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A new obstetric forceps is presented. The model is a straight divergent forceps with a sliding lock. In seventeen deliveries the forceps was technically easy to handle and caused very little trauma to the fetal head.
Two pairs of forceps for the implantation of Choyce Mark IX anterior chamber lenses are described. Both pairs of forceps can be used for problem-free implantation of the Choyce Mark IX lens. The mouth of one of them is so flat that it enables the surgeon to implant the lens without flattening the anterior chamber. The second pair of forceps is used in the rate event that an exchange of the Choyce Mark IX lens is desired. It allows a firm, secure grip on the lens.
OBJECTIVE: To notify neurosurgeons about a modified bayonet forceps that aids application of the vagus nerve stimulating electrode. METHODS: The manufacturer (Codman & Shurtleff, Inc., Raynham, MA) extended the tips of an upward-angled Malis bayonet forceps from 2 mm to 6 mm. RESULTS: The modified bayonet tips, when placed under the vagus nerve, extend well beyond the edge of the usual vagus nerve to easily accept the electrode lead. CONCLUSION: The modified bayonet forceps and depicted wrapping sequence shorten electrode wrapping time.
OBJECTIVE: To describe a new method for taking a synovial biopsy specimen under ultrasound guidance using portal and forceps. METHODS: Percutaneous ultrasound guided biopsy was performed for 37 patients with mono- or polyarthritis as outpatients. A portal to a planned area was built using a needle, guiding wire, and dilators, through which forceps could be inserted and samples taken. Biopsy samples were taken from small and large joints, bursae, and tendon sheaths. RESULTS: Representative synovial tissue in adequate amounts for histopathological evaluation was obtained in 33/37 cases--a success rate of 89%. The biopsy procedures were well tolerated, but one complication of skin infection was encountered. CONCLUSION: The new method of synovium biopsy under ultrasound guidance using sheath introducer set and flexible forceps can be performed on most joints and even bursae and tendon sheaths. The method gives sufficient samples for clinical work in most cases, but further work is needed before accepting this promising technique for scientific purposes.
A new type of foreign body retrieval forceps recently has become available. It consists of single- or multiple-tooth forceps mounted on a flexible stainless steel 0.038-inch shaft. The authors have successfully used this device in the vascular system (three cases), in the urinary tract (seven cases), and in the biliary system (two cases) without complications. Foreign bodies removed include a catheter fragment, angiographic guide wire, detachable balloon, stone retrieval basket, and various stents. All the procedures were performed quickly and without difficulty. For the authors, these forceps have become the first choice in many retrieval situations.
This paper considers two new elevator and dental forceps techniques for the atraumatic removal of teeth to avoid a surgical procedure where possible. The techniques described should be applicable in relatively well defined but commonly occurring situations. The two techniques involve the unconventional use of conventional dental extraction forceps, with the aim of facilitating removal of the retained roots of certain teeth: the first for incisors, canines and premolars and the second for lower first molars. The term 'surgical forceps technique's is tentatively put forward as a description of these hybrid procedures.
