Surgical forceps are instruments used to grasp, manipulate, or hold tissue during an operation. The Kelly forceps are a widely recognized hemostatic clamp, primarily designed to control bleeding in the surgical field. Named after Howard Atwood Kelly, a prominent American surgeon of the late 19th century, their design enables the secure, temporary closure of blood vessels and tissue bundles.
Identifying Features and Design
The design of the Kelly forceps is tailored for its specific function. The instrument features finger rings and a ratcheted locking mechanism near the handles, resembling a pair of scissors. This ratchet allows the surgeon to clamp down on a vessel or tissue and lock the forceps closed, maintaining a consistent, hands-free grip.
Kelly forceps are considered a medium-sized hemostat, typically measuring 5 to 6 inches (12.7 to 15.2 cm) in length. They are available with either straight or curved jaws, providing versatility for different surgical approaches. The most distinguishing characteristic is the pattern of transverse serrations, which extend only halfway down the length of the jaws.
Primary Applications in Surgery
The primary purpose of Kelly forceps is to achieve hemostasis by clamping medium-sized blood vessels or tissue bundles. The serrated jaws grip the vessel wall, compressing it to prevent blood loss until the vessel can be permanently sealed. The half-serration design allows for a firm grip while minimizing trauma to the surrounding tissue.
After clamping, the surgeon can perform a permanent procedure, such as ligation (tying the vessel off with suture material) or cauterization (using heat to seal the vessel). These forceps are commonly used in general surgery, obstetrics, and gynecology. They are also used to grasp, hold, or manipulate tissues for dissection and to assist in removing small foreign objects from a wound.
Comparison to Other Hemostatic Clamps
Kelly forceps are part of a family of similar hemostatic instruments, distinguished primarily by the length and extent of their jaw serrations. Crile forceps are nearly identical in size and shape, but their serrations run the entire length of the jaw surface. While Crile forceps offer a secure hold, they can cause more tissue trauma than the half-serrated Kelly instrument.
The Halsted Mosquito forceps are significantly smaller and more delicate than Kelly forceps. Mosquito forceps have fine, full-length serrations and are designed for clamping very small blood vessels in confined surgical spaces. The Kelly forceps, with their medium size and half-serrated jaw, function as a general-purpose clamp, balancing the fine grip of a Mosquito clamp with the capacity of larger instruments like the Rochester-Pean forceps.