Additionally, the fine mosquito clamps may also be used as dissecting tools ( Fig. Mosquito clamps and the larger Kelly clamps are most commonly used to secure bleeding vessels. Hemostatic clamps may be straight or curved. This is the instrument of choice for isolating large arteries from underlying veins, as occurs during hypogastric artery ligation. One variety, the right-angle clamp, has a 90° angle ( Fig. The tips of these clamps are tapered and angled. These are excellent for fine dissection and for clamping bleeding vessels deep within the pelvis, particularly in strategic locations. 3–2C, D).ĭissecting or hemostatic clamps include standard and long tonsil clamps ( Fig. Ochsner clamps, for example, may be applied to the cervix for traction during vaginal hysterectomy or on skin scars that are going to be cut out ( Fig. Babcock clamps are atraumatic instruments useful for grasping delicate structures, such as the oviducts, utero-ovarian ligaments, and other fragile tubular structures ( Fig. Allis clamps are frequently required in vaginal and abdominal surgery. Grasping clamps are relatively atraumatic, whereas traction clamps are best suited to specimens that will be excised or otherwise removed. ClampsĬlamps may be subdivided into grasping and traction clamps, which include Allis and Ochsner clamps. For fine work deep in the pelvis, for example, dissecting around the ureter or iliac vessels, the author prefers a bayonet forceps equipped with a brown-toothed tip ( Fig. Adson-Brown forceps are the best instruments for grasping skin edges during closure procedures ( Fig. Rat-tooth forceps are excellent for traction and for holding tissue securely however, they may traumatize skin and other delicate tissues. For lymph node and fat dissection, for example, obturator fossa dissection, ring forceps are quite acceptable. Atraumatic forceps include the Adson and DeBakey instruments. ForcepsĪ number of forceps are available. For convenience, this section will codify the panoply of instruments commonly used in gynecologic surgery. Throughout this book, reference is made to various instruments utilized in the performance of specific operations. Good instruments coupled with good surgeons yield the best outcomes. Although a fine surgeon may overcome the deficits of inferior instruments, the real and potential difficulties presented by using second-rate tools make doing first-rate surgery harder. High-quality instruments are required for the performance of precise and excellent surgery. A surgeon’s tools are analogous to those of a carpenter, a mechanic, a research chemist, or an atomic physicist.
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