Bronchoscopy and Esophagoscopy | Page 7

the jaws open in an up-and-down direction. On rare occasions it may be
deemed desirable to turn the stylet of either forceps in some other
direction relative to the handle.
[FIG. 18.--The author's forward grasping tube forceps. The handle
mechanism is so simple and delicate that the most exquisite delicacy of
touch is possible. Two locknuts and a thumbscrew take up all lost
motion yet afford perfect adjustability and easy separation for cleansing.
At A is shown a small clip for keeping the jaws together to prevent
injurious bending in the sterilizer, or carrying case. At the left is shown
a handle-clamp for locking the forceps on a foreign body in the solution

of certain rarely encountered mechanical problems. The jaws are
serrated and cupped.]
[FIG. 19.--Jaws of the author's side-curved endoscopic forceps. These
work as shown in the preceding illustration, each forceps having its
own handle and tube. Originally the end of the cannula and stylet were
squared to prevent rotation of the jaws in the cannula. This was found
to be unnecessary with properly shaped jaws, which wedge tightly.]
Rotation Forceps.--It is sometimes desired to make traction on an
irregularly shaped foreign body, and yet to allow the object to turn into
the line of least resistance while traction is being made. This can be
accomplished by the use of the rotation forceps (Fig. 20), which have
for blades two pointed hooks that meet at their points and do not
overlap. Rotation forceps made on the model of the laryngeal grasping
forceps, but having opposing points at the end of the blades, are
sometimes very useful for the removal of irregular foreign bodies in the
larynx, or when used through the esophageal speculum they are of great
service in the extraction of such objects as bones, pin-buttons, and
tooth-plates, from the upper esophagus. These forceps are termed
laryngeal rotation forceps (Fig. 31). All the various forms of forceps are
made in a very delicate size often called the "mosquito" or "extra light"
forceps, 40 cm. in length, for use in the 4 mm. and the 5 mm.
bronchoscopes. For the 5 mm. bronchoscopes heavier forceps of the 40
cm. length are made. For the larger tubes the forceps are made in 45
cm., 50 cm., and 60 cm. lengths. A square-cannula forceps to prevent
turning of the jaws was at one time used by the author but it has since
been found that round cannula pattern serves all purposes.
[FIG. 20.--The author's rotation forceps. Useful to allow turning of an
irregular foreign body to a safer relation for withdrawal and for the
esophagoscopic removal of safety pins by the method of pushing them
into the stomach, turning and withdrawal, spring up.]
Upper-lobe-bronchus Forceps.--Foreign bodies rarely lodge in an
upper-lobe bronchus, yet with such a problem it is necessary to have
forceps that will reach around a corner. The upper-lobe-bronchus
forceps shown in Fig. 27 have curved jaws so made as to straighten out

while passing through the bronchoscope and to spring back into their
original shape on up from the lower jaw emerging from the distal end
of the bronchoscopic tube, the radius of curvature being regulated by
the extent of emergence permitted. They are made in extra-light pattern,
40 cm. long, and the regular model 45 cm. long. The full-curved model,
giving 180 degrees and reaching up into the ascending branches, is
made in both light and heavy patterns. Forceps with less curve, and
without the spiral, are used when it is desired to reach only a short
distance "around the corner" anywhere in the bronchi. These are also
useful, as suggested by Willis F. Manges, in dealing with safety pins in
the esophagus or tracheobronchial tree.
[FIG. 21.--Tucker jaws for the author's forceps. The tiny lip projecting
down from the upper, and up from the lower jaw prevents sidewise
escape of the shaft of a pin, tack, nail or needle. The shaft is
automatically thrown parallel to the bronchoscopic axis. Drawing about
four times actual size.]
[36] Tucker Forceps--Gabriel Tucker modified the regular side-curved
forceps by adding a lip (Fig. 21) to the left hand side of both upper and
lower jaws. This prevents the shaft of a tack, nail, or pin, from
springing out of the grasp of the jaws, and is so efficient that it has
brought certainty of grasp never before obtainable. With it the solution
of the safety-pin problem devised by the author many years ago has a
facility and certainty of execution that makes it the method of choice in
safety-pin extraction.
[FIG. 22.--The author's down-jaw esophageal forceps. The dropping
jaw is useful for reaching backward below the cricopharyngeal fold
when using the esophageal speculum in the removal of foreign bodies.
Posterior forceps-spaces are often scanty in cases of foreign bodies
lodged just