glans-resurfacing. Fine dissection on the glans and sub-glanular plane during partial glansectomy / glanuloplasty.
- Penile-shaft dissection. Fine subcutaneous-dartos plane development during partial / radical circumcision revision, frenuloplasty, minor penile-skin reconstruction, and penile-disassembly procedures.
- Vulvar / introital fine work. Labial-flap mobilization during labiaplasty, mucosal-flap dissection during posterior-vestibuloplasty, Foldès clitoral reconstruction, post-defibulation introital closure, and vestibulectomy.
- Pediatric urology. Orchidopexy plane development, ureteral-reimplant dissection in the small field, pediatric pyeloplasty, and hydrocele / hernia-sac dissection.
- Microsurgery-adjacent vasal and cord work. Adventitial trim and fine plane development during vasovasostomy and microsurgical varicocelectomy when a Castroviejo / dedicated microsurgical scissor is not on the field.
- Office and ED genital procedures. Fine dissection during meatotomy / meatoplasty, foreskin-injury repair, urethral-caruncle excision, and condyloma excision.
- Flap-pedicle skeletonization in scaled-down fields. Clearing fine adventitia from small perforator flaps and recipient vessels.
Westcott — ophthalmic-style spring-action delicate work
In RU / urogyn a spring-action Westcott may be selected for a fine reconstructive task if its scale and tip are appropriate. An Aspen Westcott model is listed as reusable for ophthalmic surgery, with a 4½-in length.[6]
- Microsurgical recipient-vessel preparation in LVA / VLNT / SCIP-LFT / CHASCIP genital lymphedema work, when a Castroviejo / dedicated microsurgical scissor is not preferred.
- Foldès clitoral reconstruction and FGM/C scar work, when prolonged fine dissection is anticipated.
Castroviejo / micro tenotomy — true microsurgical layers
- Vasovasostomy and vasoepididymostomy vasal-wall and epididymal-tubule work.
- Microsurgical penile / genital replantation vessel preparation.
- LVA and supermicrosurgical anastomotic openings.
Stevens vs Westcott — When to Pick Which
Both are tenotomy-family scissors but with different handle mechanisms and tip profiles:
| Feature | Stevens | Westcott |
|---|---|---|
| Handle | Standard ring | Spring-action (self-opening) |
| Tip | Pointed or blunt, by model | Model-specific fine tip |
| Best fit | Fine tissue work when selected tip/edge suits the plane | Fine work where spring-handle control suits the operator |
| RU/urogyn role | Possible selected hypospadias, glans, labial or peri-vasal work | Possible selected reconstruction; no routine-use evidence from ophthalmic catalog |
Technique
- Grip: ring-handle grip for Stevens; pencil / squeeze grip for Westcott; the spring-action design is built around the squeeze-and-release cadence.
- Cut and spread. DTR’s Stevens models are intended for delicate dissection and cutting tissue or sutures; FCI lists both pointed- and blunt-tip variants. Choose the tip for the exposed plane, use controlled spreading when appropriate, and cut only identified tissue.[1][4]
- Controlled cuts under direct vision protect delicate glanular or labial edges; use as many small cuts as exposure and tissue demand.
- Task and IFU: a dedicated tissue pair may protect a reusable fine edge, but DTR's named single-use Stevens models explicitly permit tissue and/or suture cutting. Choose another instrument for heavy material unless the actual model's instructions allow the task.[4]
- Care and sterility: protect fine tips from damage and follow the specific model's instructions. DTR's named models are supplied sterile, ethylene-oxide-sterilized and must not be reused or resterilized. For patients with known nickel sensitivity, the DTR IFU advises risk assessment and necessary precautions for these stainless-steel models. FCI's Stevens models are reusable; Aspen's general reusable-instrument IFU recommends steam unless a device-specific instruction overrides it.[4][6]
Named Variants
| Variant | Example geometry | Possible role when scale and exposure suit |
|---|---|---|
| Stevens tenotomy | Straight/curved and pointed/blunt variants; 11–11.5 cm examples | Selected fine GU work when model and exposure suit |
| Westcott | Spring-action, ultra-fine | Prolonged delicate work; microsurgical recipient-vessel prep |
| Jameson tenotomy | Curved, slightly heavier blades | Heavier ophthalmic / strabismus work; rarely on RU trays |
| Knapp tenotomy | Straight or curved, blunt | Specialty ophthalmic |
| Castroviejo tenotomy | Ultra-fine spring-action | Microsurgical RU layers (vasovasostomy, LVA, replantation)[3] |
Naming and Origin
"Tenotomy" denotes tendon cutting. Stevens-pattern instruments retain an ophthalmic tenotomy association and are cataloged in multiple straight or curved and pointed or blunt forms.[1][5] The history of dermatologic surgical instruments has been reviewed.[2]
See also: Iris Scissors, Metzenbaum Scissors, Mayo Scissors, Potts Scissors, Iris Forceps.
References
1. FCI. Sevrin Stevens tenotomy scissors. Current product matrix: straight/curved, blunt/pointed, reusable.
2. Gandhi SA, Kampp JT. "Dermatologic surgical instruments: a history and review." Dermatol Surg. 2017;43(1):11–22. doi:10.1097/DSS.0000000000000911
3. Chacha PB. "Operating microscope, microsurgical instruments and microsutures." Ann Acad Med Singap. 1979;8(4):371–81. PMID 539800
4. DTR Medical. Stevens Tenotomy Scissors instructions for use. DTR.M.035 Rev 1.0, July 2025; applies only to listed single-use references.
5. Uniplex UK. Stevens Tenotomy Scissors. Current product matrix: reusable 11.5-cm pointed/blunt and straight/curved variants.
6. Aspen Surgical. Westcott Tenotomy Scissors 60-1797, with linked general reusable-instrument IFU, Rev 10, 30 Apr 2026.