Microvascular dissecting forceps complete with irrigator

Abstract

FREQUENT irrigation is essential for successful microvascular surgery. Not only does it remove blood and prevent drying, but it opens up the cut vessel ends (Kleinert and Neale, 1974) and indeed will dilate them (Rigg, 1975); it also floats off the adventitia around the anastomosis and makes suturing easier and safer. To obtain most help from irrigation, timing must be precise. This is impossible if, without an assistant, one has to lay down one’s instruments and pick up an irrigator like those described by Rigg (1975) and Freshwater (1976); even with an assistant, precision is much inferior to that obtained when irrigation is completely under the operator’s control. Bipolar coagulating forceps with an attached irrigation nozzle have been described (Ring and Worpole, 1972; Dujovny et al., 1975) but are not fine’enough for microvascular surgery. The following instrument1 is foot controlled and has proved a valuable aid. The control “pedal” is a plastic bag filled with a heparm/saline solution and is attached to the forceps by a length of plastic tubing, containing a non-return valve which ensures that fluid emerges immediately from the nozzle on the slightest foot pressure (Fig. I). The nozzle is firmly attached to the inner side of one arm of the forceps