Lab 1 . Part 3 - Tissue Forceps

• “tweezer-like” instruments
• used to manipulate tissues and needles
• when used properly
  • cause less trauma than fingers
  • allow more accurate manipulation of tissues,needles, and suture

Skills to Practice

1. pencil grip hold
2. atraumatic, efficient manipulation of "tissues"
3. efficient extraction of needle tip from tissues during suturing

Tissue forceps are used to:

• manipulate tissues
• support tissues while making incisions, and suturing
• retract tissues to improve exposure
• grasp suture materials and needles
• “ become your fingers in most cases” as usually less traumatic, more accurate and faster
• a variety of size and designs

• Small grooves, but no teeth on the tips
• Hold tissue by pressure applied to the handles
• Amount of trauma (crushing) varies with
  • amount of pressure
  • size and design of tips and grooves

• tips have small teeth
• size and number of teeth vary
• teeth penetrate tissue to hold it
• preferred by most surgeons over thumb forceps because:
  • less crushing injury
  • more secure hold with less finger pressure

Considerations in Forcep Selection

• size and design of tips
• length of handles
• security of hold relative to the pressure exerted
• amount of tissue trauma induced
• tissue being manipulated
• depth of area working in
• surgeon preference

• fine tips with broad handles
• smaller size more appropriate for small animals
• 2 x 1 (2 teeth on one tip, 1 tooth on other arm)
• provide a secure, delicate grasp with minimal crushing injury

• fine tips with broad handles
• multiple columns of fine interlocking teeth
• provide a delicate, but secure, grasp
• also useful for manipulating small needles during suturing

• held in the non-dominant hand with a pencil grip

thumb and index finger placed on handles handles rest on remaining fingers grip allows accurate manipulation, flexibility and fine pressure adjustment

Pencil Grip

• avoid holding with a palm grip which may at first may feel more natural because:

Using tissue or thumb forceps

• grasp the minimal amount of tissue that provides a secure hold with the least amount of pressure
• avoid handling skin when possible (bruises easily)
  • handle the subcutaneous tissue instead

To minimize trauma

• limit the number of times tissue is grasped
• minimal pressure of hold
• minimize duration held
• Use stay sutures if need repeated or prolonged manipulation

• When not in use, hold in palm of non-dominant hand