PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “FORCEPS”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 55 records · Page 3Linked to original sources
PubMedDate not supplied

Prospective, randomized comparison of disposable and reusable biopsy forceps in gastrointestinal endoscopy.

We prospectively compared biopsy specimens obtained with reusable and disposable stainless steel biopsy forceps of varying sizes and configurations. Six types of forceps were used: (1) jumbo reusable forceps, (2) jumbo disposable forceps with a Teflon sheath, (3) regular reusable forceps, (4) regular disposable forceps with a Teflon sheath, (5) regular long-jaw disposable forceps, and 6) regular long-jaw disposable forceps with a Teflon sheath. "Jumbo" forceps were those requiring an endoscopic biopsy channel of at least 3.3 mm. "Regular" forceps were those requiring only a 2.8-mm channel. Two biopsy specimens were obtained with each of the six forceps from normal-appearing stomach, duodenum, and sigmoid colon (25 sets at each location). Mixed and coded specimens were scored by a single pathologist for volume (height, width, and length) and histologic depth. Reusable and disposable jumbo forceps yielded biopsy specimens of similar volumes (30 +/- 1 mm3 and 33 +/- 1 mm3, respectively) and histologic depth (grades of 3.3 +/- 0.1 and 3.5 +/- 0.1, respectively). In comparison, the regular-sized biopsy forceps gave specimens with half the volume of those obtained by the jumbo forceps (reusable, 13 +/- 1 mm3; disposable with Teflon sheath, 15 +/- 1 mm3; long-jaw, 16 +/- 1 mm2; and long-jaw with Teflon sheath, 17 +/- 1 mm3). However, the histologic depths of specimens obtained with the regular disposable forceps were the same as those of specimens obtained with the jumbo forceps. Regular reusable biopsy forceps yielded specimens with the smallest overall volume and histologic depth. We conclude that disposable forceps are equivalent to reusable forceps and that the two types can be used interchangeably in gastrointestinal endoscopy. We recommend the use of jumbo forceps whenever possible because they provide biopsy specimens that are double the size of those obtained with regular forceps.

Biopsy↗
PubMed2000

A cost and performance evaluation of disposable and reusable biopsy forceps in GI endoscopy.

BACKGROUND: Biopsy forceps are widely used in gastrointestinal endoscopy, and yet few data exist on the usage and costs associated with disposable versus reusable forceps. METHODS: We prospectively measured the costs and operational performance of disposable and reusable forceps in 200 biopsy sessions; 100 sessions were performed using disposable forceps and 100 sessions were performed using reusable forceps. Total cost per use of the reusable forceps, including acquisition costs plus the costs of reprocessing per established guidelines, was determined. At the end of the study, the reusable forceps were disassembled to determine the cause of mechanical failures. RESULTS: The total cost per use of the disposable forceps was $38. For the reusable forceps, the acquisition cost per forceps was $415 and the total reprocessing cost was $16.56 +/- 0.07 per forceps. For 10, 15 and 20 uses, reusable forceps costs were $58.06, $44.23, and $37.31, respectively. Reusable forceps malfunction at 11 to 15 uses was 5%; at 16 to 20 uses was 25%; and at 21 to 25 uses reached 80% (p < 0.001). Dismantling of the reusable forceps at the end of the study demonstrated coiled sheath kinking, rust in the forceps closure mechanism, bent spikes, and biomaterial contamination. CONCLUSIONS: Up to 15 to 20 uses, disposable and reusable forceps costs were similar. If reusable forceps are used more than 20 times, then they are less expensive. However, in this range of uses, reusable biopsy forceps performance diminishes. With disposable biopsy forceps costing less than $40, cost differences between reusable and disposable forceps are minimal.

Biopsy↗
PubMed2002

An observer-blinded, prospective, randomized comparison of forceps for endoscopic esophageal biopsy.

