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Wangensteen Tissue Forceps

Wangensteen forceps are spring-action thumb forceps.[3][5] For example, B. Braun model BD173R is a 230-mm, 6-mm-wide, cross-serrated Wangensteen dressing forceps.[4]

Design​

  • Length: model-specific; the verified B. Braun BD173R is 23 cm (9 in).[4]
  • Profile: moderately wide flat thumb-grip handle; the tip outline is model-specific, with rounded tips on Sklar 36-1310.[6]
  • Tips. Verify the exact jaw; BD173R has cross-serrated, not documented 3×3-toothed, 6-mm-wide jaws.[4]
  • Mechanism: spring-action; no ratchet.
  • Material: model-specific; most are stainless steel, while the B. Braun BD173R DUROGRIP has tungsten-carbide inserts.[4]

Jaw Pattern and Handling​

A broad serrated tip can aid purchase, but grip and trauma depend on tissue, force and model:

  • Cross-serrated models hold by contact and friction without a prominent 1×2 tooth, but can still compress or shear tissue.[4]
  • Jaw selection. Check the selected model’s serration, tooth count and width against the tissue edge and exposure.

Reconstructive-Urology and Urogyn Uses​

  • Abdominal-wall fascial closure. Moderate-toughness rectus fascia and external-oblique aponeurosis during midline, Pfannenstiel or Gibson closure after open bladder-neck reconstruction, augmentation, diversion or ureteral reimplantation.
  • Peritoneal handling and entry. A suitable broad model may help tent a sturdy edge, with care to avoid tearing fragile peritoneum.
  • Skin-and-subcutaneous closure. A Wangensteen model may be used for thicker abdominal-wall skin, scarred reoperative skin, and dermal edges of inguinal or suprapubic incisions when its jaws fit the tissue and exposure.
  • Open prolapse and pelvic-reconstruction work. Broad-ligament peritoneum, vaginal-cuff peritoneum at high McCall culdoplasty, and peritoneum for mesh coverage during open sacrocolpopexy.[5]
  • Open fistula repair. Interposition-flap mobilization: omental or pelvic-peritoneal flaps for VVF repair,[6] and omental flaps for selected transabdominal RVF repair.[7]
  • Tissue retraction during dissection. Secure purchase on cut fascial edges to present them for layered closure.

Avoid using a broad Wangensteen-pattern tip for delicate vessel, ureteral mucosa, bowel serosa or microsurgical layers when finer control is needed; choose the actual jaw and forceps for tissue quality.

Technique​

  • Grip: use a controlled pencil grip with the selected Wangensteen model and adjust thumb-and-finger pressure to the tissue.[3]
  • Match to layer. Inspect the jaw surface and width; a broad cross-serrated pattern may suit sturdy edges, but tooth count and tissue effect are model-specific.
  • Brief, focal grasp at cut edges; release as soon as the suture has been thrown.

Distinctions from Adjacent Forceps​

ForcepsExample jaw patternPossible role
WangensteenBD173R: 6-mm cross-serrated; Sklar 36-1310: rounded, finely cross-serratedBD173R for dressing handling; Sklar 36-1310 for light tissue handling when the jaw suits exposure[5][6]
Adson-toothed1×2 fineSkin, dartos
Adson-Brown7×7 fineDelicate skin, plastic-surgery edges
BonneyModel-specific 1×2 or 2×3 teethRectus fascia, dense scar
RussianRadially serrated cupped tip on a verified modelSelected broad robust-tissue grip
SingleyFenestrated, no teethBowel, peritoneum
DeBakeyParallel-ridge platformVessels, ureter

Historical Context​

The pattern is named for Owen H. Wangensteen (1898–1981), a University of Minnesota surgeon and surgical educator. His work on continuous suction and the management of intestinal obstruction is historically important, but those treatment outcomes are separate from the performance of eponymous forceps.[1][2] The forceps name identifies a family, not a fixed jaw geometry.[4]

See also: Adson, Bonney, Russian, Singley, DeBakey.

References​

1. Edlich RF, Woods JA. "Wangensteen's transformation of the treatment of intestinal obstruction from empiric craft to scientific discipline." J Emerg Med. 1997;15(2):235–41. doi:10.1016/s0736-4679(96)00351-4

2. Faryniuk A, MacDonald A, van Boxel P. "Amnesia in modern surgery: revisiting Wangensteen's landmark studies of small bowel obstruction." Can J Surg. 2015;58(2):83–4. doi:10.1503/cjs.010814

3. Kirkup J. "The history and evolution of surgical instruments. VII. Spring forceps (tweezers), hooks and simple retractors." Ann R Coll Surg Engl. 1996;78(6):544–52. PMID 8943642

4. B. Braun. Wangensteen DUROGRIP dressing forceps model BD173R: 230 mm, 6-mm jaw, cross-serrated. Manufacturer product listing; not a comparative clinical study.

5. Coolen AW, van Oudheusden AM, Mol BW, et al. "Laparoscopic sacrocolpopexy compared with open abdominal sacrocolpopexy for vault prolapse repair: a randomised controlled trial." Int Urogynecol J. 2017;28(10):1469-1479. doi:10.1007/s00192-017-3296-5

6. Altaweel WM, Rajih E, Alkhudair W. "Interposition flaps in vesicovaginal fistula repairs can optimize cure rate." Urol Ann. 2013;5(4):270-272. doi:10.4103/0974-7796.120305

7. Kröpil F, Raffel AM, Schauer M, Rehders A, Eisenberger CF, Knoefel WT. "Differentiated surgical treatment of rectovaginal fistulae." GMS Interdiscip Plast Reconstr Surg DGPW. 2012;1:Doc10. doi:10.3205/iprs000010