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PubMed1977

Ketamine and diazepam as anaesthesia for forceps delivery. A comparative study.

In a clinically controlled trial in forceps delivery, a comparison was made between the general anaesthesia induced by ketamine and that by a combination of diazepam and N2O. Local anaesthesia was added in the diazepam group for episiotomy and suturation. The indication for operative delivery was in all cases a prolonged second stage of labour. In the katamine group, awareness was noted in four cases out of 13, even if the analgesic effect was found to be good. Four patients showed marked, short-lasting elevation of blood pressure and seven had unpleasant dreams. All thirteen mothers in the diazepam group found the anesthesia effective and the recovery pleasant. The blood pressure was stable. One mother in each group required ventilation with oxygen due to respiratory depression of short duration. Three of the children in the ketamine group and two in the diazepam group had subnormal Apgar score with slight acidosis. This was probably not attributable to the anaesthesia.

Adult↗
PubMed2004

Percutaneous tracheostomy: Ciaglia Blue Rhino versus Griggs' Guide Wire Dilating Forceps. A prospective randomized trial.

BACKGROUND: Percutaneous tracheostomy (PT) has gained widespread acceptance to control the airway in patients requiring prolonged mechanical ventilation. Since 1985, new techniques for PT have been described. It was the aim of this investigation to compare two different PT techniques: the Ciaglia Blue Rhino (CBR) and the Guide Wire Dilating Forceps (GWDF). METHODS: A prospective randomized trial was performed in four intensive care units. After informed consent, 53 consecutive patients were randomized to undergo CBR or GWDF. Procedural complications were evaluated and specific symptoms of the upper airway tract in survivors were assessed. RESULTS: Twenty-seven patients were randomly assigned to CBR and 26 to GWDF. Patients mean ages were 62.7 +/- 15.8 years and 62.2 +/- 18.3, respectively. Mean APACHE II scores were 20.6 +/- 6.8 and 21.2 +/- 7.2, respectively. Median duration of the procedure was 7 min (range: 4-17 min) with GWDF and 9 min (range: 5-32 min) with CBR (P = 0.16). Seven patients in the group undergoing GWDF had complications (desaturation: two; mild bleeding: one; infected stoma: one; inability to complete the procedure: three). Two patients had complications in the group undergoing CBR (mild bleeding) (P = 0.07). Survivors were followed up after discharge. Three patients (all of them having undergone GWDF) were symptomatic (two with mild hoarseness and one with a persistent foreign body sensation), but laryngotracheoscopy was negative. CONCLUSIONS: Our results show no differences between both techniques regarding surgical duration or procedural complications. Late symptoms were encountered in three patients undergoing GWDF, however, laryngotracheoscopy failed to document anatomical or functional abnormalities.

Chi-Square Distribution↗
PubMed1997

The use of Terson lens capsule forceps when performing punch biopsy of the skin.

When performing skin biopsy using the skin biopsy punch, it is recommended that Terson lens capsule forceps be used as an aid to avoid crush artefact. This is because secure yet gentle purchase of the specimen is allowed by a row of small inwardly directed tines that arise from the 2.5 mm horizontally placed grasping blades, which are inserted into the incision created by a 3 mm biopsy punch. The instrument also has the extra advantages of being in the correct working position when held with the hand in the resting position between prone and supine of allowing an uninterrupted line of vision to the wound during use and is of a shape that minimizes unintentional contact with tissue.

Biopsy, Needle↗
PubMed2006

Usefulness of tonsil forceps in radical retropubic prostatectomy.

The presence of positive surgical margins after radical retropubic prostatectomy (RRP) for prostate cancer leads to an increased risk of progression and reduces disease free survival. A positive surgical margin at the apex is more frequent and is associated with worse clinical prognosis compared to other locations. The urethra usually enters the prostate slightly anterior and proximal to the prostatic apex. After dividing the dorsal vessels and separating neurovascular bundles (NVB) from the prostatic urethral junction using scissors, the operator dissects around the urethra just below the apex to avoid incision into the apex and injury of the NVB and sphincter mechanism. We use tonsil forceps instead of a right-angle clamp to make this important operative step more approachable. Its special curved shape with an angle of 105 degrees and short tip should make it much easier to isolate the urethra just below the apex from the surrounding tissue.

