Description
Uterus holding forceps (Somer)
Uterus holding forceps are specialized gynecological surgical instruments designed to securely grasp, elevate, and stabilize the uterus or manipulate vaginal tissues during surgical procedures. These instruments are designed to minimize tissue trauma while providing maximum control, frequently used in procedures such as myomectomy (fibroid removal), hysterectomy, and for reducing postpartum hemorrhage.
Key Features and Design
- Structure: They are typically long, slender instruments made of high-grade, corrosion-resistant stainless steel.
- Tips: The jaws are often curved or angled to conform to uterine anatomy and enhance visibility. They can be fenestrated (oval openings) or have blunt, fine serrations to ensure a firm, non-slip grip without causing damage to the tissues.
- Mechanism: They usually feature a ratchet lock mechanism on the finger-ring handles to allow the instrument to stay locked in place, maintaining a secure, consistent hold on the tissue without requiring continuous manual pressure.
- Variations:
- Somer’s Uterine Holding Forceps: Features curved, fenestrated tips for lifting the uterus and vaginal wall.
- Dartigues’s Uterine Holding Forceps: Possesses atraumatic jaws with interlocking teeth for a secure, gentle hold.
- Shirodkar’s/Shirodkar-Collin Uterine Forceps: Uses broad, smooth tips for atraumatic manipulation.
How Uterus Holding Forceps Work (Functional Details)
- Grasping and Stabilization: During operations like a abdominal hysterectomy or myomectomy, the forceps are applied to the uterine fundus or corners (cornua) to stabilize it, allowing for better access to blood vessels and ligaments.
- Elevation and Retraction: In vaginal surgeries or procedures, they are used to elevate the uterus and vaginal walls, providing the surgeon with a clearer, more accessible surgical field.
- Hemostasis (Bleeding Control): Specialized types (like Green-Armytage or modified Uterine Holding Forceps) are used to temporarily clamp the uterine wall or vessels, particularly in cases of postpartum hemorrhage (PPH) during Cesarean sections, to stop bleeding instantly.
- Tissue Removal: The forceps are used to securely hold and extract polyps, tumors, or other uterine tissues (such as during suction curettage or polypectomy).
Clinical Applications
- Laparoscopic/Open Surgeries: Uterine manipulation, myomectomy, and hysterectomy.
- Obstetrics: Cesarean section (for clamping uterine edges) and managing postpartum hemorrhage.
- Gynecology: Cervical examination, tubal ligation, and vaginal wall retraction.
- Veterinary: Used in large animal obstetrics for holding the uterus during prolapse or cesarean cases.
Benefits
- Reduced Trauma: The atraumatic design minimizes tissue damage.
- Improved Efficiency: The locking ratchet reduces user fatigue during long procedures.
- Stability: Provides superior, steady control of the uterus.
- Durability: Being made of high-grade stainless steel, they are autoclavable and reusable.
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