BACKGROUND AND OBJECTIVE: Preoperative detection of non-small cell lung cancer (NSCLC) metastasis to the main carina and upper-lobe carina can alter the operative approach, preclude further staging procedures, and save many patients from thoracotomy. This study assessed whether bronchoscopic forceps biopsy of the normal-appearing main carina and upper-lobe carina (blind biopsy) ipsilateral to the primary NSCLC lesion improved the accuracy of cancer staging and helped guide the management of these patients. PATIENTS AND METHODS: A prospective study of 52 patients was carried out at the SSK Süreyyapasa Center for Chest Disease and Cardiothoracic Surgery. Over a 6-month period, we bronchoscopically evaluated 52 consecutive NSCLC patients who were radiologically classified as operable. At least five blind forceps biopsy specimens were obtained from the main carina and/or upper-lobe carina during each patient's initial fiberoptic bronchoscopic examination. Biopsy specimens were collected from the main carina and upper-lobe carina in 51 and 17 patients, respectively. Initially, all patients were staged and evaluated for operability in standard fashion, without histologic assessment of the blind biopsy specimens. We then restaged the disease and reassessed the patients' operability in light of the biopsy findings. RESULTS: Metastasis was histologically diagnosed in seven patients (13.7%) who underwent main carina biopsy and in four patients (23.5%) who underwent upper-lobe carina biopsy. Cancer-positive blind biopsy results changed the status of 25% (6 of 24) of patients from operable to inoperable, and changed the surgical approach in 11.1% (2 of 18) of patients who ultimately did undergo surgery. We found no statistical relationship between metastasis to either carina and tumor type, stage of disease, visibility of the tumor on fiberoptic bronchoscopy, primary tumor location, T status, or N status (p > 0.05). CONCLUSIONS: A blind forceps biopsy of the main carina and upper-lobe carina ipsilateral to the lesion site should be done routinely at initial bronchoscopic examination of all radiologically operable patients with suspected lung cancer. This type of screening can save a significant number of NSCLC patients from inappropriate or unnecessary thoracotomy and further staging procedures with their associated morbidity and risk.
PURPOSE: To compare two methods of botulinum toxin A (BTA) injection into the extraocular muscle (EOM): the electromyographically (EMG) guided injection and the injection using Mendonça's forceps. METHODS: Twenty-nine (29) patients with strabismus and low visual acuity in one eye were examined at the Department of Ophthalmology of UNIFESP. They were divided into 2 groups -- group I with 17 patients receiving the botulinum toxin A injection using Mendonça's forceps, and group II with 12 patients receiving the toxin with electromyographical guidance. The patients of both groups were examined on the 7th and 14th day after intervention and the outcome of both methods of botulinum toxin A injection were compared. Friedman and Mann-Whitney correlation tests were used in the statistical analysis of the data. RESULTS: Although the follow-up examinations on the 7th and 14th days showed a different behavior between both methods, there was no statistically significant difference between the mean values of the correction attained in both groups at the end of this study. CONCLUSION: No statistically significant difference was shown between the two groups. Mendonça's forceps can be a safe alternative to electromyography to locate an extraocular muscle for botulinum toxin A injection.
To obtain a histopathologic diagnosis at the site of a biliary obstruction, we recently have performed 24 cases of biliary biopsy using gastrofiberscopic biopsy forceps (Olympus, Tokyo, Japan) via transhepatic tracts provided in the course of the procedure of percutaneous biliary drainage. Histopathologic diagnosis was successfully made at the first attempt of biopsy procedure but a second trial was made a week later in 6 cases who were negative for malignant cells on the first attempt. The histological results from the biopsy specimens were 18 adenocarcinomas, 5 chronic inflammations and one normal epithelium. Of 6 cases who were negative for malignant cells on forceps biopsy specimen, three cases were confirmed as adenocarcinoma of the ampulla of Vater, adenocarcinoma of the pancreas and chronic pancreatitis by surgical biopsy. The latter was a true negative result, which was diagnosed as chronic inflammation on forceps biopsy and verified as chronic pancreatitis by surgery. The remaining two cases were diagnosed as malignant obstructive jaundice by clinical and radiological follow-up findings. Major complications (bile peritonitis, bleeding, and hemopneumothorax) occurred in 3 patients, which mainly arose in the earlier period of study. This procedure can be performed at the same time as percutaneous transhepatic biliary drainage with low morbidity or mortality, and although the potential for perforation of bile ducts and injury to adjacent blood vessels is considered it is a useful addition to existing biopsy techniques for yielding material sufficient for histologic analysis.
