Bronchoscopic And Esophagoscopic Grasping Forceps
Categories: INSTRUMENTARIUMSources: A Manual Of Peroral Endoscopy And Laryngeal Surgery
are of the tubular
type, that is, a stylet carrying the jaws works in a slender tube so
that traction on the stylet draws the V of the open jaws into the
lumen of the tube, thus causing the blades to approximate. They are
very delicate and light, yet have great grasping power and will
sustain any degree of traction that it is safe to exert. They permit
of the delicacy of touch of a violin bow. The two types of jaws mos
frequently used, are those with the forward-grasping blades shown in
Fig. 18, and those having side-grasping blades shown in Fig. 19. The
side-curved forceps are perhaps the most generally useful of all the
endoscopic forceps; the side projection of the jaws makes them readily
visible during their closure on an object; their broader grasp is also
an advantage., The projection of the blades in the side-curved
grasping forceps should always be directed toward the left. If it is
desired that they open in another direction this should be
accomplished by turning the handle and not by adjusting the blade
itself. If this rule be followed it will always be possible to tell by
the position of the handle exactly where the blades are situated;
whereas, if the jaws themselves are turned, confusion is sure to
result. The forward-grasping forceps are always so adjusted that the
jaws open in an up-and-down direction. On rare occasions it may be
deemed desirable to turn the stylet of either forceps in some other
direction relative to the handle.
[FIG. 18.--The author's forward grasping tube forceps. The handle
mechanism is so simple and delicate that the most exquisite delicacy
of touch is possible. Two locknuts and a thumbscrew take up all lost
motion yet afford perfect adjustability and easy separation for
cleansing. At A is shown a small clip for keeping the jaws together to
prevent injurious bending in the sterilizer, or carrying case. At the
left is shown a handle-clamp for locking the forceps on a foreign body
in the solution of certain rarely encountered mechanical problems. The
jaws are serrated and cupped.]
[FIG. 19.--Jaws of the author's side-curved endoscopic forceps. These
work as shown in the preceding illustration, each forceps having its
own handle and tube. Originally the end of the cannula and stylet were
squared to prevent rotation of the jaws in the cannula. This was
found to be unnecessary with properly shaped jaws, which wedge
tightly.]
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