Abstract:
An adjustable surgical instrument stringer, tray system, and method of sterilization comprising, in general, a one or more axis adjustable stringer to be inserted into the finger rings or ring handles of the surgical instruments to sequentially group the surgical instruments, a surgical instrument tray and lid configured with a pattern of sterilization apertures, the lid having two or more recessed valleys configured to receive the stringer of ringed surgical instruments and releasably hold the surgical instrument therein.

Description:
PRIORITY CLAIM 
       [0001]    To the full extent permitted by law, the present United States Non-provisional patent application, is a Continuation-in-Part of, and hereby claims priority to and the full benefit of United States Non-provisional application entitled “Surgical Instrument Tray System and Method of Sterilization,” having assigned Ser. No. 13/284,099, filed on Oct. 28, 2011, incorporated herein by reference in its entirety. 
     
    
     TECHNICAL FIELD 
       [0002]    The disclosure generally relates to surgical instrument receptacle, organizational system and, more specifically, is related to a stringer and tray system for retaining a collection of surgical instruments for sterilization, transport and storage. 
       BACKGROUND 
       [0003]    Present day surgical procedures regularly use sets of pre-selected surgical instruments for a specified surgical procedure, such as clamps, hemostat, forceps, scissors, retractors, and the like. These instruments are regularly grouped together to form a set. The set of surgical instruments is stored in a sterilized condition until required for surgery. Prior to sterilization the set of surgical instruments is subject to a time consuming multi-step sorting, identifying, grouping, cleaning and sterilization process. The set of surgical instruments is collected post operation, co-mingled in a wire mesh basket or holed tray for transport to the central sterile processing area. Next, the basket or tray of surgical instruments is placed in a wash sink to brush and manually wash the surgical instruments to remove any foreign debris, such as tissue or dried body fluid. Next, the basket or tray of surgical instruments is transported to and run through an automated washer/decontaminator. Next, the basket or tray of surgical instruments is transported to and emptied out on a sorting table where a technician inspects, counts and sorts each surgical instrument into groupings of instruments for a specified surgical procedure. Next, pivoting or hinged scissor-like surgical instruments are commonly sequentially grouped using a fixed stringer, bar or retaining rod positioned through both of the finger rings or ring handles, and the set is laid or positioned in a basket or tray. Next, the basket or tray of surgical instruments is placed in a sealed container and sealed before entering the sterilization machine. Next, the wrapped or containerized basket or tray of surgical instruments is placed in an industrial sterilization machine/autoclave for sterilization of the surgical instruments. Next, the sealed sterilization container of surgical instruments is stored until transported to an operating area for use as required. When needed the sterilized surgical instruments are transported to the operating room where the surgical instruments are removed from the basket or tray and arranged on a stand or instrument roll in a configuration that enables efficient transfer to a surgeon. 
         [0004]    Much time is utilized during the process of cleaning, sorting, counting, and grouping procedure for the assembly and sterilization of surgical instruments. In addition, the onset of infectious diseases has dramatically increased the biohazard risk for medical personnel and central sterile personnel handling post operation cleaning, sorting, counting, and grouping of surgical instruments due to potential contact with sharp surgical instruments, such as needles. Such contact may result in loss of work for recovery, testing for contamination, and/or a workers compensation claim. 
         [0005]    Furthermore, surgical instruments are often damaged when transported, stacked one on the other as well as when the surgical instruments are emptied out on a sorting table for a technician to inspect, count, and sort. Such handling may scratch, bend and may even break the surgical instruments resulting in increased cost to replace such instruments, which are often delicate and expensive. Such damage to the surgical instruments reduces the life expectancy of the surgical instruments resulting in increased medical costs to replace the surgical instruments. Moreover, if such damaged surgical instruments are accidentally returned to the operating room, such surgical procedures may be delayed or cancelled due to non-functioning surgical instruments causing lost revenue for the surgery center and an upset surgical team and patients in queue. 
         [0006]    Still further, the environmental impact of the above multi-step process of pre-washing, automated washer/decontaminator, and running the surgical instruments through industrial sterilization machine/autoclave requires large quantities of water, sterilization chemicals and energy. 
         [0007]    Yet still further, counting the surgical instruments before and after surgical procedures is particularly important for ensuring that no instruments are left in the patient after the operation procedure has been completed. 
         [0008]    Yet still further, one problem with fixed or hinged stringers, bars or retaining rods is that the stringer is not adjustable to string, group or accommodate a variety of surgical instruments nor do such fixed stringers enable adjustment to hold or maintain a variety of surgical instruments in an open position ready for sorting, identifying, grouping, cleaning and sterilization. 
         [0009]    Therefore, it is readily apparent that there is a recognizable unmet need for an adjustable surgical instrument stringer and tray system and method of sterilization that reduces the time spent cleaning, sorting, counting, identifying and grouping surgical instrument, extends the life expectancy of the surgical instruments, provides an adjustable stringer, and decreases the contamination potential of the surgical instruments by maintaining the surgical instruments in a side-by-side open configuration during cleaning and sterilization. 
       SUMMARY 
       [0010]    Briefly described, in an example embodiment, the present apparatus and method overcomes the above-mentioned disadvantages and meets the recognized need for an adjustable surgical instrument stringer, tray system, and method of sterilization comprising, in general, a one or more axis adjustable stringer to be inserted into the finger rings or ring handles of the surgical instruments to sequentially group the surgical instruments, a surgical instrument tray and lid configured with a pattern of sterilization apertures, the lid having two or more recessed valleys configured to receive the stringer of ringed surgical instruments and releasably hold the surgical instrument therein and, thus such apparatus, functions to removeably secure the surgical instrument in a group for identification, cleaning, sterilization, and storage prior to surgery. 
         [0011]    According to its major aspects and broadly stated, the present system meets the recognized need for An adjustable stringer configured to string the ring handles of one or more surgical instruments including two or more rod sections, each rod section configured with at least one angle section therein, and wherein each rod section is configured to be inserted in one ring handle of the one or more surgical instruments, and two or more slidable coupler sections, each slidable coupler section configured to extend and retract two of said two or more rod sections. 
         [0012]    In a further exemplary embodiment of a surgical instrument support tray configured to support a plurality of ring handled surgical instruments including a surface configured to support the plurality of surgical instruments, the surface further includes two or more valleys formed in parallel in said surface and configured to receive the ring handled surgical instruments, and a stringer having at least two rod sections, each rod section configured to be inserted in one ring handle of the plurality of ring handled surgical instruments. 
         [0013]    In a further exemplary embodiment of a method of organizing surgical instruments having ring handles comprising the steps of providing a stringer having two or more rod sections, each rod section configured with at least one angle section therein and two or more slidable coupler sections, each slidable coupler section configured to extend and retract two of the two or more rod sections, inserting each rod section in one ring handle of the one or more surgical instruments to group the one or more surgical instruments, providing a surface configured to support the plurality of surgical instruments, the surface further comprises two or more valleys formed in parallel in the surface and configured to receive the ring handled surgical instruments, adjusting the two or more slidable coupler sections of said stringer to fit the two or more valleys formed in parallel in the surface, and positioning said stringer of the ring handled surgical instruments in two of the two or more valleys formed in parallel in the surface to releasably retain the ring handles of the surgical instruments evenly spaced in an open jaw position. 
         [0014]    Accordingly, a feature of the adjustable surgical instrument stringer, tray system, and method of sterilization is its ability to reduce the time required to identify, clean, sort, count, and group surgical instrument between surgeries. 
         [0015]    Another feature of the adjustable surgical instrument stringer, tray system, and method of sterilization is its ability to organize, protect and enable thorough cleaning and sterilization of surgical instruments. 
         [0016]    Still another feature of the adjustable surgical instrument stringer, tray system, and method of sterilization is its ability to accommodate a variety of surgical instruments, such as size, shape, angle of bend, tip type, instruments purpose and the like all in one support tray system. 
