Page 16 - BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery, 2nd Edition

Chapter 1 · Surgical principles and instrumentation

• Halsted mosquito forceps: These are small
(9–12.5 cm) fine-tipped artery forceps useful for grasping
VetBooks.ir separ ate and explore delicate areas of tissue or tissue
a bleeding vessel. They can also be used to gently
containing important structures. They have transverse
serrations and are available with regular or extra fine tips.
• Kelly or Crile forceps: These are sturdier, larger (14 cm)
artery forceps that can be used on thicker portions of
tissue, as well as for the placement of stay sutures. Both
(a) have transverse serrations, but Kelly forceps have
serrations over only the distal half of the jaw.
• Rochester–Pean forceps: These are strong artery
forceps, available in a variety of sizes (14–30 cm). They
have similar uses to Kelly and Crile forceps but may
also be used to clamp larger pedicles of tissue.
• Rochester–Carmalt and Schnidt forceps: These
(b) curved forceps can be used for oesophagostomy tube
placement. The forceps should be advanced from the
(a) Thumb forceps: 1 = Debakey forceps; 2 = Adson forceps.
1.4 (b) Debakey detail. oral cavity into the mid-cervical oesophagus and the
curved tips pushed laterally until they can be seen and
felt on the skin to be incised (Reiter, 2013).
Tissue forceps
Angled forceps
• Allis forceps: These have traumatic gripping teeth
(Figure 1.5) and should never be used on delicate Angled forceps (Figure 1.6) that can be used to dissect
tissue. They may be used on tissue that is definitely to around large vessels and pass ligatures are important
be excised and to secure suction, diathermy and power instruments in cardiothoracic surgery. The tips should be
lines to drapes. inspected before each use to ensure that they are smooth
• Babcock forceps: These have a smoother grasping and free of burrs.
surface (Figure 1.5) with curved longitudinal striations,
and may be used to stabilize soft tissues (e.g. • Mixter forceps: These are dissecting forceps with
pericardium or mediastinum in the chest), although the transverse serrations and a ratchet. They are available
use of stay sutures is even less traumatic. in a selection of sizes (14–23 cm) with standard or
• Backhaus towel clamps: These are available in small delicate tips. Right-angled Mixter forceps are
(9 cm) and large (13 cm) sizes and are generally used to commonly used in cardiothoracic surgery, but forceps
secure drapes to the skin. They are penetrating towel with varying curvatures <90 degrees may be useful.
clamps, so once they have been placed they are Right-angled Mixter forceps can also be used to
non-sterile. The tips of these clamps end in a fine point, dissect free and encompass the inferior alveolar
so they do not have a wide crushing area. They may neurovascular bundle in preparation for ligation just
also be used to grasp small bones or flaps for before it enters the mandibular canal at the mandibular
manipulation during elevation and apposition prior to foramen on the caudomedial aspect of the mandible. In
suturing (Reiter, 2013). addition, curved Mixter forceps can be used to aid
oesophagostomy tube placement (see above).
• Lahey bile duct forceps: These dissecting right-angled
forceps have longitudinal serrations and a blunt tip.
• Waterston forceps: These ligature forceps have
smooth rounded blunt tips, which reduce the risk of
puncturing a vessel. They are available with 45-degree
and 90-degree angles. Ligature forceps have no
ratchet and only the tips of the instrument meet, which
prevents accidental clamping or tearing of the vessel
wall when passing a ligature around it.

1.6
Angled forceps.
1 = Mixter;
Tissue forceps and clamps. 1 = Allis; 2 = Babcock; 3 = Backhaus; 2 = Lahey bile
1.5
4 = Lane’s. duct;
3 = Waterston.
Haemostatic forceps
Haemostatic forceps are crushing instruments. Many differ-
ent types are available in varying sizes, curved or straight,
with longitudinal or transverse serrations. Grasping too
much tissue or inappropriate material with delicate artery
forceps will lead to damage of the tips and overload of the
ratchet mechanism. Haemostatic forceps should not spring
open when clamped on to the first tooth of the ratchet and
the jaws should align properly.

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