Humans↗
PubMed2005

Bipolar electrocoagulation vs conventional monopolar hot biopsy forceps in the endoscopic treatment of diminutive rectal adenomas.

OBJECTIVE: To assess whether a cold biopsy from a diminutive rectal adenoma followed by destruction with bipolar (gold probe) electrocoagulation using large probes and high power setting would be a safe and efficient alternative to conventional monopolar hot biopsy forceps (MHBF). PATIENTS AND METHODS: Eligible patients were those undergoing colonoscopy, fulfilling the criteria of additional clearing colonoscopy and having at least one suspected rectal adenoma < or = 5 mm. At the time of endoscopy patients were randomized to receive treatment for their diminutive rectal adenomas either with cold biopsy followed by repeated gold probe electrocoagulation (Group A) using a 10 Fr catheter with setting 8 (40 W) for 1 second or with MHBF (Group B). These patients were followed up with a colonoscopy at 2-4 months. RESULTS: A total number of 24 (15 males, 9 females; mean age 56 years) patients were included in group A and 26 (14 males, 12 females; mean age 58 years) in group B. A total number of 38 and 37 diminutive rectal adenomas was detected in patients of Group A and Group B, respectively. At follow up colonoscopy residual adenoma tissue was found in 2 (5.2%) adenomas of 38 in Group A and in 4 (10.8%) of 37 in Group B (P > 0.3). No complications related to colonoscopy or endoscopic treatments in both groups occurred. CONCLUSIONS: Our data suggest that the use of cold biopsy followed by bipolar electrocoagulation using large probes and high power setting for destroying diminutive rectal adenoma seems to be equally effective and safe as MHBF.

Adenoma↗
PubMed1991

The Carmalt straight splinter forceps: a versatile economical instrument.

The inexpensive Carmalt straight splinter forceps has many uses including removal and placement of wound closure adhesive strips, suture removal, isolating small blood vessels for electrosurgical destruction, and holding suture ends prior to cutting. It can also be used to assist in suturing.

Equipment Design↗
PubMed1993

In vitro determination of the forceps level for extraction of teeth for periodontal reasons.

The aim of the present study was to validate dentists' periodontal reasons for extraction by comparison with the in vitro periodontal status of extracted teeth. A national systematic random sample of Norwegian dentists (n = 500) was requested to record primary, secondary and tertiary reasons for tooth extraction for a period of 2 weeks in 1988. The response rate was 70%. The extracted permanent teeth from the first 2 patients of each dentist were collected. Of the 365 teeth, 329 satisfied the criteria for assessment of periodontal attachment after staining. Using a dissecting microscope (10x), 4 to 8 linear measurements were recorded per tooth. 159 of the 329 teeth had loss of periodontal support. Of the 93 teeth for which the dentists' reason for extraction included periodontal considerations, 1% had 1-10% loss of attachment, 59% had 11-50% loss and 40% had 51-76% loss of periodontal support. There was a significant correlation between in vitro measurements of attachment loss and a ranking of teeth on a scale from 1 to 3 based on the dentists' emphasis on periodontal reasons for extraction (The Spearman Rs = 0.29, p < 0.01). The results suggest that the forceps level for removal of teeth for periodontal reasons was set at a relatively early stage of the disease process by Norwegian dentists, and that there was a weak association between attachment loss and the dentists' emphasis on periodontal reasons for extraction.

Age Factors↗
PubMed1996

Influence of conventional forceps extraction and extraction with an extrusion instrument on cementoblast loss and external root resorption of replanted monkey incisors.

Cementoblast loss and root resorption on the root surface was registered histologically after removal and immediate replantation of maxillary central incisors in monkeys (Cecropithecus aethiops). Incisors were removed with either a conventional extraction technique using forceps or with a special designed extrusion instrument and in both cases teeth were immediately replanted. Altogether 18 monkeys were used for the experiments in which 9 monkeys were sacrificed after 3 d and 9 animals after 8 wk. Histological analysis was made in horizontal sections perpendicular to the long axis of the tooth using either 24 measuring points or 12 sections. Histometric analysis showed extensive cementoblast loss in the periodontal ligament (PDL) and with a maximum of damage occurring on the corner surfaces of the root. Extracted teeth showed significantly more extensive cementoblast loss than extruded teeth. Root resorption was also found in the corner locations and was significantly more frequent in extracted than in extruded teeth. There was a similarity in the distribution of cementoblast loss and root resorption indicating that root resorption develops in the same areas where cementoblast loss takes place, i.e. locations that are more compressed during removal of the tooth and must have caused by mechanical damage to the PDL exerted on the root surface during tooth removal.