         [0017]    Yet another feature of the adjustable surgical instrument stringer, tray system, and method of sterilization is its ability to rapidly identify the appropriate instrument in the tray during sorting, counting, and grouping of the surgical instrument post-surgery, during pre-wash, pressure washing, sorting, grouping, sterilization or storage for pre-surgical use. 
         [0018]    Yet another feature of the adjustable surgical instrument stringer, tray system, and method of sterilization is its ability to rapidly identify and select the appropriate surgical instrument during surgery without confusion and lapse of time and to also identify all surgical instruments post-surgery. 
         [0019]    Yet another feature of the adjustable surgical instrument stringer, tray system, and method of sterilization is its ability to reduce inefficiency and waste in turning around sterile surgical instruments as set forth in the Affordable Care Act. 
         [0020]    Yet another feature of the adjustable surgical instrument stringer, tray system, and method of sterilization is its ability to decrease the loss of surgical instruments, decrease the time to count the surgical instruments before and after surgical procedures, and decrease assembly time of surgical instrument sets. 
         [0021]    Yet another feature of the adjustable surgical instrument stringer, tray system, and method of sterilization is its ability to reduce surgical instrument inventory or reduce the need for additional capital expenditures due to increased surgical volume as a result of more efficient processing time. 
         [0022]    Yet another feature of the adjustable surgical instrument stringer, tray system, and method of sterilization an adjustable surgical instrument stringer, tray system, and method of sterilization is its ability to enable a uniform cleaning process for reducing the potential for surgical site infection. 
         [0023]    Yet another feature of the adjustable surgical instrument stringer, tray system, and method of sterilization is its ability to reduce the occurrences of malfunctions, delays or cancellations during the surgical procedure due to improperly inspected or cleaned surgical instruments. 
         [0024]    Yet another feature of the adjustable surgical instrument stringer, tray system, and method of sterilization is its ability to reduce the capital budget for repairs associated with care and handling of surgical instruments. 
         [0025]    Yet another feature of the adjustable surgical instrument stringer, tray system, and method of sterilization is its ability to integrate the surgical instrument support tray as the tray top of box like container. 
         [0026]    Yet another feature of the adjustable surgical instrument stringer, tray system, and method of sterilization is its ability to reduce the number of sharps being sent to central sterile and the reduction of accidents associated with needle/sharps injuries. 
         [0027]    Yet another feature of the adjustable surgical instrument stringer, tray system, and method of sterilization is its ability to inventory surgical blades and needles after being disengaged therefrom. 
         [0028]    Yet another feature of the adjustable surgical instrument stringer, tray system, and method of sterilization is its ability to color coordinate a group of trays within a surgical service for easy identification for specific surgical specialties. 
         [0029]    Yet another feature of the adjustable surgical instrument stringer, tray system, and method of sterilization is its ability to reduce surgical instrument damage when transporting, stacking, sorting, inspecting, counting, and/or when empting out on a sorting table for a technician to inspect, count, and sort. Such handling may scratch, bend and may even break the surgical instruments resulting in increased cost to replace such instruments, which are often delicate and expensive. Such damage to the surgical instruments reduces the life expectancy of the surgical instruments resulting in increased medical costs to replace the surgical instruments. 
         [0030]    Yet another feature of the adjustable surgical instrument stringer, tray system, and method of sterilization is its ability to sort, identify, group, clean, and sterilize and to further prevent damaged or improperly cleaned surgical instruments from accidentally being returned to the operating room, where such surgical procedures may be delayed or cancelled due to non-functioning surgical instruments and further causing lost revenue for the surgery center. 
         [0031]    Yet another feature of the adjustable surgical instrument stringer, tray system, and method of sterilization is its ability to reduce the environmental impact of the multi-step process of pre-washing, automated washer/decontaminator, and running the surgical instruments through industrial sterilization machine/autoclave to reduce the requirements for large quantities of water, sterilization chemicals and energy. 
         [0032]    Yet another feature of the adjustable surgical instrument stringer, tray system, and method of sterilization is its ability to provide an adjustable stringer to group or accommodate a variety of surgical instruments and provide adjustment to hold or maintain a variety of surgical instruments in an open position ready for sorting, identifying, grouping, cleaning and sterilization. 
         [0033]    These and other features of the adjustable surgical instrument stringer, tray system, and method of sterilization will become more apparent to one skilled in the art from the following Brief Description of the Drawings, Detailed Drawings, Detailed Description and Claims when read in light of the accompanying drawings. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0034]    The present adjustable surgical instrument stringer, tray system, and method of sterilization will be better understood by reading the Detailed Description of the embodiments with reference to the accompanying drawings, in which like reference to numerals denote similar structures and refer to like elements throughout, and in which: 
           [0035]      FIG. 1  is a perspective view of an example adjustable stringer; 
           [0036]      FIG. 2  is a top view, side view and bottom view of the adjustable stringer of  FIG. 1 ; 
           [0037]      FIG. 3  is an exploded perspective view of the adjustable stringer of  FIG. 1 ; 
           [0038]      FIG. 4.1  is top views of an example surgical instrument for storage in the surgical instrument support tray system shown herein; 
           [0039]      FIG. 4.2  is perspective view of a plurality of surgical instruments of  FIG. 4.1  shown strung together; 
           [0040]      FIG. 5.1  is perspective view of an example embodiment box like tray bottom and lid surgical instrument support tray system with exemplary adjustable stringer position thereon; 
           [0041]      FIG. 5.2  is an exploded perspective view of an example embodiment box like tray bottom and lid surgical instrument support tray system with exemplary adjustable stringer; 
           [0042]      FIG. 5.3  is a top and cross sectional view of an example embodiment box lid and surgical instrument support system; 
           [0043]      FIG. 5.4  is a top and cross sectional view of an example embodiment box like tray bottom and internal small box support system; 
           [0044]      FIG. 6.1  is a perspective view of an example embodiment of a surgical instrument support tray system with exemplary adjustable stringers shown in two positions affixed to the top or lid of the surgical instrument support tray system; 
           [0045]      FIG. 6.2  is a perspective view of an example embodiment of a surgical instrument support tray system with a plurality of surgical instrument sets held by exemplary adjustable stringers to the top of the surgical instrument support tray system; 
           [0046]      FIG. 7.1  is an exploded perspective view of the attachment device of FIG.  5 . 2 . 2 ; 
           [0047]      FIG. 7.2  is a perspective view of an alternate exemplary attachment device of  FIG. 7.1 ; and 
           [0048]      FIG. 8  is a flow diagram of a method of sorting, identifying, grouping, counting, cleaning, pressure washing, sterilizing, and storing prior to surgical use. 
       
    
    
       [0049]    It is to be noted that the drawings presented are intended solely for the purpose of illustration and that they are, therefore, neither desired nor intended to limit the disclosure to any or all of the exact details of construction shown, except insofar as they may be deemed essential to the claimed invention. 
       DETAILED DESCRIPTION 
       [0050]    In describing the exemplary embodiments of the present disclosure as illustrated in  FIGS. 1-8  specific terminology is employed for the sake of clarity. The present disclosure, however, is not intended to be limited to the specific terminology so selected, and it is to be understood that each specific element includes all technical equivalents that operate in a similar manner to accomplish similar functions. Embodiments of the claims may, however, be embodied in many different forms and should not be construed to be limited to the embodiments set forth herein. The examples set forth herein are non-limiting examples, and are merely examples among other possible examples. 
