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[Psychomotor development of children born operatively by Caesarian section, vacuum or forceps in the period between 3 and 7 years (author's transl)].

In the period between 1966 and 1977 9,591 children were born at the UFK, Mannheim, and of these 1.008 were operative deliveries (10.5%). Out of these children, 99 of those delivered by section, 39 by forceps, 140 by vacuum and 67 spontaneous births were examined in an alphabetically determined group (R) for mental and motor development. The means used for the follow-up investigation were the Kramer-Binet Intelligence Test, and careful questioning of the parents on their children's early development. No connection between the type of delivery and intelligence quotient could be determined. A mean IQ of 114.4 was found for those delivered by section, 116.6 for those by forceps, and 117.7 for thos delivered by vacuum. The spontaneously-born children had an IQ of 108.7. The IQ results determined were correlated with the following data: EPH-gestosis, alteration in the child's heart sounds, protracted birth and Apga. No significant differences in the intelligence or any delayed motor development could be found in relation to the comparative group.

Adult↗

[Optic attachment to a microsurgical forceps].

The authors suggest an original optic attachment to a microsurgical forceps which removes the shortcomings of the traditional optic apparatuses used in microsurgery. The attachment allows the lens to be brought directly to the operative zone and combines the functions of two instruments--forceps and magnifying glass. Such a combination expands considerably the possibilities of the operator and creates optimal conditions for precision manipulations. The optic attachment is used in reconstructive and restorative operations on the bile ducts and in operations on the large intestine at the stage of precision suture application.

Humans↗

[A case of polypoid bronchial neurofibroma originating from right B2b successfully treated by bronchoscopic snaring forceps and Nd-YAG laser therapy].

A 34-year-old man with persistent cough was admitted to our hospital. Bronchoscopic examination revealed a polypoid tumor with smooth surface which almost completely obstructed the right main bronchus. The tumor was removed by transbronchial snaring forceps and histologically confirmed as neurofibroma. Residual tumor was excised by biopsy forceps and further endoscopic Nd-YAG laser vaporization was performed. This is the first case in our country in which bronchoscopic treatment was performed for bronchial neurofibroma. Bronchoscopic removal might be the preferred treatment in the present case, although long-term follow-up is also required.

Adult↗

[A forceps for the bile ducts].

The authors suggest and use in the practice an original forceps for the bile ducts. With its application the stump of the cystic duct is intubated in minimal time and with less damage in operations on the bile ducts. The design and use of the suggested forceps are described.

Bile Ducts↗

Bladder and bowel injury after electrodesiccation with Kleppinger bipolar forceps. A clinicopathologic study.

To evaluate the extent of electrocoagulation damage in tissue undergoing bipolar desiccation, five mature female pigs were used as models of tissue and adjacent vital structures commonly encountered during operative laparoscopy. Electrocoagulation was performed on bowel mesentery, sidewall peritoneum, ureters, uterus, uterotubal junction and broad ligament; superficial bowel and bladder burns were treated. Kleppinger forceps were also used to coagulate various-sized arteries to determine hemostasis. Histopathologic analysis demonstrated no inflammation or tissue destruction beyond the desiccated area seen immediately after coagulation and no direct correlation between tissue thickness and spread of electrocoagulation. It also appears that blood vessel hemostasis can be achieved safely with Kleppinger forceps on vessels up to 3 mm in diameter.

Animals↗

[History of surgical instruments: 4. The Deschamp ligation needle for the Overholt forceps: development of instruments for blood-saving tissue preparation].

The development of effective ligature carrying forceps is described, which are useful in dissection. The ligature needle, which has been developed by the French surgeon J.F.L. Deschamp (1740-1824), is presented on the basis of his original publication from 1793. Today many surgeons use a ligature forceps, which has been developed in 1938 by R.H. Overholt (b. 1901) in Boston and was modified by R. Geissendörfer (1902-1976) in the 1950s.

Equipment Design↗

Low-cost self-irrigating bipolar forceps.

A low cost method for providing continuous saline drip in bipolar diathermy is described, which use is adaptable to any type of standard bipolar forceps. The advantages of this system versus commercially available self-irrigating forceps are reported.

Cost Control↗

Visual prognosis in patients with ruptures in Descemet's membrane due to forceps injuries.

