Jacobs Tenaculum
The Jacobs tenaculum (or Jacobs vulsellum) is a ratcheted, ring-handled cervical or uterine grasper with opposing multi-tooth jaws, and it differs from the single-tooth tenaculum. Named manufacturer examples have 2 × 2 teeth, rather than the 3–4 teeth per jaw used by some other vulsellum patterns. The distributed purchase can be useful when a single-point grip tears through tissue, but this device still has penetrating teeth; its relative pain, bleeding and grip security have not been established by the Allis-versus-single-tooth IUD trials.[3][4]
Design
- Opposing 2 × 2 toothed jaws in B. Braun EO202R (straight, 215 mm) and MedGyn 031197/031198 (straight or side-curved, 215 mm). Other named patterns and lengths require their own catalog check.[3][4]
- Ratcheted ring handles provide controlled closure; tooth contact and tissue penetration depend on the actual model and applied force.
- The cited examples are reusable stainless-steel instruments. Obtain the chosen manufacturer's model-specific reprocessing instructions; the catalog entries do not supply a universal steam cycle.[3][4]
Reconstructive-Urology and Urogyn Uses
The Jacobs offers a multi-point grip in situations where a single-tooth design tears through or where a broader bite is useful. Choice still depends on tissue quality, exposure and required traction; it is not automatically less traumatic:
- Friable, atrophic, or scarred cervix. Consider a different bite or less penetrating alternative if forceps purchase causes tearing; prior surgery or radiation calls for especially gentle traction.
- Vaginal-cuff grasping after hysterectomy. Potential operative grasper for cuff revision, mesh-exposure excision, fistula or prolapse repair when the tissue can tolerate toothed purchase; use atraumatic grasping or sutures where penetration is undesirable.
- Cervical traction during vaginal hysterectomy or selected uterine-preserving reconstruction when multi-point purchase is useful.
- Transcervical instrumentation (IUD, endometrial biopsy, hysteroscopy, Hegar dilator dilation) when cervical stabilization is needed; the named Jacobs device was not the test instrument in the cited Allis or atraumatic-vulsellum randomized comparisons.
Single-Tooth vs Jacobs vs Atraumatic Alternatives
| Feature | Single-tooth tenaculum | Jacobs (multi-tooth) | Allis clamp / atraumatic vulsellum |
|---|---|---|---|
| Grip mechanism | Opposing 1 × 1 penetrating points | Opposing 2 × 2 toothed jaws in named models | Allis has multiple teeth; the studied atraumatic vulsellum is a separate design |
| Traction security | Point purchase; depends on tissue/force | Distributed toothed purchase; depends on tissue/force | Depends on jaw design and cervical anatomy |
| Tissue trauma | Focal penetration or tear-through possible | Multiple tooth contacts; not nonpenetrating | Allis may still traumatize; atraumatic variants reduce penetration |
| Bleeding after IUD placement | 26/47 (55.3%) in Andrews trial | Not tested in that trial | Allis 3/48 (6.3%); Doty trial measured shorter hemostasis time with a distinct atraumatic vulsellum[1][2] |
| Practical choice | When reliable focal purchase is needed | When a multi-point toothed grip suits the tissue | Consider less penetrating devices when feasible |
These IUD data do not rank the Jacobs between the other instruments for trauma, pain or grip in surgical or atrophic-cervix settings.
Limitations and Evidence Notes
- Slip or tear-through can occur when traction exceeds tissue purchase, especially in fragile tissue; no comparative Jacobs slip rate was established from the cited trials.
- Limited named-device comparative data: Andrews compared Allis with single-tooth during IUD insertion (95 participants); Doty compared a distinct atraumatic vulsellum with single-tooth (80 participants). Neither trial tested Jacobs, an atrophic-cervix subgroup or a vaginal-cuff operation.[1][2]
- Pain and processing. Counsel and offer individualized procedural analgesia for office cervical instrumentation; inspect tooth contact and hemostasis afterward. Follow the actual model's reprocessing directions, not an assumed generic autoclave setting.[5]
See also: Single-Tooth Tenaculum, Allis Clamp, Ring (Sponge) Forceps, Hegar Dilators, Auvard Weighted Speculum.
References
1. Andrews B, Quick K, MacLeod E, Edwards K, Rone BK. "Cervical bleeding with cervical stabilization during IUD placement: Allis clamp versus single-tooth tenaculum, a randomized control trial." Arch Gynecol Obstet. 2023;307(4):1015–9. doi:10.1007/s00404-022-06784-x
2. Doty N, MacIsaac L. "Effect of an atraumatic vulsellum versus a single-tooth tenaculum on pain perception during intrauterine device insertion: a randomized controlled trial." Contraception. 2015;92(6):567–71. doi:10.1016/j.contraception.2015.05.009
3. B. Braun Aesculap. EO202R Jacobs tenaculum/vulsellum forceps. Manufacturer catalog; straight, 215 mm, 2 × 2 teeth.
4. MedGyn. Surgical instrument catalog, tenacula. Catalog p 48: Jacobs 031197/031198, straight/side-curved, 2 × 2 teeth, 215 mm; other patterns separately listed.
5. ACOG. Pain management for in-office uterine and cervical procedures. Clinical Consensus No. 9, 2025; distinguish counseling/analgesia from device-comparison evidence.