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Cadiere Forceps (da Vinci)

Non-energized EndoWrist grasper with broad fenestrated jaws — the bowel-handling specialist of the da Vinci grasper family and a versatile broad retractor. Named for Guy-Bernard Cadière, the Belgian surgeon who was among the first to perform robotic-assisted general surgical procedures. 8 mm on the multi-arm platforms (S / Si / Xi); a semi-rigid 5 mm version exists for the da Vinci Single-Site platform through curved cannulae.[1][2][3][4]

Design​

  • Broad fenestrated jaws — Brown 2014 bench data confirm fenestrations meaningfully improve grip when the surface-contact-to-fenestration area ratio exceeds 1:0.4.[5]
  • No electrical energy — purely mechanical, like the ProGrasp and Tip-Up Fenestrated graspers.
  • Full EndoWrist (7 DoF) on multi-arm platforms; semi-rigid non-wristed on Single-Site (software-compensated master reassignment handles the crossed-cannulae geometry).[4][6]

Reconstructive-Urology and Urogyn Uses​

In WARWIKI scope, the Cadiere is the bowel-handling instrument for robotic urinary-diversion / augmentation work and a versatile broad retractor for pelvic robotics:

Bowel-handling during urinary-diversion / augmentation reconstruction​

  • Robotic ileal conduit / Bricker, Wallace, Studer / Hautmann neobladder, Indiana pouch, Mitrofanoff appendicovesicostomy, Monti channel, ileal-ureter substitution, ileocystoplasty augmentation — running the bowel, identifying the ileocecal valve, measuring segment length, presenting the omentum for division. The combination of broad atraumatic jaws plus fenestration grip is well suited to slippery bowel serosa. This mirrors the role described for totally robotic Roux-en-Y gastric bypass (Mohr 2005).[2]

Broad retraction in pelvic robotics​

  • Robotic sacrocolpopexy — broad sigmoid / sigmoid-mesentery retraction; alternative to ProGrasp when broad atraumatic-grasp profile is preferred.
  • Robotic ureteral reimplant / Boari flap — bladder-dome and ureteral-segment retraction.
  • Robotic transvaginal-mesh excision — broad mesh / vaginal-wall retraction.

Where the Cadiere is not the right choice in RU​

  • Bowel-injury risk without haptic feedback — Hubens 2008 robotic RYGB series reported intestinal lacerations in 5/45 patients (11%) requiring conversion during bowel manipulation with robotic instruments. The Cadiere is gentle by design, but gentle technique still matters because the operator has no haptic feedback for tension on bowel — a daily concern in robotic urinary diversion / augmentation.[7]

Retraction-Technique Pearl​

Oberhelman 2024 describes the wrist-medializing maneuver that applies to all broad-tipped graspers (Cadiere, fenestrated bipolar) on the da Vinci SP — bringing the wrists toward the midline generates significantly greater retraction (distance and tension) than the more natural lateral wrist-flaring motion. The "push" movement is more fluid when using fingertips proximally on the surgeon controls (cobra pose).[1]

Cadiere vs Other Graspers​

FeatureCadiereProGraspTip-Up FenestratedFenestrated bipolar
Diameter8 mm multi-arm / 5 mm Single-Site8 mm Si-Xi / 6 mm SP8 mm5–8 mm Xi / 6 mm SP
EnergyNoneNoneNoneBipolar
Jaw geometryBroad fenestratedBroad atraumatic teethFenestrated, tip-up scoopBroad fenestrated
Best forBowel handling, broad retractionSustained 4th-arm retractionPerpendicular liftRetraction + diffuse coag
Single-Site availableYes (semi-rigid)NoNoNo

The Cadiere overlaps substantially with the fenestrated bipolar; choose Cadiere when energy is not needed for that arm (lowest disposable cost) or for the Single-Site platform where it is one of the few grasper options.

Single-Site Platform Position​

On the da Vinci Single-Site, the Cadiere is part of the standard cholecystectomy instrument set alongside the Maryland dissector, monopolar curved scissors, Hem-o-lok applier, monopolar cautery hook, and suction-irrigator. Designed for the 2–2.5 cm transumbilical incision with software-handled master-control reassignment for the crossing cannulae.[3][4][6]

Practical Considerations​

  • Low disposable cost vs the bipolar instruments — a useful pick when bipolar energy is not required in that arm.[8]
  • Single-Site semi-rigid version is less dexterous than the wristed multi-arm version; this is the standard trade-off of the Single-Site platform.[4][6]
  • Bowel-manipulation gentleness matters — broad fenestrated jaws are gentle but not haptic; visual tension cues only.[7]

Limitations​

  • No energy — companion instrument required for hemostasis.
  • No scoop / lift geometry — choose Tip-Up Fenestrated when the retraction vector is perpendicular to the shaft.
  • Posture-dependent grip variance (Lee 2015 — 1.84–3.37× variability across articulation angles) — applies to all EndoWrist graspers and warrants conservative grip on delicate structures.

See also: ProGrasp, Tip-Up Fenestrated Grasper, Maryland Bipolar, Fenestrated Bipolar, Force Bipolar.

References​

1. Oberhelman N, Bruening J, Jackson RS, et al. "Comparison of da Vinci Single Port vs Si systems for transoral robotic-assisted surgery: a review with technical insights." JAMA Otolaryngol Head Neck Surg. 2024;150(2):165–71. doi:10.1001/jamaoto.2023.3994

2. Mohr CJ, Nadzam GS, Curet MJ. "Totally robotic Roux-en-Y gastric bypass." Arch Surg. 2005;140(8):779–86. doi:10.1001/archsurg.140.8.779

3. Wren SM, Curet MJ. "Single-port robotic cholecystectomy: results from a first human use clinical study of the new da Vinci single-site surgical platform." Arch Surg. 2011;146(10):1122–7. doi:10.1001/archsurg.2011.143

4. Pietrabissa A, Sbrana F, Morelli L, et al. "Overcoming the challenges of single-incision cholecystectomy with robotic single-site technology." Arch Surg. 2012;147(8):709–14. doi:10.1001/archsurg.2012.508

5. Brown AW, Brown SI, McLean D, Wang Z, Cuschieri A. "Impact of fenestrations and surface profiling on the holding of tissue by parallel occlusion laparoscopic graspers." Surg Endosc. 2014;28(4):1277–83. doi:10.1007/s00464-013-3323-7

6. Escobar-Dominguez JE, Hernandez-Murcia C, Gonzalez AM. "Description of robotic single site cholecystectomy and a review of outcomes." J Surg Oncol. 2015;112(3):284–8. doi:10.1002/jso.23931

7. Hubens G, Balliu L, Ruppert M, et al. "Roux-en-Y gastric bypass procedure performed with the da Vinci robot system: is it worth it?" Surg Endosc. 2008;22(7):1690–6. doi:10.1007/s00464-007-9698-6

8. Ramirez D, Ganesan V, Nelson RJ, Haber GP. "Reducing costs for robotic radical prostatectomy: three-instrument technique." Urology. 2016;95:213–5. doi:10.1016/j.urology.2016.03.067