Mayo Scissors
Heavy, robust surgical scissors — the universal standard for cutting fascia, dense connective tissue, sutures, and dressings. Part of the "common core" of surgical instruments stocked on every operating-room tray across specialties and continents.[1][2] Available in straight and curved configurations, each with a specific operative role.
Design
- Blades: thick, heavy, more robust than Metzenbaum or iris scissors; semi-blunt tips minimize the risk of inadvertent injury to surrounding structures.
- Blade-to-handle ratio: blades are roughly equal to or longer than the handles — distinguishing the Mayo from the Metzenbaum (which has short blades on long handles for fine dissection).
- Configurations:
- Straight Mayo — the standard suture / dressing / drain scissor at the operative field; tip is straight and blunt.
- Curved Mayo — gentle curve along the blade for cutting heavy intra-operative tissue (fascia, dense connective tissue, large pedicles).
- Length: 14 cm (5.5 in) to 23 cm (9 in); 17 cm (6.75 in) is the daily workhorse size. Long Mayo at 22.5 cm reaches deep pelvic fields.
- Material: surgical-grade stainless steel.
Reconstructive-Urology and Urogyn Uses
Curved Mayo — tissue cutting
The fascial and dense-tissue scissor for every open RU/urogyn case:
- Rectus fascia and external-oblique aponeurosis — division and trim during open BNR, augmentation, urinary diversion, AUS pump-pouch incisions, and re-do laparotomies.
- Fascial-sling harvest — rectus-fascia / fascia-lata strip cutting for pubovaginal-sling harvest.
- Tunica vaginalis and dartos — division during open hydrocelectomy, varicocelectomy, IPP / AUS scrotal exposure.
- Bovie-eschar trimming — sharpening the cut edge after monopolar incision when a clean approximation is needed.
- Dense peri-vesical and retroperitoneal scar — re-do pelvic exposure for re-do BNR, re-do AUS, re-do diversion.
- Mesh trimming — cutting polypropylene or biologic mesh to size at the field.
- Bowel mesentery — coarser mesenteric work during diversion / augmentation where a finer Metzenbaum slips off.
- Specimen division during partial cystectomy, partial nephrectomy, radical orchiectomy.
Straight Mayo — suture and material cutting
The suture scissor at the field:
- Suture cutting at every step of every open RU/urogyn case — the closest instrument to the surgeon's right hand throughout.
- Drain and tube trimming — cutting Penrose, red-rubber, channel-drain, and Foley to length at the field.
- Dressing and packing material — cutting Kerlix, gauze rolls, and vaginal packing strips.
- Skin-staple removal adjunct — assisting with adhesive-strip cutting.
The straight Mayo is not for tissue work — keeping straight Mayos as the dedicated suture-and-material scissor preserves the curved Mayo's edge for tissue. Most teams enforce this distinction at the back table.
Blunt dissection
The closed tips of a curved Mayo can be used to spread tissue planes in coarse blunt dissection — but the Metzenbaum is the better instrument for fine planes. Reserve the Mayo for dense peri-fascial planes, mature scar, and adhesion takedown where the Metzenbaum would deflect.
Mayo vs Metzenbaum
The two universal pelvic scissors are routinely paired on the field; the distinction is well-evidenced:[1]
| Feature | Mayo | Metzenbaum |
|---|---|---|
| Blade thickness | Heavy, robust | Thin, delicate |
| Blade-to-handle ratio | Blades ≥ handles | Short blades, long handles |
| Primary tissue | Fascia, muscle, dense connective tissue | Fat, areolar tissue, peritoneum, thin membranes |
| Dissection style | Coarser cut-and-divide | Fine sharp / blunt dissection |
| Non-tissue use | Sutures, dressings, drains (straight Mayo) | Generally not for non-tissue cutting — protect the edge |
Anglo-American practice converges on Mayo + Metzenbaum as the irreducible "common core" of scissors across institutions and specialties.[1]
Care and Maintenance
- Dedicate the straight Mayo to non-tissue cutting and reserve the curved Mayo for tissue — crossing roles dulls the edge faster than any other single factor.
- Inspect the cutting edge before each case; a dulled Mayo crushes rather than cuts, and crushed fascia is harder to re-approximate cleanly.
- Sharpen or replace on a defined cycle; institutional sterile-processing programs typically replace scissors on a wear-driven schedule rather than time alone.
Historical Context
Named for the Mayo brothers — William James Mayo (1861–1939) and Charles Horace Mayo (1865–1939) — co-founders of the Mayo Clinic in Rochester, Minnesota.[2][3] The Mayo brothers' contributions to American operative surgery span gastric, biliary, thyroid, and oncologic surgery, and the eponymous Mayo stand — the small wheeled instrument table positioned at the operating field — bears their name alongside the scissors. The Mayo line is part of a broader genealogy of eponymous surgical instruments that defines the standard operative tray.[3]
See also: Metzenbaum Scissors, Electrosurgical Pencil, Bonney Forceps.
References
1. Pepper T, McMillan D, Jenzer A, et al. "Transatlantic tools of the trade: Anglo-American instrumentation in oral and maxillofacial surgery." Br J Oral Maxillofac Surg. 2026;64(3):223–33. doi:10.1016/j.bjoms.2025.12.006
2. El-Sedfy A, Chamberlain RS. "Surgeons and their tools: a history of surgical instruments and their innovators — part I: place the scissors on the Mayo stand." Am Surg. 2014;80(11):1089–92.
3. Strulak L, Gronki F, Shariat K, Schöni D, Alfieri A. "Eponyms of cranial neurosurgical instruments: an international collaboration to optimize the field of neurosurgery." World Neurosurg. 2021;153:26–35. doi:10.1016/j.wneu.2021.06.073