BACKGROUND: The designs of 2 new biopsy forceps attempt to address the difficulty of obtaining esophageal biopsy specimens. The angled design is a modified version of currently used straight forceps. The lateral cup forceps has a straight shaft with a bullet-shaped cuffing head for a tangential approach. METHODS: Seventy-five patients were enrolled in a prospective study in which 3 different forceps were compared in random order: a reusable straight-shaft spiked forceps, a reusable angled-shaft spiked forceps, and a disposable lateral cup forceps. Two biopsy specimens were obtained with each device per patient. Two pathologists, blinded as to forceps used, graded the tissue samples for size, histologic depth, shear artifact, crush artifact, and adequacy for diagnosis. Data were compared by using multivariate analysis of variance and Scheffé's method. RESULTS: Analysis of variance showed overall differences in specimen size, histologic depth score, and diagnostic adequacy (p < 0.001). There was no significant difference for crush (p = 0.459) or shear artifacts (p = 0.243). Pair-wise comparisons demonstrated that tissue samples obtained with the straight forceps were larger (p = 0.020) and deeper (p = 0.040) than the angled forceps. These 2 designs were similar in terms of diagnostic adequacy. Biopsy specimens obtained with the straight forceps were larger (p < 0.001) and deeper (p < 0.001) than those obtained with the lateral cup forceps. Both the straight and angled forceps were superior to the lateral cup forceps in terms of diagnostic adequacy (p = 0.020, p = 0.008, respectively). CONCLUSIONS: The reusable straight-shaft spiked forceps provides larger and deeper esophageal biopsy specimens than either the angled or lateral cup forceps. The angled forceps provides specimens of similar adequacy for diagnosis compared with the straight forceps. The lateral cup forceps should not be used in the esophagus.

Adult↗
PubMed1984

[History and sidelights on the forceps].

The author starts by showing that the first forceps were originally designed to handle hot metal in founderies and that the word derived from "formus" (hot) and "capere" (to take). The author, Professor Dumont, tries to trace the history of the development of modern forceps, discussing whether the Arabs or such well known authors of classical works as Roesslin, Raynald, Rueff and Rousset knew of the instrument or whether they just described instruments of destruction. Crainz in 1941 had written an article to discuss whether the early Romans had forceps and came to no firm conclusion. Speert in 1957 said that a live baby had been born earlier than the 17th Century, possibly as early as the 2nd or 3rd century of the Roman empire, i.e. over 300 years before Jesus-Christ, by forceps. The description is given of a bas-relief depicting forceps delivery but no one knows whether the bas-relief is genuine or not. The discovery of the Chamberlen forceps in 1813 at Woodham Mortimer Hall in Essex, England, and the lengthy description of how the Chamberlens kept the secret of the invention of the forceps over several generations is very well described. Then follows the story of Jean Palfyn's "mains de fer" which led later to Levret and his long curved forceps. Returning to England, the authors describes how William Smellie covered his forceps with leather so that the patients should not feel the cold metal or hear the clink of the handles. The author then quotes Dr Slop, who appears in Laurence Sterne's "Tristram Shandy" and who knew the Smellie's forceps. Sacombe was an arch enemy of instrumental delivery. The role of the Dane Saxtorph, and how Antoine Dubois delivered Napoleon's son, the future King of Rome, by forceps, is reviewed. Madame La Chapelle and her work as well as that of Scanzoni, and finally of Simpson who first used anaesthesia after inventing a forceps, continues the history. Great names such as Pajot, Tarnier with his axis-traction forceps and finally Barton, Piper and Kielland with their inventions are all described in this beautiful history of forceps.

Extraction, Obstetrical↗
PubMed2000

A performance, safety and cost comparison of reusable and disposable endoscopic biopsy forceps: a prospective, randomized trial.

BACKGROUND: Many gastroenterologists believe that disposable forceps are more expensive than reusable forceps. It has been shown, however, that cross contamination and spread of infection are possible with reusable forceps. We conducted a prospective, randomized study to evaluate the performance, safety and cost of reusable versus disposable biopsy forceps. METHODS: Endoscopists were randomly assigned reusable or disposable biopsy forceps during upper and lower endoscopy. Forceps were evaluated for ease of passage through the endoscope, ease of opening and closing, adequacy of sample, and overall evaluation following the endoscopy using an ordinal scale. The cost per biopsy session was calculated using the following formula: (Acquisition cost + Reprocessing costs)/Number of biopsy sessions. RESULTS: Disposable forceps received a predominantly excellent rating versus a predominantly good rating for reusable forceps. Disposable forceps were also found to be more cost-effective than reusable forceps with an average savings of $5. 94 per biopsy session. Examination of reusable forceps revealed residual patient debris despite "adequate" cleansing. CONCLUSIONS: Disposable forceps outperformed reusable forceps and were found to be more cost-effective. Residual patient debris on reusable forceps may pose a risk of cross contamination and the spread of infection.

