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PubMedDate not supplied

[New models of forceps for bipolar coagulation].

Operations on the brain require an optimum coagulation effect to be produced by forceps for bipolar coagulation. New forceps models are described in which the elimination of heat from the operating ends is considerably improved by making the whole forceps of copper and providing intermittent supply of high-frequency current to it. As a result the coagulation effect is distinguished by slight necrosis of the tissues adjoining the ends of the forceps and no sticking of these tissues to these ends.

Brain↗
PubMed1994

[The use of the Babcock forceps for hemostasis of the pre-prostatic veins in radical prostatectomy of total cystoprostatectomy].

Haemostasis of Santorini's venous plexus during radical prostatectomy or total cystoprostatectomy is a delicate phase of the procedure which facilitates the conditions of the surgery and the postoperative course. Based on a series of 150 prostatectomies, the authors describe their technique using Babcock forceps for "en bloc "ligation of the venous plexus. After opening the pelvic aponeurosis and section of the puboprostatic ligaments, a Babcock forceps is placed above the urethra and prostatic apex, including all of Santorini's plexus enclosed by its fibrous tissue, allowing exposure of the abascular plane of cleavage situated between the anterior surface of the urethra and this plexus. Klikenberg scissors are then introduced into the depression formed underneath the jaws of the Babcock forceps and are guided by the index finger into the symmetrical depression of the other side. The hypogastric connective tissue is perforated lateromedially and the scissors are gently opened to enlarge the passage. A right-angle dissector is then inserted and grips n.1 or 2 absorbable suture material which, after removing the Babcock forceps, is used to tie all of the anterior venous complex. This technical device allows a more reproducible and standardised approach to this operative step.

Cystectomy↗
PubMed1995

[Application of large curved forceps for taping in cardiovascular surgery].

A new large curved forceps was manufactured for trial with the object of taping in cardiovascular surgery. Widely used and commercially available forceps could be utilized on the taping of large vessel less than 5 to 5.8 cm in diameter. With this new forceps, aneurysmally dilate great vessels (less than 8 cm in diameter) could be safely taped without compression of aortic wall. This forceps has already applied not only for the major vascular surgery, but also for the wearing of cardiac net in coronary artery bypass grafting.

Aortic Aneurysm↗
PubMed1995

[From the history of surgical instruments: 3. The dressing forceps (16th century)].

The dressing forceps ("Kornzange") is one of the very few surgical instruments that have extensively preserved its form, its function and even its name throughout the centuries. In the Germany of the 16th century, the dressing forceps was mentioned as a widely used instrument among the barber-surgeons (Stromayr 1559, Ryff 1559). At that time, it mostly found use as a foreign body removing forceps. The dressing forceps can be traced back until today in German or English surgery instrument-books in nearly unchanged shape.

Barber Surgeons↗
PubMed1996

The history and evolution of surgical instruments. VII. Spring forceps (tweezers), hooks and simple retractors.

Instruments manufactured by bending a basic metal strip or rod, either about its middle to create spring forceps (tweezers), or towards one extremity to create hooks and retractors are related structures. Spring forceps depend on tension mediated at the bend (hoop) or fixed end which is transmitted as dynamic 'spring' to the jaws, whereas the bend of hooks and retractors remains fixed and static. If such instruments refine the digital postures of pinch, pincer and retraction during surgery, they have not supplanted these manual actions entirely. After a brief historical introduction, the structure, modifications, functions and controls of spring forceps are analysed. Importantly, this instrument enjoys both right and left-handed functions, some of which are ancient, some transient as haemostats and needle-holders, and some, including left-handed dissection, surprisingly recent. Hooks are sharp or blunt and, among other functions, pre-date the left-handed spring forceps for dissection; in general hooks function as retractors. Hand-held retractors are enlarged blunt hooks, the wide retracting contact surface reducing trauma to wound margins and viscera. The physical effort of employing these retractors deep in body cavities is abated by applying them autostatically around a square or circular frame.

Dissection↗
PubMed1997

Comparison of endobronchial needle aspiration with forceps and brush biopsies in the diagnosis of endobronchial lung cancer.