Animals↗
PubMed1986

Posterior chamber intraocular lens implantation--a new forceps to simplify capsular bag fixation.

The case for capsular bag fixation of the Sinsky-Kratz type of posterior chamber intraocular implant lens is presented, and the various methods in use to position implant lenses are outlined. The new forceps are described and the rationale for their adoption and use is given in an illustrated, step-by-step fashion. Their additional use in anterior chamber intraocular lens implantation is mentioned. There is a brief summary of the author's experience with this instrument.

Cataract Extraction↗
PubMed1986

The magician's forceps phenomenon in exotropia under general anaesthesia.

Prifinium bromide was administered for eight weeks to three patients with exotropia. Under general anaesthesia active discharges from the lateral rectus muscles were demonstrated by electromyography. When a slight adductive force was applied to the straight or the master eye, active discharge from the lateral rectus of the associate eye disappeared in all patients, and this eye moved in the direction of orthophorisation. The discharge reappeared when the master eye was released from the forced adduction. From these results the authors concluded that proprioception is involved in the magician's forceps phenomenon discovered by Mitsui in exotropic patients in 1978.

Adolescent↗
PubMed1992

Percutaneous visceral pleural biopsy with fenestrated cup biopsy forceps.

When there is an exudative pleural effusion often both the parietal and the visceral pleura are affected, but the usual practice is to perform a percutaneous parietal pleural biopsy alone for diagnosis. Percutaneous visceral pleural biopsy was carried out in 20 patients with exudative pleural effusions with fenestrated cup biopsy forceps. In all 20 biopsies pleural tissue was obtained and it was diagnostic in 19 cases. The procedure is painless and appears safe.

Adolescent↗
PubMed1999

Effect of cautery with irrigation forceps on the remnant liver after hepatectomy in rats.

Monopolar cautery with irrigation forceps (CIF) was devised for use in liver resection that does not require occlusion of inflow to the remnant liver. However, a high power output is required to divide the hepatic parenchyma which boils the irrigation water. This study was performed to investigate the effects of using CIF on the hepatic parenchyma. Histologic and biochemical examination was performed in rats which had undergone hepatectomy using the CIF, irrigating bipolar (IB), Pringle's maneuver with blunt dissection (group P), or a sham operation. A greater cautery distance was obtained with the CIF than the IB. There was no significant difference in the remnant liver function after the 1st postoperative day in any of the groups. CIF is an effective instrument for anatomic or nonanatomic hepatic resection.

Animals↗
PubMed2000

Open thumb forceps. An unusual foreign body in the urethra: technique of its removal.

A great variety of foreign bodies in the urethra have been reported in the literature. Mostly, these cases were reported to emphasize the unusual nature of the objects requiring technical modifications for their removal. We report an interesting case of self introduced open thumb forceps into the urethra and technique of its retrieval.

Adult↗
PubMed1994

Stereotactic brain biopsies in AIDS patients: superior diagnostic yield with side-cutting needle than with cup forceps.

Controversy still exists over the indicators for, and usefulness of, performing brain biopsies in AIDS patients with focal cerebral lesions. One of the sources of doubt is the relatively poor diagnostic yield in biopsying lesions in AIDS patients compared with patients who do not have AIDS. In our institution, we performed 25 CT-guided stereotactic biopsies using the Brown-Roberts-Wells system within a 1-year period. Of these, 11 were performed with a 2-mm-diameter cup forceps, and 14 with a 10-mm-long x 2-mm-diameter side-cutting needle. Abnormal tissue was obtained from all patients, but, in the first group, 5 (45%) biopsies were nondiagnostic, and, in the second group, none (0%) were nondiagnostic. Of the diagnostic biopsies, there was roughly an equal proportion of lymphoma, progressive multifocal leukoencephalopathy, and toxoplasmosis between the two techniques. It is surmised that the deciding factor leading to an enhanced diagnostic yield with the side-cutting needle was the larger amount of tissue obtained with this instrument.

Acquired Immunodeficiency Syndrome↗