Biopsy↗
PubMedDate not supplied

Biopsy forceps: disposable or reusable?

Current debate surrounds the cost-effectiveness of disposable and reusable biopsy forceps. Although a complex and arduous task, performing a cost analysis may be necessary to determine which forcep type is more cost-effective. Costs associated with disposable biopsy forceps include their initial cost as well as storage and disposal costs. In addition to initial cost, costs associated with reusable biopsy forceps include reprocessing, maintenance, and repair costs. Estimating the number of times forceps are likely to be reused is also essential to evaluating the cost-effectiveness of reusable biopsy forceps. In general, once a reusable biopsy forcep performs a threshold number of procedures, it becomes more cost-effective than a disposable forcep. While reusable biopsy forceps may be more suitable and cost-effective for larger gastrointestinal endoscopy centers that perform many procedures per day, the convenience of disposable biopsy forceps may make them the more appropriate choice for centers that are smaller and perform only a few procedures each day. Due to significant decreases in the initial cost of disposable biopsy forceps, the cost-effectiveness of reusable biopsy forceps is waning. This article reviews the various issues associated with disposable versus reusable biopsy forceps and provides readers with guidelines for evaluating the appropriateness of both forcep designs in their unique practice setting.

Biopsy↗
PubMed1975

[Some considerations on forceps delivery with excenter handle (author's transl)].

The introduction of electronic monitoring techniques in delivery increasingly has lead to the use of vaginal surgery in delivery. Vacuum and forceps extraction, in our view, do not compete with each other. Years ago forceps extraction was decisively improved by introducing the axial traction forceps. However, we believe that this technique has not been given due attention and is not applied widely enough. In vacuum extraction and in forceps deliveries without axial traction considerable part of the force is exerted in the direction of the symphysis. When using the excentric handle forceps, it is necessary in addition to the traction and pressure components to include the lever action. This is a so-called couple of forces. The additional torque involved in the use of an axial traction forceps shifts the fetal head during extraction in the direction of the hollow of the sacrum. The force needed for this shift and the progression of the head is many times less than that required for conventional forceps extraction. This is due to the absence of the component directed at the symphysis which impedes delivery. The axial traction forceps may also be used in case of the infant's abnormal positioning of the head. In case of a transverse position of the fetal head, a special fastener on the forceps makes it possible to use an excentric handle on the traction hook of the Kielland forceps and thus render possible rotation of the fetal head from the transverse position. The extentric handle in forceps extraction is optimal in order to overcome increased mechanical resistance to delivery. Adjustment of the handles to all types of forceps being used today is possible. From the results mentioned it is clear that the use of the axial traction forceps constitutes a valuable contribution toward declining perinatal mortality rates.

Apgar Score↗
PubMed2002

A comparison of three types of biopsy forceps in the endoscopic surveillance of Barrett's oesophagus.

BACKGROUND AND STUDY AIMS: Periodic endoscopic biopsy surveillance is recommended for selected patients with Barrett's oesophagus. A new angled swing-jaw forceps has become available which is said to facilitate tangential oesophageal biopsy sampling. We examined the size and quality of oesophageal biopsies obtained with the forceps of angled design in comparison with the large cup disposable forceps and the conventional reusable upper gastrointestinal forceps. PATIENTS AND METHODS: In this prospective comparative study, three biopsies were taken at each of three levels, using a different design of forceps at each level, in each of 48 patients undergoing endoscopic surveillance. The order in which the forceps were used was randomized. A pathologist assessed the size and quality of each set of biopsies obtained. RESULTS: The mean biopsy diameter was significantly greater at 3.00 mm with the angled forceps (P < 0.01), in comparison with 2.52 mm with the elliptical forceps and 2.07 mm with the conventional forceps. Fewer biopsies obtained with the angled forceps were graded as inadequate (8.3 %) compared with those obtained using the disposable large cup and conventional forceps (25 % and 22.9 %, respectively). CONCLUSIONS: The design of forceps used influences the size and quality of tissue obtained during endoscopic surveillance of Barrett's oesophagus. The angled swing-jaw forceps are recommended as the most suitable for this purpose.

Adult↗