Friday, October 14, 2011

CRUSHING CLAMPS




Crushing clamps



When is GI re-section required?

Re-section of bowel is required in cases of gangrene of the bowel (which may be caused by strangulation, thrombosis) or cancer.

The special instruments required are

·       Crushing clamps

·       Non-crushing clamps.



Crushing clamps

Crushing clamps are generally used with an objective to crush the muscle coat of the bowel thus obliterating the vascular supply.
These crushing clamps thus have



·       Blades that are heavy and strong

·       Blades of parker-Kerr are curved and of Lang-Stevenson are straight

·       Loops for finger

·       A catch for gradual crushing.



Identification points

·       The instrument is heavy.

·       The jaws appose closely.

·       These occlude lumen and vessels.

·       These are used on the segment that is removed from the body.



These clamps are of three types:

(a)    Payr’s smaller crushing clamp

(b)   Payr’s smaller clamps

(c)    Parker-Kerr’s crushing clamps.



Identification points

·       Payr’s gastric crushing clamps have heavy blades and handle.

·       The joints are 4 and these double the force of action of the blades.

·       The jaws have longitudinal serrations.

·       The jaws are long so as to reach from lesser to greater curvature of stomach.

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