[Illustration: FIG. 60.—Various forms of raspatories employed in detaching the muco-periosteal flaps in uranoplasty. The three in the left-hand lower corner are used for detaching the flaps anteriorly (After _Durham_).] [Illustration: FIG. 61 A, B, C.—Fine hook forceps. Long smooth-nosed forceps. Knife for paring the edges of the cleft (_Mason_).] A small scalpel, raspatories of various shapes, right and left-handed (Fig. 60), long smooth-nosed, and fine hooked forceps, and a long-handled, narrow-bladed, very sharp paring-knife (Fig. 61) are necessary. For seizing the edge of the cleft in order to remove the mucous membrane therefrom, the surgeon will find the forceps depicted in Fig. 62 extremely useful; they are an adaptation of a pair of German trachelorraphy forceps, and possess the following advantages: first, by their angular prehension they can seize the exact edge of the palate, and then when seized, the hold is maintained by means of a spring catch in the handle. It is obvious that a pair of straight hooked forceps (Fig. 61 A) introduced into the mouth cannot so certainly seize the edge, whilst the slightest relaxation of the fingers causes it to loose its hold. [Illustration: FIG. 62.—Angular long-handled catch forceps (the teeth are a little coarser than in the original).] [Illustration: FIG. 63.—Various forms of needles employed in palate operations. The left-hand figures show the double-curved needles used in suturing the uvula.] The _needles_ best adapted for this work deserve a somewhat detailed description, inasmuch as the clumsy forms generally in use twenty years ago have been superseded by much more satisfactory and delicate instruments, which inflict less injury in passing through the palatal structures. Those most commonly employed are a special modification of the Hagedorn type of needle (Fig. 63), long, narrow, measuring with the handles about eight inches, fine, curved, and flattened laterally, with a small eye near the point, and so ground and set that there is only a short cutting edge on the convex side close to the extremity. The advantage of this is that when introduced quite close to the edge of the palate, its blunt concave border directed towards it has no tendency to cut its way out, whilst the convex cutting edge makes a track for the needle and suture to follow. It is manifest that the incision thus made is at right angles to the margin of the cleft, and consequently when the suture is drawn tight, the tendency is rather to close than to open the needle track. With the old needles making as they did in their passage an incision parallel with the edge of the cleft, the tightening of the suture caused the opening to gape, and this occasionally resulted in the establishment of a fistulous aperture leading to subsequent trouble. (Compare Figs. 64 and 65.) Mr. T. Smith emphasised this point as far back as 1868. (_Vide_ an interesting paper of his in ‘Med.-Chir. Trans.,’ vol. 51.)