Choosing the Right Surgical Forceps

There are four essential criteria to consider when choosing surgical forceps: the function for which they are intended, hygiene, their material, and ergonomics.

• Function: There are different types of forceps associated with specific functions (see question 2) and fields of application (see question 3).

• Hygiene: Surgical forceps are invasive and may come into contact with the patient’s flesh and internal organs. They therefore require special attention when it comes to cleaning and sterilization. Cleaning to remove foreign matter from surgical instruments is generally carried out using water and suitable detergents or enzymatic cleaners. Instruments must be thoroughly cleaned before high-level disinfection and sterilization, as inorganic and organic material remaining on the surface interferes with the effectiveness of these processes.

• Material: Surgical forceps are mainly made of stainless steel. They are also available in plastic (for single use), titanium, tungsten carbide, tantalum, platinum, and palladium (see question 4).

• Ergonomics: The body of the forceps must be long enough (between 11 and 13 cm) to ensure good stability in the hand. In terms of ergonomics, they will be easier to handle if the body of the forceps is slightly rounded rather than flat.

There are many different types of forceps with specific functions. The two main categories are hemostatic forceps and grasping forceps.

Hemostatic forceps

Grasping forceps

Hemostatic forceps

Hemostatic forceps are used to control bleeding by holding compresses against the wound or clamping a blood vessel. Here are the main hemostatic forceps:

• Kocher forceps: Named after their creator, Kocher forceps are small, scissor-like instruments used daily by healthcare professionals in surgical procedures. They are very useful during operations and are most often used in traumatology, as they have strong traction. Kocher forceps are easy to handle and can be straight or curved and made with or without teeth.

• Halsted Mosquito forceps: Also known as “mosquito forceps”, these are surgical forceps with serrated jaws and a self-locking ratchet system. They are used to stop bleeding (vascular clamps), as well as for gripping and manipulating tissues or medical materials (compresses, needles, etc.). There are straight and curved versions, with or without teeth.

• Rochester-Pean forceps: These forceps have a scissor-like shape with thin, serrated jaws running the full length. Unlike Kocher forceps, they have no teeth. They are therefore less traumatic for the tissue. These forceps have many uses. In surgery, they are used to clamp vessels, apply compresses, or manipulate fragile tissue. For minor care, they are used to grasp and handle dressings, unscrew nozzles, etc. They are available in straight and curved versions.

• Kelly forceps: Kelly forceps are generally used for surgery and routine medical procedures. They are available in many different sizes. Larger forceps allow more tissue to be clamped at once but are not suitable for procedures involving small amounts of tissue or for delicate procedures. On the other hand, small forceps may not be able to stop bleeding properly if used as a hemostat. The teeth of Kelly forceps can be curved or straight. Straight Kelly forceps are the most common. Straight forceps are ideal when moderate force is required. If you need more force, or if the tissue is at an angle that is difficult to reach, then curved forceps may be a better option.

MEDESY Halsted Mosquito forceps

Medicta Instruments Kocher forceps

Grasping forceps

Grasping forceps are used to grasp and manipulate tissues. These include dissecting forceps. Here are the main forceps available:

• Adson forceps: Adson forceps are ideal for medical procedures that require high precision. The handgrip area is wide and serrated and the jaws are narrow, ensuring a firm hold on the tissue. They can be found with or without teeth.

• DeBakey forceps: These are dissecting forceps with atraumatic jaws for gentle grasping and holding of sensitive tissue. The handgrip area is serrated across the width of the handle, making it ideal for secure handling. They are available in straight or curved form.

• Graefe forceps: Graefe forceps are anatomical forceps used in surgery for precise gripping and dissecting of tissue. They enable the surgeon to isolate an anatomical element. They can be with or without teeth, straight, or curved.

STILLE Adson forceps

Medicta Instruments DeBakey forceps

The material from which surgical forceps are made is of the utmost importance. Forceps can be made of stainless steel, titanium, tungsten carbide, tantalum, platinum, palladium, or plastic. Here are the characteristics of each of these materials:

• Stainless steel: Stainless steel forceps are the most common. Stainless steel is effective against instrument corrosion and can withstand temperatures of up to 400°C. Several grades of stainless steel are available:
  • Austenitic steel 316: This steel is very strong and corrosion-resistant. It is commonly known as “surgical steel”.
  • AISI 301: This is the most common grade.

• Titanium: Titanium is 100% antimagnetic, corrosion-resistant, light, and strong.

• Tungsten carbide: Tungsten carbide is harder than stainless steel. Surgical instruments with tungsten carbide handles offer a stronger grip and last longer. Tungsten carbide instruments generally have gold-plated handles.

• Tantalum: Strong and ductile for the manufacture of surgical forceps, this material is characterized by its high biocompatibility. It is immune to body fluids and is also highly corrosion-resistant, so it can be used in surgery without causing adverse effects. It is mainly used in orthopedic surgery.

• Platinum and palladium: These two materials have similar properties. They are malleable and ductile, making them suitable for the manufacture of precision surgical instruments. They are also particularly corrosion-resistant. However, they are very expensive.

• Plastic: Plastic is only used for disposable surgical forceps.