BACKGROUND/AIMS: When a benign-malignant borderline lesion is diagnosed by the usual small gastric biopsy, there is sometimes difficulty in making a clinical decision. To clarify potentially useful findings to predict the existence of gastric cancer in borderline lesions diagnosed by forceps biopsy, we retrospectively analyzed endoscopic features. METHODOLOGY: We diagnosed 68 consecutive gastric benign-malignant borderline lesions (57 cases) by forceps biopsy and endoscopically resected them. The final diagnosis for 24 lesions (35.3%) was adenocarcinoma (adenocarcinoma group), and for 40 lesions (58.8%) was adenoma (adenoma group). Comparison with endoscopic findings for the groups was carried out using digitally filed endoscopic photos. RESULTS: We found six endoscopic findings (distal location, reddish surface color, lack of smoothness, lack of glossiness, focal roughness, and focal redness) having statistically significant relationships with adenocarcinoma at the final pathological diagnosis. In multivariate analysis, focal redness (p<0.01) and lack of glossiness (p<0.05) were found to have a significant relationship to gastric cancer. CONCLUSIONS: Endoscopic findings such as focal redness and lack of glossiness were potentially predictive of gastric cancer in borderline lesions diagnosed by forceps biopsy.
The reduction of the forceps major of the corpus callosum was estimated quantitatively in relation to the lesions to the neocortex in animals to which methylazoxymethanol-acetate (MAM) had been administered on the 13 th, 15 th or 17 th day of embryonic development. The specimens which received a prenatal injection of MAM the 13 th or 15 the day of gestation show noticeable reductions in both the extension of the occipital neocortex and the forceps major of the corpus callosum. Parallelly in MAM 13 there is a significant reduction in cell density both in the deeper layers and the more superficial ones, whereas in MAM 15 only the supragranular layers seem to be altered. Such a quantitative analysis shows a close correlation among the decreases in the area of the forceps major of the corpus callosum, in the area of the occipital neocortex and in cell density of the infragranular and supragranular layers.
It was the aim the present study to evaluate maternal morbidity and fetal outcome of 832 pelvic outlet forceps deliveries during the years 1974 through 1977 with special reference to the method of anesthesia (Epidural anesthesia (EA) with Bupivacain 0,5% or general anesthesia (GA) with Methohexital-Na and Succinylcholin). Maternal vaginal and/or cervical injuries were seen significantly (p less than 0,001) more often in the forceps group than in spontaneous, vacuum, or breech deliveries. Vaginal injuries occurred less often (p less than 0,01) in the EA- than in the GA-group. Forceps deliveries were not associated with increased maternal morbidity in fetuses weighing 3750gr or more. The cardiotocography scores (Hammacher et al. 1974) of the 30 minutes preceeding delivery (final scores) were better with EA than with GA (p less than 0,01). Arterial cord pH and 1 minute Apgar values were similar in both groups. The same was true for fetuses with a birthweight of 3750gr or more. The time for cervical dilatation from 7 to 10 cm and duration of the second stage of labor did not influence maternal morbidity or fetal outcome, regardless of the method of anesthesia.
Eighteen recent cases of failed forceps operations are reviewed. Although no maternal or fetal deaths occurred, low Apgar scores were found in more than half of those patients considered at significant risk with the use of the Perinatal Morbidity Index (PMI) and Maternal Morbidity Index (MMI) developed at our institution. Among low-risk patients more favorable results were found. Whenever difficulty in a forceps delivery is encountered because of misjudgement of pelvic capacity or fetal size, further attempts at vaginal delivery should cease and a cesarean section should be performed. This procedure will most likely lead to a favorable outcome for mother and child. A patient already at significant risk should, under ordinary circumstances, not be considered a candidate for a forceps trial. If the trial is successful, the infant has a nearly 50% chance of unfavorable outcome; if it is unsuccessful, the chance of an unfavorable outcome is 64%.
Lenses were pulled from rabbit and human eyes with a Verhoeff forceps suspended from a pulley. One human lens capsule ruptured with 10 gm and one with 14 gm. Eight human lenses were pulled out intact with 10 to 18 gm. One rabbit lens capsule ruptured with 18 gm and one with 20 gm. Eight rabbit lenses were pulled out intact with 12 to 24 gm. The cryoprobe on the pulley did not rupture any lenses. Thirty grams of counter pressure reduced the pull required to extract rabbit lenses by 50%. Weights were added to a Verhoeff forceps suspended from a rabbit lens supported by a lens loop. One lens was ruptured at 17 gm, and nine lenses were pulled through the loop with 17 to 27 gm. Capsule rupture occurred in 2.4% of 500 consecutive senile immature cataract extractions done with the Verhoeff forceps and counter pressure. Counter pressure did not disturb the vitreous body.
