03.05 Handling of Instruments - Artery Forceps (Haemostat)
If you are new to suturing, you will need to learn to recognize each of the instruments you are going to use, understand their function and practise the basic techniques of using them.
This section covers the artery forceps.
In this module
03.05 Artery Forceps (Haemostat)
Artery forceps (also called a haemostat) are designed to grasp tissue and vessels delicately and precisely.
Various sizes are available. The smallest are known as mosquito forceps and are typically used on fine, delicate vessels. Roberts forceps are longer, heavier duty forceps and are typically used on large vascular pedicles.
Artery forceps are also suitable for mounting and removing a scalpel blade.
03.05.01 Principles Video 1
Artery forceps allow small blood vessels and other tissue to be grasped precisely and without unnecessary damage.
The long, grooved jaws make it possible to grasp tissue delicately without extensive crushing.
The grooves in each jaw coincide to form a series of circular channels when the instrument is closed.
Artery forceps have a ratchet on the handles, usually with three notches. This allows you to position the artery forceps and lock the handles closed. The ratchet’s teeth will tighten automatically as the handles are squeezed together.
To release the ratchet, the handles must be squeezed and then moved slightly apart.
03.05.02 Principles Video 2
Artery forceps and needle-holders look superficially similar. They are in fact quite different. The crucial difference lies in the structure of the jaws. Those of artery forceps are long compared to those of the needle holder and the surface of each jaw has parallel grooves cut into it.
The curved jaws of artery forceps allow a blood vessel to be caught and a ligature tied around it.
Artery forceps are completely unsuitable for holding a needle, as the needle will align itself with the instrument’s grooves and swivel round. By contrast, the needleholder's jaws have criss-cross lines cut into them to improve the grip on a curved needle.
03.05.03 Practise Right Hand Hold & Control
Place your ring finger and thumb in the artery forceps’ finger holes.
Use your index finger to steady the instrument where the blades join, so that you can position the jaws precisely.
Close the handles to engage the ratchet, taking care not to overtighten them. To release, first squeeze the handles to disengage the ratchet, then separate the handles fractionally while opening them. Most ratchets are designed for right-handed surgeons. Releasing a right-handed ratchet with the left hand requires a conscious effort and a different technique.
03.05.04 Left Handed Hold & Control
Opening and closing the ratchet when holding artery forceps in your left hand requires a different technique. Hold one ring of the handles between your thumb and index finger and rest your middle and ring finger against the other ring. Then apply pressure from the middle and ring finger against the thumb and index finger to open the artery forceps in a controlled way.
Try and avoid a jerky opening movement which could result in damage to any tissue or vessel that you are holding.
03.05.05 Things to Avoid
This section covers the most common problems encountered when learning to use artery forceps:
- incorrect hold
- confusing your artery forceps with a needle holder
- and early release when assisting at a procedure
03.05.05.01 Confusion with Needle Holder
Avoid confusing artery forceps and needle holders which look superficially similar. Their jaws are in fact quite different.
Artery forceps have long, jaws with parallel grooves. Needle holders have short jaws with criss-crossed lines cut into them.
If you mistakenly use artery forceps as a needle holder for suturing, the needle will align itself along one of those channels between the jaws. It will then swivel round, making it impossible to put in the suture with precision.
03.05.05.02 Incorrect Hold
Do not use your index finger and thumb in the artery forceps’ handles as this will cause loss of control. Use your ring finger and thumb.
03.05.05.03 Release When Assisting
If using artery forceps as an assistant in a procedure, you should not release the artery forceps until instructed to do so by the surgeon. Be aware of inadvertent release.