Seven patients with Descemet's membrane ruptures associated with a forceps injury to the eye at birth were studied. A complete ophthalmological examination was done on each patient, and two patients had ultrasound measurements of the axial lengths of both eyes. We found that the ruptures in Descemet's membrane were single or multiple vertically oriented breaks associated with high astigmatism along the axis of the breaks and deep amblyopia in all patients. The astigmatic errors were corneal in origin. High myopia was also present in the involved eye and was thought to be axial in all patients. Two patients did have elongated axial lengths demonstrated by ultrasonography. The presence of axial myopia and deep amblyopia may relate to partial occlusion of the involved eye during the early postnatal months. The latter possibility is discussed in light of recent reports of myopia induced by early postnatal occlusion in animals.

Adolescent↗

Vesicouterine fistula as a complication of forceps delivery: a case report.

We report a case of vesicouterine fistula as a complication of forceps delivery revealed by urinary incontinence in a 68-year-old woman. Diagnosis was confirmed by examination and cystography. The treatment was a transperitoneal excision of the fistula. The literature is briefly reviewed and the treatment options are discussed.

Aged↗

Forceps-assisted vaginal delivery.

Operative vaginal delivery using forceps has been an important part of obstetric practice for nearly 400 years. Countless women and their children have benefited from timely and expertly performed procedures. Physicians must, therefore, make every effort to retain these skills, to modify and improve them in every possible way, and to pass them on. In this way, women and children of future generations will benefit from the many years of experience that have gone before them.

Equipment Design↗

Spinal cord transection, cerebral ischaemic and brain-stem injury in a baby following a Kielland's forceps rotation.

A full-term infant suffered a high cervical cord transection after a Kielland 's forceps rotation and extraction. Quadriplegia developed immediately and initial cerebral swelling was followed by atrophy with ventricular dilatation on CT examination. Death occurred at 60 days. At post-mortem complete necrosis of the cervical cord at C2-C3 with old haemorrhage in the meninges was found, with damage to the inferior corpora quadrigemina , the thalamus, striatum, cerebellar and cerebral cortex. The mechanism is discussed briefly.

Adult↗

A randomised controlled trial of biopsy forceps and cannula aspiration for transcervical chorionic villus sampling.

OBJECTIVE: This trial compared two instruments for transcervical chorionic villus sampling (CVS). DESIGN: Randomised controlled trial. SETTING: Regional university prenatal diagnosis and treatment centre. POPULATION: Two hundred women were randomised at 10(+0)-12(+6) weeks of gestation to transcervical CVS using cannula aspiration (CA) or biopsy forceps (BF). METHODS: Women undergoing indicated CVS signed informed consent. Randomisation after decision to perform transcervical CVS. MAIN OUTCOME MEASURES PRIMARY OUTCOME: the rise in maternal serum alpha-fetoprotein (alpha-FP). SECONDARY OUTCOMES: (i) placental trauma (fetomaternal haemorrhage [FMH]); (ii) laboratory, procedure, and cytogenetic results and pregnancy outcomes; (iii) patient and operator satisfaction; and (iv) economic analyses. Analyses were performed by intention to treat. RESULTS: The -FP rise did not differ between groups; there was no other evidence of placental trauma. BF were better tolerated by women, provided culturable tissue, after fewer instrument passes, with greater ease and in less time. BF were associated with cost savings. CONCLUSIONS: Unlike -FP, other markers of FMH were unaltered, questioning the reliability of alpha-FP as an indicator of FMH. Compared with CA, transcervical BF caused comparable placental trauma, appeared to be similarly effective and safe and were preferred by operators and patients.

Biopsy, Needle↗

Wrigley forceps to deliver a bulky uterus following a total laparoscopic hysterectomy for endometrial cancer.

Morcellation of the uterus is contraindicated in endometrial cancer and a uterine size of 11 weeks or larger has been considered a contraindication for total laparoscopic hysterectomy (TLH) in endometrial cancer. We describe a new technique of removing a bulky uterus in a patient with endometrial cancer with the use of Wrigley forceps following a total laparoscopic hysterectomy.

Adenocarcinoma↗

Dr Christian Kielland of Oslo (1871-1941) and his straight forceps.

Christian Kielland, a Norwegian obstetrician, published a description of his straight forceps in 1916. Although internationally recognised as a most valuable instrument for rotation of the fetal head, for many years his instrument received little appreciation in his own country.

Equipment Design↗

A preterm infant with upper cervical spinal cord injury, following delivery with Kielland's forceps.

A report is presented of a male infant who was born at 34 weeks' gestation, following rotation and delivery using Kielland's forceps. The initial diagnosis of hypoxic ischaemic encephalopathy delayed recognition of an upper cervical spinal and cord injury, which was subsequently confirmed by magnetic resonance imaging. The infant never developed spontaneous respiration and died following withdrawal of intensive care at 21 days of age.

Adult↗