Types of Forceps: Designs, Features, and Applications
Forceps designs vary considerably depending on what they are intended to handle and how they are operated. Different configurations are suited to specific tissue-handling requirements, with jaw design playing an important role in how the instrument engages the tissue.1
This guide examines different types of forceps across four broad categories: thumb (Non-Locking) tissue forceps, hemostatic forceps (Clamps), ringed grasping & visceral forceps, and specialized forceps. Within each, we highlight the design and functional differences between commonly used instruments to help readers understand which type may be best suited to a particular application.
1. Thumb Tissue Forceps
Thumb tissue forceps are manually operated by squeezing the handles together with the thumb and fingers, bringing the jaws into contact to grasp tissue. Unlike hemostatic forceps, they do not have a ratchet or other locking mechanism to hold the jaws closed. The type and configuration of the jaws, including the presence, size, and arrangement of teeth or serrations, can influence how securely forceps hold different types of tissue.1
| Types of Forceps | Jaw and Tip Design | Grip Characteristics | Applications |
|---|---|---|---|
| Adson Forceps | Relatively short, fine tips with a broad handle. Commonly available with 1 × 2 teeth or in smooth configurations. | Controlled, precise grip; toothed versions offer a secure hold without excessive pressure. | Precise and controlled handling of superficial tissue. |
| Adson-Brown Forceps | Fine, closely spaced interlocking teeth arranged in multiple rows or columns at the tip. | Secure grip that distributes contact across a greater portion of the tissue. | Secure and delicate tissue handling. |
| DeBakey Forceps | Fine, atraumatic tips with longitudinal serrations or grooves. | Secure, relatively atraumatic grip that distributes pressure across the tissue. | Handling vessels and other fragile tissue, as the jaw design helps reduce crushing or puncturing. |
| Rat-Tooth Forceps | Prominent interlocking teeth at the tips. Commonly arranged as a 1 × 2 tooth pattern. | Strong, secure grip that requires less reliance on sustained squeezing pressure. | Firmer grip for tissue that can tolerate a more aggressive toothed grasp. |
| Russian Forceps | Broad, rounded, spoon-shaped jaws with serrated or textured gripping surfaces. | Broad grasping surface. | Broader contact area for grasping and manipulating tissue. |
Choosing between thumb tissue forceps: The most important distinction is often the jaw configuration and the degree of tissue grip required. Adson forceps, for example, are available with toothed or smooth configurations, while fine serrated or atraumatic designs may be better suited to delicate tissue handling.
2. Hemostatic Forceps (Clamps)
Hemostatic forceps are designed to clamp and hold tissue or blood vessels, particularly when maintaining a grip without continuous hand pressure is important. They have ring handles and a ratchet locking mechanism that allows the jaws to remain closed once engaged. This makes them useful when tissue or a vessel needs to be held securely while the clinician performs another part of a procedure.
| Types of Forceps | Jaw and Tip Design | Grip Characteristics | Applications |
|---|---|---|---|
| Halsted Mosquito Forceps | Small, fine jaws with delicate serrations. Available straight and curved.2 | Precise, controlled clamp on small structures. | Fine instrument for smaller-scale hemostatic applications. |
| Kelly Forceps | Moderately sized jaws with transverse serrations along the distal portion. Available straight and curved. | Secure clamp with greater jaw capacity than mosquito forceps while remaining relatively fine. | Medium-sized instrument for clamping and holding vessels or tissue. |
| Crile Forceps | Transverse serrations extending along the full length of the jaws. Available straight and curved. | Secure grip with continuous serrated surface that maintains contact across the jaws. | A full-length serrated gripping surface for clamping vessels or tissue. |
| Rochester-Péan Forceps | Larger, heavier hemostatic clamp with long, substantial jaws and longitudinal serrations. | Larger jaw surface accommodates a stronger, more substantial clamp. | Greater jaw capacity for larger vessels, tissue bundles, or other larger structures. |
| Rochester-Carmalt Forceps | Long, broad jaws with longitudinal grooves and fine cross-serrations near the tips. | Longitudinal and transverse gripping patterns hold substantial tissue securely. | Long, substantial gripping surface for larger tissue pedicles and structures. |
Choosing between hemostatic forceps: The key considerations are the size of the structure being clamped, the required jaw capacity, curvature, and serration pattern. Smaller instruments such as mosquito forceps are suited to finer work, while larger hemostats provide greater capacity and a more substantial grip for larger vessels or tissue.
