Chapter 3: Table of contents
Hemostatic forceps are crushing instruments used to temporarily clamp and occlude bleeding vessels. The crushing action on the vascular wall at the site of application stimulates physiological clotting mechanisms. Unlike thumb forceps, they are equipped with a ratchet mechanism that enables to maintain hands-free occlusion while a ligature is applied. Hemostatic forceps come in various lengths, shapes (straight or curved) and types. Hemostatic forceps of larger size (e.g. Rochester-Carmalt) are typically used to crush pedicles and stumps prior to ligation and transection. Hemostatic clamps are delicate instruments that are subject to wear and tear and therefore require routine inspection for jaw alignment, shank tension and ratchet wear.
Straight or Curved:
Hemostatic forceps come in a variety of sizes with curved or straight jaws.
The jaw of the mosquito forceps contains transverse striations along its entire length making it a good choice for the occlusion of small vessels. The tip of the instrument is typically used to grasp and crush bleeding vessels. These small hemostatic forceps are delicate and should not be used for ligation of large vascular pedicles or stump ligation that include excessive additional tissue.
Kelly forceps are larger and less delicate than mosquito forceps. These forceps have transverse serrations along the distal half of the jaws only. These instruments are available with straight or curved jaws and are often selected for the occlusion of small to medium sized vessels.
Crile forceps are larger and less delicate than mosquito forceps. These forceps have transverse serrations along the entire length of the jaw surface and are available with straight or curved jaws. These instruments are often used for the occlusion of small to medium sized vessels.
Rochester-Carmalt forceps are often used in veterinary surgery, particularly for ligation of vascular pedicles and stumps. The serrations on the jaw surface run longitudinally for the entire length, except at the jaw tip where they also run in a transverse direction (resulting in cross striations). The longitudinal serrations allow easy removal during suture ligation, and the cross striations at the tip of the jaw help hold tissues within the confines of the instrument. These are available with straight or curved jaws.
Satinsky or tangential clamps are designed to non-traumatically occlude a portion of a large blood vessel such as the vena cava while allowing blood to flow in the non-occluded portion of the vessel.
Bull Dog Clamp:
Bull dog clamps are used to temporarily occlude blood vessels during vascular surgery. They are small and fairly light which is an advantage when working in confined spaces or when there is little support from the surrounding tissues. Various modifications of these clamps are available with some that allow to adjust the pressure created by the clamp on the vascular wall. The instruments are available in various sizes and with straight or curved jaws.