Three of the arms are for tools that hold objects, act as a scalpel, scissors, bovie, or unipolar or bipolar electrocautery instruments.
en.wikipedia.org Items included in the medical cache are medicines, intravenous fluids, blankets, suture sets, airways, tracheal tubes, defibrillators, burn treatment supplies, bone saws and scalpels.
en.wikipedia.org Skin snips can be obtained using a corneal-scleral punch, or more simply a scalpel and needle.
en.wikipedia.org While operating on one of the victims, he accidentally nicks the aorta with the scalpel, causing the victim to bleed to death.
en.wikipedia.org