Objective To enhance the sufficiency and intactness of surgical instruments in neurosurgery, and to ensure successful completion of the surgery. Methods A total of 14 823 surgical patients were divided into two groups chronologically. Routine management of surgical instruments in the surgery was applied in 9 952 patients (the control group), while alternative management was provided for 4 871 patients of the intervention group, in which a team was built to analyze causes of inadequacy and malfunction of the instruments and to develop targeted long-running management mechanism (perfecting rules and regulations, strengthening information construction, and optimizing management process, etc.).Results The incidence rates of insufficiency and malfunction of the instruments were significantly decreased, whereas surgeons′ satisfaction was significantly increased in the intervention group compared with the control group (P<0.01 for all). Conclusion The practice of long-running management mechanism can effectively reduce insufficiency and malfunction of the surgical instruments, ensure successful completion of the surgery, and facilitate a better cooperation between surgeons and nurses.