         [0051]    Referring now to  FIG. 1  there is illustrated a perspective view of an exemplary bar or retaining rod, such as stringer  100 . Preferably, stringer  100  includes one or more bars, tubes, conduits or the like, such as rod  101 A/B or  111 A/B, one or more bends, corners, angles, right angle, acute angle, curves, or turns, such as angle sections  104 A/B or  114 A/B, and one or more expand and contract sections, slidable sections, connector, telescope, or coupler, such as slidable coupler sections  130 A/B/C/D. It is contemplated herein that other configurations of slidable coupler sections  130 A/B/C/D known to one of ordinary skill in the art, such as other coupler configurations, multi segment coupler, telescopic slidable coupler sections or the like to accommodate larger surgical instruments I are included herein. It is further contemplated herein that rod  101 A/B and/or  111 A/B and angle sections  104 A/B or  114 A/B may be formed as a plurality of pieces or parts for assembly as a whole stringer  100  or as one or more single elements for assembly as a whole stringer  100 . Stringer  100  is preferably configured as an adjustable rectangular configuration with adjustments in one or more axis, such as x axis X and y axis Y via slidable coupler sections  130 A/B/C/D; however, other configurations, such as square, and other adjustments or adjustment mechanisms in and between axis are contemplated herein. 
         [0052]    Referring now to  FIG. 2  there is illustrated a top view, side view and bottom view of stringer  100 .  FIG. 2.1  further illustrates the rectangular configuration of rods  101 A/B and  111 A/B, angle sections  104 A/B and  114 A/B, and slidable coupler sections  130 A/B/C/D.  FIG. 2.2  further illustrates the linear adjustment capability in the y axis Y between rods  101 A and  111 A via slidable coupler section  130 C configured to enable extension and retraction of rod  101 A in and out therein of slidable coupler section  130 C. It is contemplated herein that rod  111 A may be configured to enable extension and retraction in and out therein of slidable coupler section  130 C.  FIG. 2.3  further illustrates the linear adjustment capability in the x axis X between rods  101 A and  101 B via slidable coupler section  130 A configured to enable extension and retraction of rods  101 A and  101 B in and out therein of slidable coupler section  130 A. It is contemplated herein that slidable coupler section  130 B/D likewise may be configured to enable extension and retraction in and out therein of rods  101 B/ 111 A and  111 B/ 111 B, respectively. 
         [0053]    Stringer  100  is preferably formed of a suitable surgical material, such as stainless steel, aluminum, metal, metal alloys, shape memory alloys, carbon fibers, ceramic or the like, capable of providing structure whether as a solid or hollow stringer  100 . Preferably, the material includes other suitable characteristics, such as durability, rigidity, stain-resistance, bacteria-resistant, light weight, chemical inertness, oxidation resistance, ease of workability, or other beneficial characteristic understood by one skilled in the art. Moreover, stringer  100  is preferably configured having a cross-sectional circular diameter; however, other configurations, such as square or the like, are contemplated herein. Stringer  100  is preferably solid for the purpose of preventing any interior surface capable of colonizing bacteria, viruses or other infectious diseases and difficult for sterilization chemicals to reach; however, a hollow interior is contemplated herein if such interior is sealed or alternatively if a plurality of holes or apertures are present to enable sterilization of the interior surface of stringer  100 . 
         [0054]    Referring now to  FIG. 3  there is illustrated an exploded view of rod  101 A, rod  101 B, rod  111 A, rod  111 B, and slidable coupler sections  130 A/B/C/D of stringer  100 . Preferably rod  101 A includes first rod section  102 A which further includes first rod end  102 . 1 A and second rod end  102 . 3 A. First rod end  102 . 1 A preferably includes a solid end, rounded end, pointed end, or cover, such as rod end cap  102 . 2 A. Second rod end  102 . 3 A preferably transitions to or is coupled to angle section  104 A, which further transitions to or is coupled to second rod section  106 A. Preferably angle section  104 A is configured as a ninety-degree turn positioning first rod section  102 A perpendicular to second rod section  106 A. Second rod section  106 A preferably includes first rod end  106 . 1 A and second rod end  106 . 4 A. Preferably first rod end  106 . 1 A preferably includes a solid end or cover, such as rod end cap  106 . 3 A. Furthermore, first rod end  106 . 1 A preferably further includes a hole or threaded hole, such as rod aperture  106 . 2 A. It is contemplated herein that rod  101 A may be formed of one continuous piece and bent to form angle section  104 A. 
         [0055]    Preferably rod  101 B includes first rod section  102 B which further includes first rod end  102 . 1 B and second rod end  102 . 3 B. First rod end  102 . 1 B preferably includes a solid end, rounded end, pointed end, or cover, such as rod end cap  102 . 2 B. Second rod end  102 . 3 B preferably transitions to or is coupled to angle section  104 B, which further transitions to or is coupled to second rod section  106 B. Preferably angle section  104 B is configured as a ninety degree turn positioning first rod section  102 B perpendicular to second rod section  106 B. Second rod section  106 B preferably includes first rod end  106 . 1 B and second rod end  106 . 4 B. Preferably first rod end  106 . 1 B preferably includes a solid end or cover, such as rod end cap  106 . 3 B. Furthermore, first rod end  106 . 1 B preferably further includes a hole or threaded hole, such as rod aperture  106 . 2 B. It is contemplated herein that rod  101 B may be formed of one continuous piece and bent to form angle section  104 B. 
         [0056]    Preferably rod  111 A includes first rod section  112 A which further includes first rod end  112 . 1 A and second rod end  112 . 2 A. Second rod end  112 . 2 A preferably transitions to or is coupled to angle section  114 A, which further transitions to or is coupled to second rod section  116 A. Preferably angle section  114 A is configured as a ninety degree turn positioning first rod section  112 A perpendicular to second rod section  116 A. Second rod section  116 A preferably includes first rod end  116 . 1 A and second rod end  116 . 4 A. Preferably first rod end  116 . 1 A preferably includes a solid end or cover, such as rod end cap  116 . 3 A. Furthermore, first rod end  116 . 1 A preferably further includes a hole or threaded hole, such as rod aperture  116 . 2 A. It is contemplated herein that rod  111 A may be formed of one continuous piece and bent to form angle section  114 A. 
         [0057]    Preferably rod  111 B includes first rod section  112 B which further includes first rod end  112 . 1 B and second rod end  112 . 2 B. Second rod end  112 . 2 B preferably transitions to or is coupled to angle section  114 B, which further transitions to or is coupled to second rod section  116 B. Preferably angle section  114 B is configured as a ninety degree turn positioning first rod section  112 B perpendicular to second rod section  116 B. Second rod section  116 B preferably includes first rod end  116 . 1 B and second rod end  116 . 4 B. Preferably first rod end  116 . 1 B preferably includes a solid end or cover, such as rod end cap  116 . 3 B. Furthermore, first rod end  116 . 1 B preferably further includes a hole or threaded hole, such as rod aperture  116 . 2 B. It is contemplated herein that rod  111 B may be formed of one continuous piece and bent to form angle section  114 B. 
         [0058]    Stringer  100  further includes two or more slidable coupler sections  130 A/B/C/D for extension and retraction of rods  101 A/B,  111 A/B,  101 A/ 111 A,  101 B/ 111 B,  116 A/B,  106 A/B respectively. Preferably, slidable coupler section  130 A is positioned between rod  101 A/ 106 A and rod  101 B/ 106 B and includes a hollow tube or conduit member, such as tubular member  136 A. Tubular member  136 A preferably includes first tube end  132 A and second tube end  134 A. Preferably first tube end  132 A and second tube end  134 A includes open ends, such as first tube aperture  139 . 1 A and second tube aperture  139 . 2 A. Moreover, slidable coupler sections  130 A includes a groove, slot, or aperture, such as channel  137 A configured to enable pins, screws, rivets, or fasteners, such as set screws  138 . 1 A and  138 . 2 A to slide therein. For assembly, first rod end  106 . 1 A of second rod section  106 A is preferably inserted in second tube aperture  139 . 2 A of first tube end  132 A of tubular member  136 A, wherein set screw  138 . 1 A is preferably fastened therein aperture  106 . 2 A. Preferably set screw  138 . 1 A is configured to enable second rod section  106 A to travel, adjust, extend, or retract along x axis X within the boundary of channel  137 A. Moreover, first rod end  106 . 1 B of second rod section  106 B is preferably inserted in first tube aperture  139 . 1 A of second tube end  134 A of tubular member  136 A, wherein set screw  138 . 2 A is preferably fastened therein aperture  106 . 2 B. Preferably set screw  138 . 2 A is configured to enable second rod section  106 B to travel, adjust, extend, or retract along x axis X within the boundary of channel  137 A. Such linear motion between second rod section  106 A, tubular member  136 A, and second rod section  106 B enables x axis X parallel adjustment, positioning, or spacing of rod  101 A and rod  101 B. 
