SURGICAL INSTUMENTS 10 Gastric Intestinal Clamps

Gastric and Intestinal Clamps

Intestinal clamps are large self-retaining forceps with a primary function to occlude the bowel lumen.

         These clamps are indeed tissue forceps to allow firm holding of stomach and intestines.

         The non-crushing intestinal clamps do not cause permanent injury to the wall of the held viscus.

•       They occlude the viscus lumen and prevent spillage of infected bowel contents.

•       Temporarily occlude circulation in the bowel wall and thus keep the operative field free of blood.

•       Facilitate anastomosis by allowing the bowel ends to be approximated and manipulated.

         The varieties of clamps in use are:

         •       Doyen’s (Fig. 8.64)

         •       Kochers (Figs 8.65A and B)

         •       Lane (Fig. 8.66)

         •       Lane twin anastomotic clamp (Fig. 8.67)

         •       Lloyd Davies Rectal occlusion forceps (Fig. 8.68)

         •       Payr intestinal clamp (Figs 8.69A and B)

         •       Lang Stevenson (Fig. 8.70)

         •       Parker Kerr (Fig. 8.71)

         •       Zachary Cope (Fig. 8.72) (see pages 156-157) 

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SURGICAL INSTRUMENTS 9 Tissue forceps

Tissue Forceps

Tissue grasping forceps are designed to grasp tissues without crushing them so as to allow their manipulation.

         They look like hemostatic forceps except that the blades approximate only at the tips leave a space along the shaft for the tissue held. The tips are usually made in the form of teeth to reduce tissue damage and improve grip.

         To facilitate dissection body tissues need to be held, maneuvered, freed and approxi­mated. These instruments have shafts, rings and locking device.

         Their holdings ends however have:

         •       Elasticity to reduce injury.

         •       Space to accommodate tissue.

         •       Narrow tips.

         The varieties are:

         •       Allis (Fig. 8.57)

         •       Lane (Fig. 8.58)

         •       Babcock (Fig. 8.59)

         •       Littlewood (Fig. 8.60)

         •       Stile (Fig. 8.61)

         •       Duval (Fig. 8.62)

         •       DeBakey lung forceps (Fig. 8.63) (see pages 154-155).

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SURGICAL INSTRUMENTS 8 Heamostats

Hemostats

The function of hemostat forceps is to stop or prevent bleeding.

         They look very much like scissors and incorporate a rachet lock on spring steel handles and crushing jaws instead of blades.

         Artery forceps are primarily for holding open ends of bleeding blood vessels.

         The tips have serrations with or without teeth to provide a firm grip.

         There is also a locking device this allows the vessels to be held while others can be dealt with.

         The handles have rings to accommodate the fingers. The tissue is grasped between the jaw tips. The varieties are:

•       Spencer-Wells artery forceps (Figs 8.51A and B)

•       Crile artery forceps (Fig. 8.52)

•       Dunhill artery forceps (Fig. 8.53)

•       Rochester-Ochsner forceps (Figs 8.54A and B)

•       Kocher artery forceps (Figs 8.55A and B)

•       Moynihan artery forceps (Fig. 8.56) (see pages 151-153).

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SURGICAL INSTRUMENT Dissecting forceps canadian - lane

Dissecting Forceps

These are also called thumb forceps because their shafts are closed by the surgeon’s thumb. They are used to grasp tissues in order to facilitate dissection or suturing and are divided into toothed and non-toothed.

         Dissecting forceps have two shaft and no joint the tip is serrated and may have teeth. When pressed they provide a firm grip on tissues but the firmness depends on how much pressure is put on the shafts. There is no locking catch on the shafts. The shafts spring back to open position when pressure is released. They are used to hold tissues while dissecting. The varieties are:

•       Canadian (Fig. 8.47)

•       Mitchell’s (toothed and non-toothed) (Figs 8.48A and B)

•       Adson’s (Fig. 8.49)

•       Lane (Fig. 8.50).

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