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Potts (Potts-Smith) Scissors

Angled vascular-pattern scissors that can provide a useful line of approach when extending an incision in an exposed vessel or other tubular wall. Potts and Potts-Smith catalog models vary widely in angle, blade length and overall size; no one model is the default for every arteriotomy, urethrotomy, ureterotomy or vasotomy.[4][5][6]

Design​

  • Blade angle and size. Teleflex lists Potts/Potts-Smith examples at 60° and 9.5 cm (352140) and 45° and 18.5 cm (640245). Aspen's registered Symmetry Potts-Smith 54-8001 is 25° and 7.5 in (19 cm). Other patterns exist; use the actual catalog or IFU rather than a universal 18–25 cm range or a presumed 45° preference.[4][5][6]
  • Blade and tip: fine cutting geometry varies by model. A sharp tip and adequate control remain important; the instrument itself cannot guarantee a nontraumatic mucosal incision.
  • Reach and handling: the selected blade angle may improve access to a particular exposed wall; this is a handling consideration, not evidence of superior anastomotic outcomes.

Reconstructive-Urology and Urogyn Uses​

Extending a urethrotomy​

An appropriately sized angled scissor may extend a urethrotomy in some open reconstructions after the site and cut direction are exposed. Potts is not required, and the starting incision and blade depend on the operation. Potential settings include:

  • Anastomotic urethroplasty. Extending the urethrotomy at the proximal and distal ends to define the cut-back length for tension-free anastomosis.
  • Augmentation / substitution urethroplasty. Extending the urethrotomy to receive a BMG or skin-flap onlay (TIP / TIPU / Mathieu / onlay-island-flap).
  • Posterior urethroplasty. Extending the urethrotomy at the level of the stricture to define the spatulation lines.

Spatulating ureter and urethra for anastomosis​

  • Ureteral spatulation during ureteral reimplantation, ureteroureterostomy, ileal-ureter interposition, Boari-flap reconstruction, and trans-ureteroureterostomy; the goal is a viable, adequately opened end for the chosen anastomosis, not a universal 6–10 mm Potts cut. A published laparoscopic pyeloplasty technique describes extracorporeal spatulation with Potts atraumatic scissors; another describes standard laparoscopic scissors, showing that instrument choice is approach-specific.[7][8]
  • Urethral spatulation at the distal stump during posterior urethroplasty and at the apical stump during VUA / re-do VUA after radical prostatectomy.

Microsurgical vasovasostomy and vasoepididymostomy​

  • Vasal mucosal opening. If the selected instrument fits the lumen and magnified field; do not assume a Potts variant is preferred for every vasal repair.
  • Epididymal tubule opening. Requires an instrument matched to the extremely small target; do not assume an ordinary Potts-Smith model is appropriate.

Genital-vessel and microsurgical reconstructive work​

  • Vascular preparation during penile / genital replantation. Recipient-vessel arteriotomy and venotomy for the microvascular anastomosis.
  • Microsurgical lymphovenous anastomosis (LVA). Vessel and lymphatic openings require supermicrosurgical-scale tools; an ordinary Potts-Smith catalog model should not be assumed suitable for those tiny lumens.
  • Microvascular pedicle preparation for free flaps. RFFF / ALT / DIEP / TRAM recipient and donor vessel openings during phalloplasty and vulvar / pelvic free-flap reconstruction.

Mucosal trim and graft / flap shaping​

  • BMG and FTSG / STSG trimming to fit the recipient bed. A suitable fine scissor can trim an edge; Potts geometry does not itself prevent tissue crush.
  • Flap-edge trimming during scrotal, vulvar, and perineal flap work when the actual blade suits the task.

Open vascular control during pelvic dissection​

  • Extension of an iatrogenic or planned venotomy during deep pelvic dissection (DVC tributaries, internal iliac branches) where a small controlled extension allows repair without enlarging the defect.

Technique​

  • Orient the angled blade along the planned, directly visualized incision and select the model by access, blade length and target size; do not choose angle by hand position alone.
  • Control the wall gently with an appropriate atraumatic forceps, such as DeBakey when its size suits the tissue, while maintaining visibility of both blades.
  • Advance deliberately in controlled cuts. Avoid ragged edges, but do not require a single uninterrupted cut regardless of exposure or wall thickness.
  • Use a task-appropriate pair for suture, drains or heavy connective tissue; a separate tissue pair may help protect a fine cutting edge. Follow the chosen model's instructions and local instrument policy.

Distinctions from Adjacent Scissors​

ScissorBladeTissueBest fit
PottsAngled, model-dependentExposed vessel or other tubular wall when size suitsSelected controlled wall incisions; not a universal default
MayoStraight or curved, heavyFascia, mesh, suture, dressingsWorkhorse cut-and-divide
MetzenbaumStraight or curved, fineAreolar / fat / peritoneum / thin fasciaPelvic plane dissection
IrisStraight or curved variants, fineDelicate exposed tissue, by modelSelected glansplasty or fine dissection
Castroviejo / microSpring-action, ultra-fineMicrosurgical layersVasovasostomy, LVA

Historical Context​

The Potts name is associated with pediatric cardiovascular surgeon Willis J. Potts (1895–1968).[1][2] His Potts shunt is a pulmonary-to-systemic (descending aorta to left pulmonary artery) anastomosis, first used to palliate cyanotic congenital heart disease and more recently revived in pediatric pulmonary hypertension. It is a distinct development from the scissors.[3] Modern catalogs use both Potts and Potts-Smith for angled vascular scissors.[4][5][6] The reviewed catalog entries and accessible historical abstracts do not establish who the "Smith" in the product name was or a specific design collaboration, so no individual collaborator is attributed here.

See also: Mayo Scissors, Metzenbaum Scissors, DeBakey Forceps, Gerald Forceps.

References​

1. Ailawadi G, Nagji AS, Jones DR. "The legends behind cardiothoracic surgical instruments." Ann Thorac Surg. 2010;89(5):1693–700. doi:10.1016/j.athoracsur.2009.11.019

2. El-Sedfy A, Chamberlain RS. "Surgeons and their tools: a history of surgical instruments and their innovators — part I: place the scissors on the Mayo stand." Am Surg. 2014;80(11):1089–92.

3. Grady RM. "Beyond transplant: roles of atrial septostomy and Potts shunt in pediatric pulmonary hypertension." Pediatr Pulmonol. 2021;56(3):656–60. doi:10.1002/ppul.25049

4. Teleflex/Pilling. Potts Scissors 352140. Current catalog description: 60°, 9.5 cm, 25-mm blades.

5. Teleflex/Pilling. Potts Smith Vascular Scissors 640245. Current catalog description: 45°, 18.5 cm, 18-mm blades.

6. National Library of Medicine AccessGUDID. Aspen Symmetry Potts-Smith 54-8001. Device description: 25° angle, 7.5 in.

7. Enikeev M, et al. Extracorporeal ureter handling during laparoscopic pyeloplasty: tips and tricks for beginners. Cent European J Urol. 2019;72(4):413–417. doi:10.5173/ceju.2019.0022.

8. Giannakopoulos S, et al. A simplified technique for ureteral spatulation in laparoscopic pyeloplasty. J Endourol. 2012;26(6). doi:10.1089/end.2011.0354.