         [0059]    Preferably, slidable coupler section  130 B is positioned between rod  111 A and rod  111 B and includes a hollow tube or conduit member, such as tubular member  136 B. Tubular member  136 B preferably includes first tube end  132 B and second tube end  134 B. Preferably first tube end  132 B and second tube end  134 B includes open ends, such as first tube end  139 . 1 B and second tube end  139 . 2 B. Moreover, slidable coupler section  130 A includes a groove, slot, or aperture, such as channel  137 B configured to enable pins, screws, rivets, or fasteners, such as set screws  138 . 1 A and  138 . 2 A to slide therein. For assembly, first rod end  116 . 1 A of second rod section  116 A is preferably inserted in second tube aperture  139 . 1 B of first tube end  132 B of tubular member  136 B, wherein set screw  138 . 1 B is preferably fastened therein aperture  116 . 2 A. Preferably set screw  138 . 1 B is configured to enable second rod section  116 A to travel, adjust, extend, or retract along x axis X within the boundary of channel  137 B. Moreover, first rod end  116 . 1 B of second rod section  116 B is preferably inserted in first tube aperture  139 . 2 B of second tube end  134 B of tubular member  136 B, wherein set screw  138 . 2 B is preferably fastened therein aperture  116 . 2 B. Preferably set screw  138 . 2 B is configured to enable second rod section  116 B to travel, adjust, extend, or retract along x axis X within the boundary of channel  137 B. Such linear motion between second rod section  116 A, tubular member  136 B, and second rod section  116 B enables x axis X parallel adjustment, positioning, or spacing of rod  111 A and rod  111 B. 
         [0060]    Together motion between second rod section  106 A, tubular member  136 A, and second rod section  106 B and motion between second rod section  116 A, tubular member  136 B, and second rod section  116 B enables x axis X parallel adjustment, positioning, or spacing of adjoining rods, such as rod  101 A and rod  111 A and rod  101 B and rod  111 B. 
         [0061]    Preferably slidable coupler section  130 C is positioned between rod  101 A and rod  111 A and includes a hollow tube or conduit member, such as tubular member  120 A. Tubular member  120 A preferably includes first tube end  122 A and second tube end  124 A. Preferably first tube end  122 A and second tube end  124 A includes an open end and longitudinally extending interior passageway therein, such as first tube aperture  122 . 1 A and second tube aperture  124 . 1 A. For assembly, first rod end  112 . 1 A of first rod section  112 A is preferably inserted in second tube aperture  124 . 1 A of second tube end  124 A of tubular member  120 A, wherein first rod end  112 . 1 A may be affixed to second tube end  124 A of tubular member  120 A. It is contemplated herein that first rod end  112 . 1 A may be affixed to second tube end  124 A of tubular member  120 A utilizing a weld, adhesive, compression fit or the like. It is further contemplated herein that first tube aperture  122 . 1 A and tubular member  120 A may be formed by mechanically widening or flaring first tube aperture  122 . 1 A and tubular member  120 A of hollow rod  111 A. Moreover, first rod end  102 . 1 A of first rod section  102 A is preferably inserted in first tube aperture  122 . 1 A of first tube end  122 A of tubular member  120 A, wherein first rod end  102 . 1 A of first rod section  102 A is configured to enable travel along y axis Y within the boundary of tubular member  120 A. Such linear motion between first rod end  102 . 1 A of first rod section  102 A and first tube aperture  122 . 1 A of first tube end  122 A enables y axis Y parallel adjustment, positioning, or spacing of rods, such as second rod section  106 A and second rod section  116 A. 
         [0062]    Preferably slidable coupler section  130 D is positioned between rod  101 B and rod  111 B, and include a hollow tube or conduit member, such as tubular member  120 B. Tubular member  120 B preferably includes first tube end  122 B and second tube end  124 B. Preferably first tube end  122 B and second tube end  124 B includes an open end and longitudinally extending interior passageway therein, such as first tube aperture  122 . 1 B and second tube aperture  124 . 1 B. For assembly, first rod end  112 . 1 B of first rod section  112 B is preferably inserted in second tube aperture  124 . 1 B of second tube end  124 B of tubular member  120 B, wherein first rod end  112 . 1 B may be affixed to second tube end  124 B of tubular member  120 B. It is contemplated herein that first rod end  112 . 1 B may be affixed to second tube end  124 B of tubular member  120 B utilizing a weld, adhesive, compression fit or the like. It is further contemplated herein that first tube aperture  122 . 1 B and tubular member  120 B may be formed by mechanically widening or flaring first tube aperture  122 . 1 B and tubular member  120 B of hollow rod  111 B. Moreover, first rod end  102 . 1 B of first rod section  102 B is preferably inserted in first tube aperture  122 . 1 B of first tube end  122 B of tubular member  120 B, wherein first rod end  102 . 1 B of first rod section  102 B is configured to enable travel, adjust, extend, or retract along y axis Y within the boundary of tubular member  120 B. Such linear motion between first rod end  102 . 1 B of first rod section  102 B and first tube aperture  122 . 1 B of first tube end  122 B enables y axis Y parallel adjustment, positioning, or spacing of rods, such as second rod section  106 B and second rod section  116 B. 
         [0063]    It is contemplated herein that stringer  100  may include a single axis of adjustment or telescope, such as along the x axis X or y axis Y or alternatively a multi axis adjustment or telescope, such as along the x axis X or y axis Y. 
         [0064]    It is further contemplated herein that slidable coupler sections  130 A/B/C/D of stringer  100  may include inner rod that is slidably longitudinally received within a hollow outer rod and that each end of a rod may be interchanged from inner to outer. 
         [0065]    It is still further contemplated herein that slidable coupler sections  130 A/B/C/D of stringer  100  may be interchanged. 
         [0066]    It is still further contemplated herein that slidable coupler sections  130 A/B/C/D of stringer  100  may include one or more expand and contract sections or slidable sections to enable x axis X and/or y axis Y parallel adjustment or spacing of the rods that form stringer  100 . 
         [0067]    Referring now to  FIG. 4.1  an exemplary surgical instrument I, such as a hemostat having moveable shank S 1  and shank S 2 , which preferably includes a pair of opposing first jaw member J 1  and second jaw members J 2 , jaw members, wherein at least one of the jaw members is movable relative to the other. Such jaw members may be pivotable about pivot point P, within box lock B, between first open position O in which the jaw members are disposed in a spaced relation relative to one another, and second closed position C in which the jaw members are configured to grasp or clamp something therebetween, such as tissue, or the like. Moreover, opposing first jaw member J 1  and second jaw members J 2  may be locked or held in position by a lock such as ratchet lock L preferably positioned on an extension stem or support member such as shank S 1  and shank S 2  between the two ring handles R. In use, for example a user positions their thumb in first ring handle R 1  and their index or middle finger within second ring handle R 2 . By a user opening and closing their thumb and index or middle finger this causes first ring handle R 1  and second ring handle R 2  to move apart (first open position O) and together (second closed position C), accordingly. The movements of first ring handle R 1  and second ring handle R 2  causes shank S 1  and shank S 2  to pivot about pivot point P which results in first jaw member J 1  and second jaw members J 2  to likewise pivot about pivot point P between first open position O and second closed position C. 