Some healthcare practitioners have recommended the use of disposable medical accessories as standard practice. Advantages of using disposable medical equipment include the potential for infection prevention, convenience, and decreased reprocessing and storage costs. Disadvantages of reusable accessories include the initial cost, "down time" required for repair and, most importantly, the potential for spreading infection. In this study, the investigators provide a cost analysis of reusable biopsy forceps for a 12-month period from April 1993 through March 1994. This prospective, descriptive study evaluated purchase price, number of uses, repair history, and cleaning costs for reusable biopsy forceps used in the endoscopy unit of a large multi-specialty clinic. Results of the study revealed that the reusable biopsy forceps became cost-effective after seven uses.
The paper studies the basic parameters of dental forceps, which affect the possible destruction of the tooth removed at surgery by using mathematical simulation. Evidence is provided for the truthfulness of the anatomical rule when the dentist chooses dental forceps. Emphasis is laid on the necessity of rationally using the forceps. A procedure is proposed to assess dental instruments.
The purpose of this study was to assess the effects of spontaneous and instrumented deliveries, the baby's birthweight, the presence of stress incontinence and the woman's age and weight on bladder neck (BN) position and mobility using perineosonography, a simple non-invasive method, and to compare these results with those from continent nulliparous controls. Two hundred and fourteen women, including 74 nullipara, 29 para-1, 64 para-2 and 3, 16 with previous forceps deliveries and 32 with stress incontinence, underwent perineosonography with measurements of BN position and backwards/downwards displacement of BN using a two-axis calculation system. Results showed that bladder neck position undergoes a significantly backwards and downwards displacement on assuming an upright position. When compared with nulliparous controls, the bladder neck position at rest was the same in all groups of parous women in the supine/standing positions, but lower in patients having undergone forceps delivery (standing position) and in stress incontinent patients (both supine and standing); the bladder neck position during Valsalva was significantly lower in all groups of patients in the standing position, but the only significant difference in the supine position was seen in stress incontinent patients; the extent of bladder neck displacement was not significantly different between the groups, except in stress incontinent patients. A strong correlation (r = 0.66) was found between the relative importance of backwards and downwards displacement, but no correlation was found between bladder neck displacement and baby's birth-weight or patient's weight. It was concluded that compared to nulliparous continent patients, normal and instrumented delivery induces no modifications of BN position at rest, but is responsible for a lower bladder neck position during Valsalva in the standing position only. The extent of BN displacement is virtually the same in all groups of patients in both positions, except for stress incontinent patients, who have a significantly lower and more mobile bladder neck, the values of which overlap to a great extent (sensitivity of 78%/75% for a displacement > 14 mm) within those seen in continent nulliparous women. The correlation between the importance of backwards and downwards displacement is strong, making superfluous a two-dimensional coordinate system for routine BN position/mobility assessment.
BACKGROUND: Eyes with tears in Descemet's membrane secondary to forceps injuries frequently develop myopic astigmatism. Little is known regarding the longitudinal changes in the refractive errors of these eyes. METHODS: We performed a retrospective review of two children with tears in Descemet's membrane following forceps injuries to their left eyes. The refractive errors were followed longitudinally. RESULTS: Both patients developed myopic astigmatism in their affected eye and received optical correction and occlusion therapy. In both cases there was reduction in the myopic refractive error during early childhood. While the astigmatic refractive error was stable in one patient it decreased in the second patient. CONCLUSION: Myopia decreased in two children with myopic astigmatism secondary to tears in Descemet's membrane. Myopia in children with tears in Desemet's membrane is likely due to deformation of the cornea rather than form-deprivation.