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The Use Of Forceps In Endoscopic Foreign Body Extraction
Category: MECHANICAL PROBLEMS OF BRONCHOSCOPIC FOREIGN BODY EXTRACTION
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Two different strengths of forceps are supplied, as will be seen in the
list in Chapter 1. The regular forceps have a powerful grasp and are
used on dense foreign bodies which require considerable pressure on
the object to prevent the forceps from slipping off. For more delicate
manipulation, and particularly for friable foreign bodies, the lighter
forceps are used. Spring-opposed forceps render any delicacy of touch
impossible. Forceps are to be held in the right hand, the thumb in one
ring, and the third, or ring finger, in the other ring. These fingers
are used to open and close the forceps, while all traction is to be
made by the right index finger, which has its position on the forceps
handle near the stylet, as shown in Fig. 78. It is absolutely
essential for accurate work, that the forceps jaws be seen to close
upon the foreign body. The impulse to seize the object as soon as it
is discovered must be strongly resisted. A careful study of its size,
shape, and position and relation to surrounding structures must be
made before any attempt at extraction. The most favorable point and
position for grasping having been obtained, the closed forceps are
inserted through the bronchoscope, the light reflex obtained, the
forceps blades now opened are turned in such a position that, on
advancing, the foreign body will enter the open V, a sufficient
distance to afford a good grasp. The blades are then closed and the
foreign body is drawn against the tube mouth. Few foreign bodies are
sufficiently small to allow withdrawal through the tube, so that tube,
forceps and foreign body are usually withdrawn together.
[FIG. 78.--Proper hold of forceps. The right thumb and third fingers
are inserted into the rings while the right index finger has its place
high on the handle. All traction is made with the index finger, the
ring fingers being used only to open and close the forceps. If any
pushing is deemed safe it may be done by placing the index finger back
of the thumb-nut on the stylet.]
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