         [0068]    Further, surgical instruments I may include hemostats, forceps, clamps, scalpels, scissors, picks, retractors, hooks, clips, pliers, punches, curettes, specula and the like, which are generally of high precision and intricate construction and come in a variety of types, shapes and sizes, all of which may be used during a particular surgical procedure. A variety of surgical tools exist for each category of instruments. For example, considering only forceps, they come straight, left curved, right curved, serrated, cupped, etc. In addition, a range of medical, dental and veterinary tools have been developed for each discipline, such as in medicine sub-categories of surgical procedures include anesthesia, cardio, dermatology, ear nose &amp; throat, hand (specific limbs), facial, ob/gyn, orthopedic and the like each discipline having a variety of specialty and common surgical instruments. Over the years, surgical procedures along with the type and quantity of surgical instruments used in a given procedure have become predominantly standardized. Many of the above-mentioned instruments are scissor action instruments, having a pair of ring handles R that are connected through a pivot P to working moveable members shank S 1  and shank S 2 . Preferably, lever, extension or support members such as shank S typically include ring handles R at the ends thereof to facilitate the opening and closing of shank S 1  and shank S 2  connected to first jaw member J 1  and second jaw members J 2 . 
         [0069]    Referring now to  FIG. 4.2  an exemplary embodiment of a plurality of surgical instruments I strung together by stringer  100 . Preferably rod  101 A and rod  101 B of stringer  100  are positioned through first ring handle R 1  and second ring handle R 2  of one or more surgical instruments I to group surgical instruments I in sequential order along y axis Y. Moreover, one exemplary function of the extension and retraction capability of slidable coupler sections  130 C and  130 D is to enable stringer  100  to accommodate additional (expansion) or fewer (retraction) numbers of surgical instruments I. Such extension and retraction maintains a tight y axis Y fit around ring handles R of the group surgical instruments I and holds the group surgical instruments I in an erect position. Such erect position, space between instruments, and organization of the group surgical instruments I enables shortened time to identify, clean (whether pre-wash, pressure washing or the like), sort, count, group, and sterilize surgical instrument I. Moreover, such erect position, space between instruments, and organization of the group surgical instruments I reduces instrument damage when transporting, stacking, sorting, inspecting, and counting, and additionally when positioning on a sorting table for a technician to inspect, count, and sort. Still further, such extension and retraction of slidable coupler sections  130 C and  130 D enables stringer  100  to adjust and accommodate a variety of sizes of surgical instruments I and numbers or groups of surgical instruments I. 
         [0070]    Procedurally the surgical instruments I should be strung post-surgery when in their aligned position on the surgical instrument roll by feeding stringer  100  through first ring handle R 1  and second ring handle R 2 . Thereafter the surgical instruments I are preferably handled as a group of surgical instruments I bound together by stringer  100  through the multi-step sorting, identifying, grouping, cleaning and sterilization process. Such bundling of surgical instruments I preferably helps to protect surgical instruments I from damage when transported, stacked one on the other as well as when the surgical instruments are emptied out on a sorting table (no longer required) for a technician to inspect, count, and sort. Such handling may scratch, bend and may even break the surgical instruments resulting in increased cost to replace such instruments, which are often delicate and expensive. Moreover, such damage to the surgical instruments reduces the life expectancy of the surgical instruments resulting in increased medical costs to replace the surgical instruments. Furthermore, if such damaged surgical instruments are accidentally returned to the operating room, such surgical procedures may be delayed or cancelled due to non-functioning surgical instruments causing lost revenue for the surgery center and an upset surgical team and patients in queue. 
         [0071]    Moreover, one exemplary function of the extension and retraction capability of slidable coupler sections  130 A and  130 B is to enable stringer  100  to accommodate surgical instruments I in an open position O and upright. Such extension and retraction of slidable coupler sections  130 A and  130 B maintains x axis X spacing between first ring handle R 1  and second ring handle R 2  of the group surgical instruments I. Such movement of first ring handle R 1  and second ring handle R 2  causes shank S 1  and shank S 2  to pivot about pivot point P which results in first jaw member J 1  and second jaw members J 2  to likewise pivot about pivot point P. Preferably stringer  100  holds the group surgical instruments I in an erect position with opposing first jaw member J 1  and second jaw members J 2  held in open position O. Such open position O, spacing between instruments, and organization of the group surgical instruments I enables more thorough cleaning and sterilization of surgical instruments I. In addition, maintaining such open position O between first jaw member J 1  and second jaw members J 2  preferably reduces the time to sort, identify, inspect, group, clean and sterilize the group surgical instruments I. Moreover, such open position O of the plurality of surgical instruments I strung together by stringer  100  reduces the number of sharps being sent to central sterile and the reduction of accidents associated with needle/sharps injuries retained in a surgical instrument I or hidden in an un organized cluster of surgical instruments I. Such erect position, spacing between instruments, and organization of the group surgical instruments I enables shortened time to identify, clean (whether pre-wash, pressure washing or the like), sort, count, group, and sterilize surgical instrument I. Still further, such extension and retraction of slidable coupler sections  130 A and  130 B enables stringer  100  to adjust and accommodate a variety of sizes of surgical instruments I and groups of surgical instruments I. 
         [0072]    Referring now to  FIG. 5.1  there is illustrated a perspective view of an example embodiment box like tray bottom and lid surgical instrument support tray system  10  with exemplary adjustable stringer  100  position or affixed thereon. Preferably, surgical instrument support tray system  10  includes a container or basket and lid, such as tray bottom  220  and tray top  320 . Tray bottom  220  and tray top  320  are preferably formed of a suitable material, stainless steel, aluminum, metal, metal alloys, shape memory alloys, carbon fibers, ceramic, and includes chrome or other plated metals or coated metal and anodizing or the like, capable of providing structure to tray bottom  220  and tray top  320 . Preferably, the material includes other suitable characteristics, such as durability, rigidity, stain-resistance, bacteria-resistant, light weight, chemical inertness, oxidation resistance, ease of workability, color coding, or other beneficial characteristic understood by one skilled in the art. 
         [0073]    Referring now to FIG.  5 . 2 . 1  there is illustrated a perspective view of an example embodiment tray bottom  220 . Preferably, tray bottom  220  may be configured as a basket-like housing or enclosure in which surgical instruments I may be positioned, sterilized, transported and stored for later use. Tray bottom  220  comprises four generally perpendicular, upwardly projecting, continuous planar member(s), surface(s) or side(s) such as such as side walls  222 ,  223 ,  224 ,  225  and bottom  226  arranged preferably as a rectangle or square and having an open top box. Side walls  222 - 225  preferably define a generally open top having an upper perimeter  227 . 
         [0074]    It is contemplated herein that one or more sides walls  222 ,  223 ,  224 ,  225  and bottom  226  may be formed from a wire grid construction. 
         [0075]    It is further contemplated herein that tray bottom  220  may include a variety of shapes and sizes to accommodate a variety of surgical instruments I. 
         [0076]    Referring again to FIG.  5 . 2 . 1 , preferably side walls  222 ,  223 ,  224 ,  225  and bottom  226  may be formed or configured with a plurality or set of holes such as apertures  240  to enable steam or other sterilant to flow through apertures  240  formed in side walls  222 ,  223 ,  224 ,  225  and bottom  226  and permeate the entire interior of tray bottom  220 . Furthermore, such sterilant may pass up, under and over the surgical instruments I positioned in tray bottom  220 , thus ensuring effective sterilization. 
         [0077]    Preferably, tray bottom  220  includes two or more wire handles such as handle wire  230  configured generally in a u-shape. Handle wire  230  is preferably positioned approximate an interior side of one of side walls  222 ,  223 ,  224 , or  225  (preferably  223  and  225 ) and removably affixed thereto and configured to enable swivel movement of handle wire  230  about a plate such as handle retainer plate  232 . At least two handle retainer plates  232  are preferably affixed to side walls  223  and  225  by an attachment device such as machined screw  234  positioned through machined apertures  236  configured in side walls  223  and  225 . Handle wires  230  are preferably affixed to side walls  223  and  225  to facilitate the lifting, carrying and positioning of tray bottom  220 . 