Endobronchial forceps biopsy (FB) specimens of lung carcinoma are not uncommonly interpreted as nondiagnostic owing to extensive crush artefact, necrosis, or insufficient tissue. FB cannot be performed in some endobronchial lung cancers (EBLCs) with massive bleeding tendency due to fragility and friability. Cytological studies from the brushings and washings may also be unproductive, increasing the bronchoscopist's frustration. The aim of this study was to compare the diagnostic yield and complications of endobronchial needle aspiration (EBNA) with those of FB and brush biopsy (BB) in EBLCs examined by fibreoptic bronchoscopy. A prospective sequential study was carried out on 151 in-patients with EBLC. Bronchial aspiration (BA), EBNA and BB were performed in the patients with respiratory distress and with accompanying tumours of high bleeding tendency, completely obstructing main bronchi (Group 1: 68 patients). BA, EBNA and FB were performed in those with either central or peripheral EBLCs but without respiratory distress and/or significant bleeding tendency (Group 2: 83 patients). In Group 1, the diagnostic yield of EBNA was found to be 90%, whereas that of BB was 66% (p < 0.05). In the same group, EBNA provided cell types in 95%, compared with 88% by BB (p > 0.05). EBNA was diagnostic in 92% of Group 2 patients, while FB established diagnosis in 78% of patients (p > 0.05). In determining cell type, no significant difference was found between EBNA (95%) and FB (97%) (p > 0.05). Regarding complications (only bleeding), there was no significant difference (p > 0.05) between EBNA (7%) and BB (13%), or between EBNA (4%) and FB (17%). We conclude that in endobronchial lung cancers: 1) the diagnostic yield of endobronchial needle aspiration is higher than brush biopsy; 2) endobronchial needle aspiration increases the yield of brush biopsy when forceps biopsy cannot be performed owing to significant bleeding; 3) endobronchial needle aspiration increases the diagnostic yield when a forceps biopsy specimen is inadequate because of crush artefact, necrosis, or tissue resistance; and 4) endobronchial needle aspiration is as safe as brush biopsy and forceps biopsy.

Biopsy↗
PubMedDate not supplied

Percutaneous transhepatic transluminal forceps biopsy in obstructive jaundice.

BACKGROUND/AIMS: To evaluate the technical feasibility and sensitivity of percutaneous transluminal forceps biopsy of bile duct diseases. MATERIAL AND METHODS: Seventeen fluoroscopic-guided transluminal forceps biopsies were performed in 16 patients with obstructive jaundice. The technique was performed through an existing percutaneous transhepatic tract. Multiple specimens were obtained after passing the forceps biopsy into a long 9-French sheath and the specimens were fixed with formalin for histopathologic diagnosis. RESULTS: Adequate samples for histological diagnosis was obtained in 12 of 17 procedures (sensitivity, 71%). Pathologic reports included pancreatic head carcinoma n = 2, cholangiocarcinoma n = 3, hepatoma with intrahepatic-bile duct invasion n = 3, common bile duct tumors n = 3 and chronic inflammation n = 1. Minor complications such as pain was noted in three patients while transient hemobilia was seen in two patients. CONCLUSIONS: Percutaneous transhepatic transluminal forceps biopsy is a safe technique which is easy to perform. This can be done through an existing transhepatic biliary tract with a sensitivity rate of 71%.

Adult↗
PubMed1997

[New angulated cardiovascular forceps].

New cardiovascular forceps have been conceived and a prototype of the new design has been fabricated. The new forceps feature a pair of gripping edges mounted on the tips of the handles at a 45-degree angle. Opening and closing the gripping ends are done in the same manner as conventional forceps. These new forceps are found to be quite effective when gripping tissues in narrow, deep operative fields.

Cardiovascular Surgical Procedures↗
PubMedDate not supplied

Percutaneous cholangiofiberscopic endoluminal forceps biopsy of intrabile duct diseases.

