Freer Septum Elevator, Double Ended Sharp and Blunt, 18cm

What the Freer septum elevator is

The Freer septum elevator is a hand instrument used to separate soft tissue from cartilage and bone inside the nose. Surgeons also call it a Freer elevator, a Freer periosteal elevator, a Freer nasal elevator, a Freer mucoperichondrial elevator or a Freer septal dissector. It is made by Adas Instruments in high quality medical grade stainless steel, and it is reusable and fully autoclavable.

One end is ground to a point for the first cut through the perichondrium and the other is rounded for lifting the flap clear, so a single 18 cm instrument covers both moves.

The work an elevator does is always the same in principle. A layer of soft tissue is stuck to the cartilage or bone under it, and it has to come off in one sheet without a hole in it. Get that right and the rest of the operation has a dry field and a flap that will lie back down. Get it wrong and you are repairing a tear for the next ten minutes. That is why the shape of the working end, the stiffness of the blade and the length of the shaft are the three things that decide which pattern a surgeon picks up.

Key design features of the Freer septum elevator

• Sharp end starts the perichondrial incision at the mucosal junction
• Blunt end raises the mucoperichondrial flap without tearing it
• Blade width 5.0 mm, flat ground, satin finished to cut glare under the lights in an operating room
• Overall length 18 cm, about 7 in, with a knurled flat handle for a pencil grip
• High quality medical grade stainless steel, reusable and autoclavable

The handle is flat and knurled rather than round. A flat handle tells you where the blade is facing without looking at it, and the knurling holds when a glove is wet. The shaft runs straight into the blade with no step, so there is no shoulder to catch on the rim of a nostril and nothing for protein to sit in after a case.

Freer elevator sizes and build options

Every size below is a size we actually ship. Imperial figures are given beside the metric because United States buyers search in inches.

Nothing is listed above that we do not hold. If a length you need is not in the table, ask, because a pattern like this is often made to order for an OEM run and a different length is a tooling change rather than a new instrument.

Uses of the Freer septum elevator by specialty

The Freer septum elevator appears on the same trays across these specialties because the job is the same one each time, lifting a tissue plane cleanly off what lies under it.

The specialty name and the procedure name are both worth knowing when you order, because catalogues file this pattern under whichever of the two the buyer used. An operating room manager searches by procedure and a purchasing office searches by specialty, and they are looking for the same instrument.

Tissue planes the Freer septum elevator works in

An elevator handles no suture and no needle. What decides the choice of pattern is the plane it has to open and how much force that plane takes.

Force is the part nobody writes down. Perichondrium on young cartilage lifts with almost nothing. Mucoperiosteum on the bony septum needs a firm push and a stiff blade behind it. Scarred tissue in a revision case needs more again, and that is the point at which a light blade starts to flex and the plane is lost. Match the blade to the plane and the instrument does the work instead of your wrist.

How the Freer septum elevator compares with other patterns

These four sit next to each other on a nasal tray and they are not interchangeable.

Surgeons who use this pattern usually also hold the Cottle septum elevator, the Boies nasal fracture elevator and the McKenty nasal septum elevator. The closest relative in the range is the McKenty nasal septum elevator double ended.

If you are building a nasal tray from scratch, the usual answer is two elevators rather than one. Something light for cartilage and something stiffer for bone covers almost every case, and the third and fourth patterns get added for the particular operations a unit does often.

Materials and finish

The instrument is made in high quality medical grade stainless steel. The steel itself is made to a German specification. The blade is flat ground and satin finished, which cuts glare under the lights in an operating room and keeps the working end readable against wet tissue. There is no coating to chip and nothing on the shaft to trap protein.

Stainless steel is chosen here for a reason that has nothing to do with appearance. An elevator is levered, and a levered instrument that is too hard will crack at the neck while one that is too soft will take a set and stay bent. The grade used for this pattern sits between the two, which is why the blade can be thinned at the working end without losing the shaft.

Freer septum elevator care and sterilization

Rinse the instrument in cool water straight after use so blood does not dry on the blade. Clean it with a soft brush and a neutral pH enzymatic detergent, rinse in deionized water, then dry it completely. Steam autoclave at 134 degrees Celsius. Lay it in the tray so the blades do not rest against other instruments, because a bruised edge on an elevator is what tears a flap.

Look at the working end against the light before every case. A blunt end should be smooth with no flat spot and no nick, and a sharp end should still take a clean line. An elevator that has been dropped on a tiled floor is the one that buttonholes a flap two cases later, and it costs nothing to check.

Ordering and wholesale

This pattern is supplied by Adas Instruments to hospitals, surgical distributors and OEM buyers, in single units and in bulk. The item code is ADR-160.18 and it is printed in the size table above so a procurement search finds it. Backorder items dispatch in 10 to 12 working days. Every instrument carries a three year replacement against manufacturing defects.

For wholesale and OEM orders, instruments ship unpackaged in bulk or individually poly bagged, and laser marking with a distributor code or a hospital asset number is available on the shaft. Tell us the quantity and the marking you need and the quotation comes back with the lead time for that run rather than a stock figure.

Production is controlled under an ISO 13485 quality management system.

Frequently asked questions

What is a Freer elevator used for?

The Freer elevator lifts the mucoperichondrial and mucoperiosteal flaps off the nasal septum in septoplasty and rhinoplasty. Surgeons also use it to raise periosteum over the nasal dorsum and, in oral and maxillofacial work, to lift full thickness mucoperiosteal flaps.

What is the difference between the sharp and blunt end on a Freer septum elevator?

The sharp end makes the first incision through the perichondrium at the mucosal junction. The blunt end then raises the flap in a broad atraumatic sweep, so the membrane is separated rather than cut.

What is the difference between a Freer elevator and a Cottle elevator?

Both are double ended septal elevators, but the Freer pairs one sharp end with one blunt end, while a standard Cottle is spatulate at both ends and carries no depth markings. Choose the Freer when you want to start and raise the flap with one instrument.

Is a Freer elevator used in dental or oral surgery?

Yes. Oral and maxillofacial surgeons use the Freer periosteal elevator to raise full thickness mucoperiosteal flaps, and the blunt end is the working end for that job.

How do you clean and sterilize a Freer periosteal elevator?

Rinse it in cool water straight after use, clean it with a soft brush and a neutral pH enzymatic detergent, then rinse in deionized water and dry it fully. It is then steam autoclaved at 134 degrees Celsius, and the flat handle should be laid so the blades do not touch other instruments.

Related products and categories

Surgeons who work with the Freer septum elevator usually compare it against the Cottle septum elevator, the Boies nasal fracture elevator and the McKenty nasal septum elevator. The whole family sits in dissectors and elevators, and this pattern is also listed under rhinoplasty instruments.