3. Ringed Grasping and Visceral Forceps
Ringed grasping and visceral forceps use finger rings and a ratchet locking mechanism, allowing the instrument to maintain a grip without continuous hand pressure. While they share this basic handle design with hemostatic forceps, their primary function is different.
Rather than primarily clamping vessels or tissue to control bleeding, ringed grasping forceps are designed to grasp, hold, retract, or manipulate tissue and other materials. The jaw design is particularly important, as ringed grasping forceps can differ substantially in the shape, size, and surface of their working ends depending on what they are intended to grasp.
- Fenestrated or looped jaws: These create a broader contact area around the material being grasped. The larger surface can distribute pressure rather than concentrating it at a narrow point.
- Smooth or lightly serrated jaws: These are generally used when a controlled grasp is needed without the more aggressive engagement created by prominent teeth.
- Toothed jaws: Interlocking teeth engage the tissue and create a more secure hold. This can be advantageous when traction or stabilization is required.
- Long or angled jaws: These extend the working end farther from the hand and can improve access to deeper or less accessible areas.
| Types of Forceps | Jaw and Tip Design | Grip Characteristics | Applications |
|---|---|---|---|
| Foerster Sponge Forceps | Long, ring-handled with rounded, oval or looped fenestrated jaws. Available straight or curved. | Broad jaws distribute contact across the material being held. | Grasp and manipulate surgical sponges, gauze, and other materials. |
| Babcock Forceps | Rounded, fenestrated jaws with smooth or lightly serrated surfaces and broad contact area. | Holds tissue with a broader, less concentrated grip. | Broad, less traumatic contact surface for grasping and manipulating delicate or tubular structures. |
| Allis Forceps | Multiple sharp interlocking teeth along the jaws. | Strong, secure grip with the teeth maintaining the hold once engaged. | Firm tissue traction or stabilization. |
| Bozeman Dressing Forceps | Long, narrow, typically angled jaws for grasping and manipulating in less accessible areas. | Long jaws allow deeper reach while maintaining a controlled grasp. | Grasping and manipulating surgical sponges, gauze, and dressings with additional reach. |
| Pennington Forceps | Triangular or wedge-shaped fenestrated jaws with interlocking teeth. | Broad contact area with teeth creates a secure hold on tissue. | Secure, controlled grip for firm tissue grasping and manipulation. |
Choosing between ringed grasping and visceral forceps: The key considerations are how securely the tissue or material needs to be held, how much contact area is desirable, and how much reach or access is required. Broad or fenestrated jaws, as found on sponge forceps or dressing forceps, can distribute contact across delicate structures, while toothed designs are better suited to situations where a firmer grasp is necessary.
4. Specialized & Specialty-Specific Forceps
Some types of forceps are designed for a specific procedure, anatomical region, or clinical task. In these cases, the instrument's overall geometry may be just as important as its jaw configuration. Length, angulation, blade shape, fenestration, and tip design can all be adapted to provide access to a particular structure or to perform a specific function.
For example, the right-angled configuration of Magill forceps facilitates access to the posterior oral cavity and pharynx, illustrating how a specialized forceps design can be shaped around a particular anatomical application.3 Rather than simply modifying the gripping surface, the entire working geometry of the instrument is adapted to allow the clinician to approach an otherwise difficult-to-access area while maintaining control from the handle.