BACKGROUND/AIMS: The aim of the present study was to determine the usefulness and sensitivity of percutaneous cholangiofiberscopic guided forceps biopsy in patients suspected of intrabile duct diseases. This study also emphasized the use of a video monitor system in which the field of view is magnified; thus, even a small lesion can easily be detected. Furthermore, coordination of both the operator and assistant is easier because both can observe the image together on the video monitor. METHODOLOGY: Percutaneous cholangio-fiberscopic forceps biopsy was performed in 27 patients (14 men, 13 women, aged 37-81 years with a mean age of 61 years). A mature T-tube tract was used as an access for cholangioscopy in 17 cases while the remaining 10 patients underwent percutaneous transhepatic biliary drainage and gradual tract dilatation from 7-French to 16-French. A flexible fiberoptic choledoscope was gently inserted into a mature tract and once an abnormal mucosal lesion was identified, a forceps biopsy was inserted into a working channel of the scope, and 3-5 specimens were taken for histological examination. RESULTS: A histological diagnosis was obtained in 24 cases of the 27 patients (sensitivity 89%) and included cholangiocarcinoma (n=8), papillomatosis (n=3), ampullary adenoma (n=1), ampullary adenocarcinoma (n=1), hepatoma with intrabile duct invasion (n=1), and chronic inflammation (n=10). Post-procedural bleeding was noted in 1 patient. CONCLUSIONS: Percutaneous cholangiofiberscopic-guided forceps biopsy is a safe and easy to perform procedure. It yielded a high sensitivity rate for definitive diagnosis of very small or early intrabile duct lesions; thus, a curative therapeutic modality can be appropriately applied. The use of a video monitor system, which magnified the field of view without distorting the quality of the image, plays a crucial role in this technique. Mucin substance is commonly seen in cholangiocarcinoma. The association between bile duct stones and neoplasm needs further evaluation.

Adult↗
PubMed1993

The effect of forceps delivery on cognitive development.

OBJECTIVE: We evaluated the influence of forceps delivery on cognitive development of preschool children. STUDY DESIGN: A cohort of 3413 children who were born at the Kaiser Permanente Medical Center in Oakland, California, were selected at age 5 for intelligence quotient testing with the Peabody Picture Vocabulary Test and the Raven Coloured Progressive Matrices. Data were analyzed by means of the Student t test to compare mean intelligence quotient scores of intervention modes of delivery with spontaneous delivery. RESULTS: No significant difference in intelligence quotient was seen in 1192 children delivered by forceps (114 midforceps) compared with 1499 who were delivered spontaneously. CONCLUSION: The association of forceps delivery with adverse cognitive development cannot be supported.

Child Development↗
PubMed1995

High cervical spinal cord injury in neonates delivered with forceps: report of 15 cases.

OBJECTIVE: To inform obstetricians of a serious complication of forceps rotations of 90 degrees or more--high cervical spinal cord injury in neonates. METHODS: We reviewed the obstetric aspects of 15 cases of high cervical spinal cord birth injury diagnosed during 1982-1994 at two tertiary-care children's hospitals in Canada. RESULTS: The common feature in all cases was a forceps cephalic delivery, almost always a rotation of 90 degrees or more from the occipitoposterior or occipitotransverse position. CONCLUSION: High cervical spinal cord injury in neonates is a rare but specific complication of forceps rotation.

Birth Injuries↗
PubMed2004

Cohort study of forceps delivery and the risk of epilepsy in adulthood.

OBJECTIVE: The purpose of this study was to investigate the relationship between forceps delivery and epilepsy in adulthood. Study design We conducted a cohort study of 21,441 births with record linkage to data from the Tayside Medicine Monitoring unit (MEMO) and Scottish morbidity records (SMR1). RESULTS: Delivery by forceps was not associated with epilepsy compared with all other deliveries, adjusted odds ratio (OR) 1.0 (95 % CI, 0.6-1.8). Epilepsy in adulthood was associated with a family history of epilepsy, adjusted OR 2.4 (95% CI, 1.7-3.2), increasing social deprivation, adjusted OR 1.1 for each Carstairs score (95% CI, 1.0-1.2), and male gender, adjusted OR 1.4 (95% CI, 1.0-1.8). Preterm birth was associated with an increased risk of epilepsy, adjusted OR 2.0 (95% CI, 1.2-3.2) but no other antenatal, intrapartum, or neonatal risk factors were identified. CONCLUSION: These findings do not suggest an association between forceps delivery and epilepsy in adulthood; however, preterm birth may be an important risk factor.

Adult↗
PubMed1990

Risk factors for third-degree and fourth-degree perineal lacerations in forceps and vacuum deliveries.

