Debakey forceps

Abstract: Thrombosis is a major complication of central venous access devices, its incidence depending on material, diameter, tip position, and tip surface. Catheters are usually cut to the appropriate length for accurate positioning. Cutting is not recommended, however, as rough surfaces can serve as a nidus for thrombosis. The present study was performed to assess the roughness of catheter tips provided by various manufacturers versus the roughness once cut and handled. Three types of catheters (Hickman, Port-a-Cath, and Per Q Cath) were cut by scissors, iris scissors, or scalpel, and were handled with debakey forceps, a needle driver, adson with teeth or adson without teeth, to determine the damage created on the catheter. The uncut manufactured tip was compared as a control. Scanning electron microscopy was used for imaging of all samples, and roughness was quantified by atomic force microscopy for the cutting methods. Qualitative results by scanning electron microscopy showed that scalpel-cut and manufactured ends appeared smoother relative to those cut with scissors or iris scissors. This complemented the roughness analysis by atomic force microscopy. Catheters handled by debakey forceps and adsons with teeth showed most roughness, visible as deep holes or a grainy surface when observed by high-magnification scanning electron microscopy. Overall, the smoothest result was produced by scalpel, followed by the manufactured end, scissors, and iris scissors. Handling should be minimized, and use of adsons with teeth, needle drivers and debakey forceps should be avoided, as they can leave permanent damage. Adsons without teeth appeared the least damaging.

Abstract: Introduction and Objective. Bleeding is an important complication in liver transections. To determine the safety and efficacy of Debakey forceps for liver parenchymal transection and its ergonomic advantages over clamp crushing method we analysed our data. Methods. We used Debakey crushing technique in 100 liver resections and analysed data for transection time, transfusion rate, morbidity, mortality, hospital stay, influence of different types of liver conditions, and ergonomi features of Debakey forceps. Results. Mean age, transection time and hospital stay of 100 patients were 52.38 ± 17.44 years, 63.36 ± 33.4 minutes, and 10.27 ± 5.7 days. Transection time, and hospital stay in patients with cirrhotic liver (130.4 ± 44.4 mins, 14.6 ± 5.5 days) and cholestatic liver (75.8 ± 19.7 mins, 16.5 ± 5.1 days) were significantly greater than in patients with normal liver (48.1 ± 20.1 mins, 6.7 ± 1.8 days) (). Transection time improved significantly with experience (first fifty versus second fifty cases—70.2 ± 31.1 mins versus 56.5 ± 34.5 mins, ). Qualitative evaluation revealed that Debakey forceps had ergonomic advantages over Kelly clamp. Conclusions. Debakey forceps crushing technique is safe and effective for liver parenchymal transection in all kinds of liver. Transection time improves with surgeon’s experience. It has ergonomic advantages over Kelly clamp and is a better choice for liver transection.

Abstract: Intestinal injuries are usually diagnosed by abdominal findings or radiographically. It is difficult to diagnose intestinal injuries in multiple injury patients particularly if combined with severe head injury. We used laparoscopy for the definite diagnosis of three patients who were suspected to have intestinal injuries. These three patients had severe thoracic injury, severe head injury, and only abdominal injury, respectively. The first and third patients had intestinal rupture. Under general anesthesia, a laparoscope was inserted through a left lower abdominal port. We lifted the small intestine with two Debakey forceps (Jarit) through a left upper abdominal port and a right lower port, and examined all areas of the small intestine. Laparoscopic examination is thought to be a useful method for the definite diagnosis of intestinal injuries.