         [0078]    Furthermore, any of side walls  222 ,  223 ,  224 ,  225  and bottom  226  may include an identifying legend such as indicia  231  to enable identification of the surgical instruments I contained therein or the surgical procedure identified with the set or group of surgical instruments I contained within tray bottom  220 , surgical kit identification, dates of sterilization, dates of expiration, model number, serial number, ownership and the like. 
         [0079]    Referring now to FIG.  5 . 2 . 2  there is illustrated a perspective view of an example embodiment surface, lid or cover, such as tray top  320  of the surgical instrument support tray system  10 . Preferably, tray top  320  may be configured as a box top, cover, closure or lid for tray bottom  220  in which surgical instruments I may be positioned, removably affixed thereto, sterilized, transported and stored for later use. Tray top  320  comprises four generally perpendicular, downwardly projecting, continuous, planar member(s), surface(s) or side(s) arranged preferably as a rectangle or square, such as side walls  322 - 325 . Side walls  322 - 325  preferably define a top having perimeter  227  configured to engage, surround, or friction fit side walls  222 - 225  of tray bottom  220  to form an enclosure in which surgical instruments I may be positioned, removably affixed thereto, sterilized, transported and stored for later use. It is contemplated herein that tray bottom  220  and tray top  320  may include a latch mechanism to secure tray bottom  220  and tray top  320  to one another. Furthermore, any of side walls  322 ,  323 ,  324 ,  325  and/or top  326  may be configured as a support member for surgical instruments I, such as top  326 . 
         [0080]    Likewise, side walls  322 ,  323 ,  324 ,  325  and top  326  may be formed or configured with a plurality or set of holes such as apertures  340  to enable steam or other sterilant to flow through apertures  340  formed in side walls  322 ,  323 ,  324 ,  325  and top  326  and permeate the entire interior of tray top  320  and into the interior of tray bottom  220 . Furthermore, such sterilant may pass down through tray top  320  and over the surgical instruments I positioned in tray bottom  220 , thus ensuring effective sterilization. 
         [0081]    It is contemplated herein that tray bottom  220  and tray top  320  may be configured in shapes other than square and rectangle provided such configuration enables sterilization, transport and storage for later use of surgical instruments I. 
         [0082]    Referring again to FIG.  5 . 2 . 2 , preferably top  326  of tray top  320  includes regularly spaced columns or rows of a plurality or set of furrows, trenches, channel or troughs, such as valleys  650  formed therein top  326 . Valleys  650 , such as first valley  651  and second valley  652 , are formed as a pair of columns in top  326  of tray top  320 , and are preferably configured as a furrows, trenches, channel or troughs shape positioned parallel to side walls  323  and  325 , into which portions of surgical instrument I, preferably ring handles R may be held or positioned. Preferably, ring handles R may be positioned and/or held in a desired and evenly spaced position therein valleys  650  preventing surgical instrument I from coming into contact with one another, intermingling, and enabling easy identification, cleaning, sorting, counting, and grouping of surgical instruments I. Valleys  650  are preferably formed in sets of two to accommodate stringer  100  and a group of ring handles R of surgical instruments I bound together by stringer  100 . Moreover, one or more pins, plugs, screws, rivets, bolts, clips or other fastener, such as stringer attachment device  700  may be utilized to affix stringer  100  and/or a group of surgical instruments I bound together by stringer  100  to tray top  320 . It is contemplated herein that stringer attachment device  700 , more specifically first attachment device  702  and second attachment device  704 , may affix stringer  100  or a group of surgical instruments I bound together by stringer  100  to one or more apertures  340  in side walls  322 ,  323 ,  324 ,  325  and/or top  326 , especially apertures  340  adjacent perimeter  227 . 
         [0083]    Referring now to FIG.  5 . 3 . 1  there is illustrated a top view of an example embodiment lid or cover, such as tray top  320  of the surgical instrument support tray system  10 . Preferably top  326  of tray top  320  includes regularly spaced S columns or rows of a plurality of valleys  650 , such as first valley  651 , second valley  652 , third valley  653  and the like, formed therein top  320 . Valleys  650  are preferably spaced S distance apart to accommodate, cup and support ring handles R of surgical instrument I therein. In addition, valleys  650  are preferably spaced S distance apart to maintain surgical instrument I in open position O, shown in  FIG. 4 . Preferably top  326 , includes valleys  650 , as a pair, such as first valley  651  and second valley  652 , are formed as a pair of columns, and are preferably configured as a furrows, trenches, channel or troughs shape positioned parallel to side walls  323  and  325 , into which portions of surgical instrument I, such as ring handles R may be positioned or held. Preferably, ring handles R may be positioned and/or held in a desired and evenly spaced position therein valleys  650  in top  326  preventing surgical instrument I from coming into contact with one another, intermingling, and enabling easy identification, cleaning, sorting, counting, and grouping of surgical instruments I. 
         [0084]    Referring now to FIG.  5 . 3 . 3  there is illustrated a cross sectional side view along AA of tray top, such as tray top  320  of the surgical instrument support tray system  10 . Preferably top  326  shown from side wall  324 , includes valleys  650 , as a plurality of pairs, such as first valley  651  and second valley  652  (first pair) and third valley  653  and fourth valley  654  (second pair), each formed as a pair into which portions of surgical instrument I, preferably one or more sets of ring handles R may be positioned or held preventing surgical instrument I from coming into contact with one another, intermingling, and enabling easy identification, cleaning, sorting, counting, and grouping of surgical instruments I. 
         [0085]    Referring now to FIG.  5 . 3 . 2  there is illustrated a side cross sectional view of tray top  320  along line A-A showing cross sectional of surface  326  of the surgical instrument support tray system  10 . Preferably, valleys  650 , such as second valley  652 , third valley  653  and the like, formed therein top  320 . Preferably, valleys  650 , such as second valley  652  includes a curved, arced or bent surface, such as second contoured surface  662  and end edge  664 , and third valley  653  includes third contoured surface  663  and end edge  664 . Moreover, therebetween and on each side of valleys  650 , such as second valley  652  and third valley  653  there is shown cross sectional of surface  326 . Preferably contoured surfaces, such as second contoured surface  662  and third contoured surface  663  are formed in top  320  and spaced S distance apart to position or hold ring handles R in a desired and evenly spaced position when positioned therein valleys  650  to prevent surgical instrument I from coming into contact with one another, intermingling, and enabling easy identification, cleaning, sorting, counting, and grouping of surgical instruments I. It is contemplated herein that second contoured surface  662  and third contoured surface  663  may be configured or formed as polygon, curved or the like to conform to, position, or hold ring handles R of surgical instrument I. 
       Manufacture 
       [0086]    Preferably, tray bottom  220 , tray top  320  and contoured surface  662  and contoured surface  663  of valleys  650  are formed as follows: a turret machine is preferably utilized to punch all apertures  240  and  340  in a stock sheet of aluminum or stainless steel and to cut outside perimeter shape, such as perimeter  227 . Next, “brake press” (a large hydraulic press machine) is preferably used to press one or more valleys  650  into surface  326  of tray top  320 . Next, the brake press is preferably utilized to form side walls  322 ,  323 ,  324 ,  325  of tray top  320 . It is contemplated herein that large volumes of production of tray top  320  may be formed using automated processes known to one of ordinary skill in the art. For example, preferably utilizing a larger “die” shaped to press all apertures  240  and  340  in a stock sheet of aluminum or stainless steel and to cut outside perimeter shape, such as perimeter  227  in one hit/press. Next, a similar press is preferably utilized to press one or more valleys  650  into surface  326  of tray top  320  and to form side walls  322 ,  323 ,  324 ,  325  of tray top  320  in one hit/press. 
         [0087]    It is contemplated herein that tray bottom  220  may be configured or formed with one or more valleys  650 , similar to tray top  320 , formed in bottom  226  of tray bottom  220 , to accommodate ring handles R may, which may be positioned and held in a desired and evenly spaced position preventing surgical instrument I from coming into contact with one another, intermingling, and enabling easy identification, cleaning, sorting, counting, and grouping of surgical instruments I. Referring again to FIG.  5 . 3 . 2  there is illustrated a side cross sectional view of tray bottom  220  showing cross sectional surface  326  of the surgical instrument support tray system  10 . 