| Types of Forceps | Design / Function | Applications |
|---|---|---|
| Obstetrical Forceps | Specialized paired blades that fit around the fetal head. Handles that allow controlled positioning and application. | Forceps-assisted operative vaginal delivery. |
| Biopsy Forceps | Small grasping jaws for obtaining tissue specimen. Commonly passed through an endoscopic instrument or working channel. | Collecting tissue samples during endoscopic procedures. |
| Magill Forceps | Long, angled forceps with a right-angled configuration and blunt-ended jaws. | Manipulating objects or guiding devices in the airway and posterior oral cavity. |
| Schroeder Tenaculum Forceps | Ring-handled grasping forceps with pointed or hooked jaws. | Controlled grasping, stabilization, or traction of tissue in gynaecological procedures. |
| Tonsil Forceps | Long, slender forceps that provide access to the oropharyngeal region, with jaws suited to grasping tissue. | Extended reach and controlled tissue manipulation in tonsils and surrounding oropharyngeal structures |
Choosing specialized types of forceps: When choosing between specialty-specific forceps, the primary consideration is the procedure and anatomical location for which it was designed. A tenaculum, for example, is shaped around a specific grasping and stabilization function rather than general-purpose tissue handling. These instruments often incorporate specialized angles, lengths, jaw shapes, or other features that address the access and handling requirements of a particular clinical application.
Choosing the Right Types of Forceps
Selecting forceps begins with the task the medical instrument needs to perform. Consider whether the application calls for non-locking tissue instruments, locking hemostatic forceps, ring-handled grasping instruments, or specialized designs. As you compare different types of forceps, the following questions can help narrow down the characteristics that matter most:
- Intended application. What will the instrument be used to grasp, hold, clamp, or manipulate
- Instrument design. Is a thumb-operated or ring-handled instrument more appropriate?
- Locking mechanism. Does the application require a clamp that remains closed?
- Jaw configuration. Are teeth, serrations, smooth surfaces, or another configuration appropriate for the material or tissue being handled?
- Instrument size and length. Does the application require a compact instrument or greater reach?
Together, these differences show how forceps design is shaped by the tissue, structure, or material each instrument is intended to handle.
FAQs
The main types of forceps include thumb (non-locking) tissue forceps, hemostatic forceps, ringed grasping and visceral forceps, and specialized forceps. These categories differ in their handle design, jaw configuration, locking mechanism, and intended application. Within each category, individual forceps may have different teeth, serrations, grooves, tip shapes, or lengths to suit different handling requirements.
A tenaculum is a specialized instrument designed to grasp, hold, stabilize, and apply traction to dense or slippery tissue, typically using pointed or hooked jaws. Unlike general-purpose tissue forceps, a tenaculum is designed around a more specific grasping application. It is commonly associated with gyneacologic procedures, including applications involving the cervix, but specialized designs are also used for grasping and manipulating vessels, organs, or other dense tissues.
Adson forceps have relatively fine tips and a broad handle that provides a controlled grip during tissue handling. Toothed Adson forceps are designed to provide a secure grasp, making them useful when tissue needs to be held or manipulated with precision. Their configuration differs from forceps with heavier teeth, smoother jaws, or other tip designs intended for different types of tissue.
Hemostatic forceps are designed to clamp and hold tissue or blood vessels, typically using ring handles and a ratchet locking mechanism that keeps the jaws closed. Tissue forceps are generally non-locking and operated by applying pressure to the handles, with jaw designs that vary according to the tissue being handled. Hemostatic forceps also vary in size, tip shape, curvature, and serration pattern, allowing different designs to suit different applications.
Kelly forceps and mosquito forceps are both hemostatic instruments, but they differ in size and jaw configuration. Mosquito forceps are smaller and have fine serrated jaws suited to more delicate hemostatic work, while Kelly forceps are larger and designed to grasp larger vessels or tissue. Their differences in scale and jaw design make them suited to different applications.
References
- Louie O, Larson LW. Surgical techniques and tools. In: Surgical Implantation of Cardiac Rhythm Devices. 2018. p. 59-80. doi:10.1016/B978-0-323-40126-5.00003-3.
- Trott AT. Instruments, suture materials, and closure choices. In: Wounds and Lacerations. 4th ed. 2012. p. 82-94. doi:10.1016/B978-0-323-07418-6.00008-3.
- Malamed SF. Foreign body airway obstruction. In: Medical Emergencies in the Dental Office. 7th ed. 2015. p. 186-207. doi:10.1016/B978-0-323-17122-9.00011-1.