Third- and fourth-degree perineal lacerations occur frequently during operative vaginal deliveries. To identify risk factors for lacerations, 2832 consecutive forceps and vacuum extraction deliveries were analyzed. Third- and fourth-degree lacerations occurred in 30% of deliveries. Multiple logistic regression was used to control for intercorrelation between potential risk factors. Factors associated with increased risk for third- and fourth-degree lacerations were midline episiotomy, nulliparity, second-stage arrest, occipitoposterior position, low or mid station, use of forceps instead of vacuum, use of local anesthesia, and Asian race. When these factors were controlled, there was no effect of birth weight, faculty versus resident operator, gestational age, abnormalities of first-stage labor, or several other factors. Prevention of perineal lacerations requires that the operator identify the patient at risk. Possible options for management of high-risk patients include use of mediolateral episiotomy or no episiotomy, use of vacuum extraction instead of forceps, and use of conduction anesthesia.

Anesthesia, Obstetrical↗
PubMed1992

Vaginal foreign body extraction by forceps: a case report.

Cases in which foreign bodies have been inserted into the vagina are uncommon but do occur. The technique and use of obstetric forceps for the extraction of an orange as a vaginal foreign body is described in this case report. Tucker-McLane forceps are the forceps of choice for this technique in this case.

Adult↗
PubMed2000

Choroidal rupture associated with forceps delivery.

PURPOSE: To report a case of choroidal rupture associated with forceps delivery. METHOD: Case report. RESULTS: We examined a 4-year-old boy with a history of a retinal scar in the right eye. The child was delivered with forceps and had bitemporal ecchymoses at birth. There was no other history of trauma. Ophthalmoscopic examination of the right eye with a vision of counting fingers revealed linear scars from choroidal rupture in the posterior pole, including one through the macula. Anterior segment examination was normal. Examination of the left eye was completely normal. CONCLUSION: Ocular trauma associated with forceps delivery may rarely result in choroidal ruptures, even in the absence of external signs of injury, such as breaks in Descemet membrane.

Child, Preschool↗
PubMed2003

Brachial plexus paresis associated with fetal neck compression from forceps.

Instrumental vaginal deliveries have been associated with higher risks of brachial plexus injuries. The proposed mechanisms involve the indirect association of instrumental deliveries with shoulder dystocia and nerve stretch injuries secondary to rotations of 90 degrees or more. We present a brachial plexus paresis resulting from direct compression of the forceps blade in the fetal neck. A term infant was delivered by a low Kielland forceps rotation. No shoulder dystocia was noted. The immediate neonatal exam revealed an Erb's palsy and an ipsilateral bruise in the lateral aspect of the neck. The paresis resolved during the first day of life. Direct cervical compression of the fetal neck by forceps in procedures involving rotations of the presentation may result in brachial plexus injuries.

Adult↗
PubMed1999

Vanishing forceps delivery.

This study evaluates the effect of decreasing cesarean rates and increasing regional anesthesia use on the frequency of forceps deliveries. Data of women who delivered at our community hospital from 1990 through 1997 are reviewed. In 1994, the members of our department adopted several strategies to decrease cesarean deliveries. The cesarean rate decreased whereas regional analgesia use increased. We studied the frequency and type of vaginal operative deliveries during this 8 year period. These data were evaluated by chi2 analysis. Data of women who delivered in the first 4 years (group 1) were compared with data of those who delivered in the second 4 years (group 2). A p < 0.05 was considered significant. The demographic and clinical characteristics of these women remained unchanged during the study period. The total cesarean rate decreased from 23.2% in group 1 to 17.9% in group 2 (p < 0.0001). The proportion of women who received regional anesthesia increased from 18.8 in group 1 to 25.7 in group 2 (p < 0.0001). Vaginal operative deliveries increased from 3.6 to 5.5 (p < 0.0001), whereas the proportion of forceps deliveries decreased from 2.2 to 1.5 (p = 0.001). Perinatal morbidity and mortality did not change. The decrease in cesarean rate and increase in regional anesthesia use were associated with an increase in operative deliveries; however, forceps deliveries continue to decrease in our community hospital.

Analgesia, Obstetrical↗
PubMed1984

[Improved Bamberg divergence forceps. Modification for the prevention of soft tissue injuries of the pelvis].

Constant and limited (max. 300 g) force of application by the Bamberg divergent forceps helps to prevent compression injuries and slippage of the forceps with resultant trauma. No serious foetal lesions have been observed over a period of 9 years. Maternal soft-tissue injuries were somewhat above the range of vacuum extractions. This prompted us to consider modifying the Bamberg forceps with a view towards preventing such maternal injuries.

Birth Injuries↗