         [0088]    Referring now to FIGS.  5 . 4 . 1  and  5 . 4 . 2  there is illustrated a top and cross sectional view of an example embodiment tray bottom  220 . Preferably tray bottom  220  includes one or more fastener, hanger, peg, or arm, such as thumb screw  252  and  254 , more specifically thumb screws  252 A,  252 B,  252 C, and  252 D for insertion in apertures  242 A,  242 B,  242 C, and  242 D (shown in  FIG. 5.2 ) of side walls  222  and thumb screws  254 A,  254 B,  254 C, and  254 D for insertion in apertures  244 A,  244 B,  244 C, and  244 D (shown in  FIG. 5.2 ) of side walls  224 . Thumb screw  252  and  254  are preferably inserted in apertures  242 A,  242 B,  242 C, and  242 D (shown in  FIG. 5.2 ) in side walls  222  and in apertures  244 A,  244 B,  244 C, and  244 D (shown in  FIG. 5.2 ) in side walls  224 , respectively, and utilized to support an inner tray, such as surgical instrument support tray system  10 . 1 . It is contemplated herein that surgical instrument support tray system  10 . 1  may be color coordinated and/or grouped within surgical instrument support tray system  10  for easy identification of assemblies for specific surgical specialties. Preferably, surgical instrument support tray system  10 . 1  may be configured or utilized to support specialty, random, non-ring handled surgical instruments or other surgical instruments. It is contemplated that side walls  222  and  224  may include one or more parallel first set of thumb screws  252 A,  252 B,  252 C, and  252 D and one or more parallel second set of thumb screws  254 A,  254 B,  254 C, and  254 D or the like to provide support and accommodate a variety of configured inner tray(s), such as surgical instrument support tray system  10 . 1 . 
         [0089]    Referring now to  FIG. 6.1  there is illustrated a perspective view of an example embodiment of a surgical instrument support tray system  10  with exemplary adjustable stringers  100  shown adjusted in two positions affixed to tray top  320  of the surgical instrument support tray system  10 . Preferably, surgical instrument support tray system  10  includes tray bottom  220  and tray top  320 , and tray top  320  includes a plurality of regularly spaced valleys  650  formed therein top  326 , such as first valley  651 , second valley  652 , third valley  653 , fourth valley  654 , fifth valley  655 , sixth valley  656 , seventh valley  657 , and eighth valley  658 . Preferably, stringer  100 A is adjusted, positioned, or expand and contract along slidable coupler sections  130 A/B/C/D of stringer  100 A to enable x axis X and/or y axis Y parallel adjustment or spacing of the rods that form stringer  100 A to be positioned approximate first valley  651  and third valley  653  of tray top  320 . Alternatively, stringer  100 B is adjusted, positioned, or expand and contract along slidable coupler sections  130 A/B/C/D of stringer  100 B to enable x axis X and/or y axis Y parallel adjustment or spacing of the rods that form stringer  100 B to be positioned approximate fifth valley  655  and sixth valley  656  of tray top  320 . It is contemplated herein that slidable coupler sections  130 A/B/C/D of stringer  100 A/B may be adjusted or expand and contract along slidable coupler sections  130 A/B/C/D of stringer  100 A/B to enable x axis X and/or y axis Y parallel adjustment, positioning, or spacing of the rods that form stringer  100 A/B to be positioned approximate a pair or a plurality of valleys  650  of tray top  320 . 
         [0090]    It is contemplated herein that stringer  100 A/B may be color coordinated and/or grouped within inner tray, such as surgical instrument support tray system  10 . 1  and/or surgical instrument support tray system  10  for easy identification of assemblies for specific surgical specialties. 
         [0091]    Referring now to  FIG. 6.2  there is illustrated a perspective view of an example embodiment of a surgical instrument support tray system  10  with a plurality of surgical instrument sets I held in a vertical position by exemplary adjustable stringers  100 A/B affixed or positioned approximate to tray top  320  of surgical instrument support tray system  10 . Preferably, surgical instrument support tray system  10  includes tray bottom  220  and tray top  320 , and tray top  320  includes a plurality of regularly spaced valleys  650  formed therein top  326 . For example, stringer  100 A positions and holds ring handle R 1  in valley  651  and positions and holds ring handle R 2  in valley  653  of tray top  320  for surgical instruments IA. Such positioning of surgical instruments IA preferably maintains opposing first jaw member J 1  and second jaw members J 2  in open position O for cleaning and sterilization purposes. Furthermore, such positioning of surgical instruments IA preferably maintains the instruments in a desired and evenly spaced position preventing them from coming into contact with one another, intermingling, and enabling easy identification, cleaning, sorting, counting, and grouping of surgical instruments IA. 
         [0092]    As an alternative example, stringer  100 B positions and holds ring handle R 1  in valley  655  and positions and holds ring handle R 2  in valley  656  of tray top  320  for surgical instruments IB. Such positioning of surgical instruments IB preferably maintains opposing first jaw member J 1  and second jaw members J 2  of surgical instruments IB in open position O for cleaning and sterilization purposes. Furthermore, such positioning of surgical instruments IB preferably maintains the instruments in a desired and evenly spaced position preventing them from coming into contact with one another, intermingling, and enabling easy identification, cleaning, sorting, counting, and grouping of surgical instruments IB. 
         [0093]    Moreover, one or more stringer attachment device  700  may be utilized to affix stringer  100 A/B and/or a group of surgical instruments I bound together by stringer  100 A/B to tray top  320 . It is contemplated herein that stringer attachment devices  700 , more specifically first stringer attachment devices  700 A and second stringer attachment devices  700 B, may affix stringer  100 A/ 100 B or a group of surgical instruments I bound together by stringer  100 A/B to one or more apertures  340  in top  326 , especially apertures  340  adjacent perimeter  227 . 
         [0094]    Referring now to  FIG. 7.1  there is illustrated an exploded perspective view of the attachment device of FIG.  5 . 2 . 2 . Preferably, stringer attachment device  700  includes pan head bolt  780 , coil spring  760 , cylindrical spacer  740 , clip  720  and threaded end cap  710 . One or more stringer attachment devices  700  may be utilized to affix a portion of stringer  100  and/or a group of surgical instruments I bound together by stringer  100  to tray top  320 . 
         [0095]    It is contemplated herein that stringer attachment device  700  includes other configurations of attachment devices known to one of ordinary skill in the art. 
         [0096]    Referring now to  FIG. 7.2  there is illustrated a perspective view of an exemplary alternate stringer attachment device  801 . Referring now to FIG.  7 . 2 . 2  there is illustrated a perspective view of an alternate stringer attachment device  801  that preferably includes releasably friction clip, snap-in clasp, or channel, such as trough  802  having first trough wall  804  and second trough wall  806 , base  807 , and pin, dowel, threaded bolts, screws, pine tree plugs or the like, such as pegs  808 . Referring now to FIG.  7 . 2 . 3  there is illustrated a side view of an alternate stringer attachment device  801  having pegs  808 , base  807 , and first trough wall  804 . Referring now to FIG.  7 . 2 . 1  there is illustrated a perspective view of one or more exemplary alternate stringer attachment device  801  in combination with stringer attachment device  700  in use. Preferably, alternate stringer attachment device  801  is positioned on top  326  of tray top  320  and aligned with apertures  340  in top  326 , especially apertures  340  adjacent perimeter  227 . Moreover, pegs  808  are preferably pushed through apertures  340  adjacent perimeter  227  and friction fit therein to top  326  or secured thereto top  326  by nuts or other attachment mechanism know to one of ordinary skill. One or more alternate stringer attachment device  801  may be utilized to affix or frictionally secure a portion of stringer  100  and/or a group of surgical instruments I bound together by stringer  100  to tray top  320 . 
         [0097]    Procedure 
         [0098]    Referring again to FIG.  7 . 2 . 1  there is illustrated either stringer attachment device  700  or alternate stringer attachment devices  801  affixed to tray top  320 , which may be additionally utilized to position and frictionally affix one end, side, rod or section of stringer  100 , such as slidable coupler section  130 A, of stringer  100  to tray top  320  while the other end, of stringer  100  is swung or hinged up or vertically positioned with rods  102 A and  102 B perpendicular or adjacent to top  326  of tray top  320 . Moreover, slidable coupler sections  130 C and  130 D may be temporarily removed to enable stringing of ring handles R of surgical instrument I onto rods  102 A and  102 B. Once ring handles R of surgical instrument I have preferably been strung onto rods  102 A and  102 B slidable coupler sections  130 C and  130 D may be reattached to stringer  100  to group together surgical instruments I and stringer  100 . Preferably, stringer  100  is adjusted or expand and contract along slidable coupler sections  130 A/B/C/D of stringer  100  to position stringer  100  approximate valleys  650  and thereafter the other end, such as slidable coupler sections  130 B of stringer  100  is re-affixed to either stringer attachment device  700  or alternate stringer attachment devices  801 , as shown in  FIG. 6 . 
         [0099]    Referring to  FIG. 8  there is illustrated a flow diagram  800  of a method of organizing, sorting, identifying, grouping, counting, cleaning, pressure washing, sterilizing, and storing prior to surgical use with decreased damage to surgical instruments, and decreased assembly time for sterile surgical instrument sets utilizing stringer  100  and surgical instrument support tray system  10 , shown in  FIGS. 1-7 . 
         [0100]    In block or step  810  and as described above in  FIGS. 1-7 , upon completion of surgery the operating personnel break down the surgical case and the surgical instruments I are sorted and stringer  100  rods, such as rods  102 A and  102 B may be inserted in ring handles R of surgical instruments I to group the set of surgical instruments I by stringing a row of ring handles R of surgical instruments I or by the procedure above for stringer attachment device  700  or attachment devices  800 . The grouped set of surgical instruments I may be positioned in valleys  650  by adjusting stringer  100  wherein the surgical instruments I may be identified, counted, sorted and positioned in an organized, parallel relationship in valleys  650  to form a set or group of surgical instruments I. While surgical instruments I have been retained in parallel, even spaced with open jaw by surgical instrument support tray system  10  an assembler may quickly inspect, identify, sort, count, disengage any of the surgical instruments I for further inspection and operational testing, and grouping of surgical instruments I (inspecting). Thus, surgical instrument support tray system  10  reduces the time spent cleaning, sorting, counting, identifying and grouping surgical instruments I, extends the life expectancy of the surgical instruments, and enables thorough cleaning of the surgical instruments. 
         [0101]    In block or step  820 , surgical instruments I may be gathered together on one end of stringer  100 , stringer  100  may be contracted, and laid as a group of surgical instruments I on bottom  226  of tray bottom  220  and tray top  320  may be positioned on tray bottom  220  wherein the basket-like housing or enclosure maintains surgical instruments I in an organized and secure position for sterilization, transportation and storage for later use. 
         [0102]    In block or step  830 , the grouped set of surgical instruments I may be removed from tray bottom  220  and the grouped set of surgical instruments I may be positioned in valleys  650  on tray top  320  by adjusting stringer  100  wherein the surgical instruments I may be retained in parallel, evenly spaced and an open jaw position by surgical instrument support tray system  10 . In such position, the grouped set of surgical instruments I may be sprayed and evenly coated with an enzymatic to begin breaking down post-surgery contaminants (pre-washing). 
         [0103]    In block or step  840 , the grouped surgical instruments I and stringer  100  may be pre-washed by submerging into a detergent pre-wash solution or sonification system. In addition, grouped surgical instruments I may be positioned in valleys  650  on tray top  320  by adjusting stringer  100  wherein the surgical instruments I may be scrubbed or pressure washed to remove any visible contaminants remaining post-surgery and inspected for completeness (pre-washing). 
         [0104]    In block or step  850 , surgical instruments I may be gathered together on one end of stringer  100 , stringer  100  may be contracted with retained parallel spaced and open jaw surgical instruments I, and/or laid as a group of surgical instruments I on bottom  226  of tray bottom  220  and tray top  320  may be positioned on tray bottom  220  wherein the grouped surgical instruments I or basket-like housing or enclosure with surgical instruments I in an organized and secure position and open jaw surgical may be washed in a commercial washer/disinfector. Since surgical instruments I are retained in parallel, evenly spaced and in an open jaw position this enables even access of detergents and uniform cleaning of surgical instruments I by a commercial washer/disinfector. 
         [0105]    In block or step  860 , the grouped set of surgical instruments I may be removed from tray bottom  220  and the grouped set of surgical instruments I may be positioned in valleys  650  on tray top  320  by adjusting stringer  100  wherein the surgical instruments I may be retained in parallel, evenly spaced and an open jaw position by surgical instrument support tray system  10 . While retained an assembler inspects, identifies, sorts and counts surgical instruments I. Since surgical instruments I have been previously retained in parallel, even spaced with open jaw on surgical instrument support tray system  10  an assembler may quickly inspect, identify, sort, count, disengage any of the surgical instruments I for further inspection and operational testing, and finally grouping of surgical instruments I. Moreover, if one or more surgical instruments I is to be removed or added to the bundled or retained set of surgical instruments I the procedure outlined above for stringer attachment device  700  or alternate stringer attachment devices  800  may be utilized to add or remove surgical instruments I. Thus, surgical instrument support tray system  10  and stringer  100  reduces the time spent cleaning, sorting, counting, identifying and grouping surgical instruments I, extends the life expectancy of the surgical instruments, and enables thorough cleaning and decontamination of the surgical instruments. 
         [0106]    In addition, surgical instrument support tray system  10  preferably reduces the number of sharps being bundled or hidden with the surgical instruments I and being sent to sterile central. 
         [0107]    In block or step  870 , surgical instruments I may be gathered together on one end of stringer  100 , stringer  100  may be contracted with retained parallel spaced and open jaw surgical instruments I, and laid as a group of surgical instruments I on bottom  226  of tray bottom  220  and tray top  320  and may be positioned on tray bottom  220  wherein the grouped surgical instruments I or basket-like housing or enclosure with surgical instruments I in an organized and secure position and open jaw surgical may be wrapped, containerized (placed in a sterilization container, such as a basket with detachable lid) or stacked for sterile processing/distribution. Surgical instrument support tray(s) system  10  with stringer  100  retained parallel spaced and open jaw surgical instruments I may be sterilized in a commercial sterilizer using steam or other sterilant. The sterilant may access surgical instruments I via a plurality or set of holes such as apertures  240 / 340 / 440  in surgical instrument support tray system  10  to enable thorough cleaning and sterilization of surgical instruments. Once sterilized, surgical instrument support tray(s) system  10  with stringer  100  retained parallel spaced and open jaw surgical instruments I may be placed in inventory for future surgical use. 
         [0108]    The foregoing description and drawings comprise illustrative embodiments of the present invention. Having thus described exemplary embodiments, it should be noted by those ordinarily skilled in the art that the within disclosures are exemplary only, and that various other alternatives, adaptations, and modifications may be made within the scope of the present invention. Merely listing or numbering the steps of a method in a certain order does not constitute any limitation on the order of the steps of that method. Many modifications and other embodiments of the invention will come to mind to one ordinarily skilled in the art to which this invention pertains having the benefit of the teachings presented in the foregoing descriptions and the associated drawings. Although specific terms may be employed herein, they are used in a generic and descriptive sense only and not for purposes of limitation. Moreover, the present invention having been described in detail, it should be understood that various changes, substitutions and alterations can be made thereto without departing from the spirit and scope of the invention as defined by the appended claims. Accordingly, the present invention is not limited to the specific embodiments illustrated herein, but is limited only by the following claims.