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a surgical instrument that stops bleeding by clamping the blood vessel (同)haemostat

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〈U〉止血剤 / 〈C〉(手術用の)止血鉗子(しけつかんし)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/01/27 14:43:55」(JST)

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Hemostats, curved and straight tip

A hemostat (also called a hemostatic clamp, arterial forceps, or pean after Jules-Émile Péan) is a surgical tool used in many surgical procedures to control bleeding.^[1] For this reason it's common in the initial phases of surgery for initial incision to be lined with hemostats which close blood vessels awaiting ligation. Hemostats belong to a group of instruments that pivot (similar to scissors, and including needle holders, tissue holders and various clamps) where the structure of the tip determines the function.

The hemostat has handles that can be held in place by their locking mechanism. The locking mechanism is typically a series of interlocking teeth, a few on each handle, that allow the user to adjust the clamping force of the pliers. When locked on, the force between the tips is approximately 40 N (9 lbf).

Hemostats are part of the first aid kit carried by combat medics and paramedics. They are also used as heatsinks while soldering electric circuits; as tools to hold the filter of marijuana cigarettes; by fishermen to remove hooks from the mouths of fish; by motor mechanics to hold nuts, bolts, screws in constricted locations, and as tools to feed prey to captive reptiles and exotic invertebrates without being stung or bitten.

History

The earliest known drawing of a pivoting surgical instrument dates back to 1500 BC on a tomb at Thebes, Egypt. Later Roman bronze and steel pivot-controlled instruments were found in Pompeii. In the ninth century AD Albucasis made illustrations of pivoting instruments for tooth extraction^{[citation needed]}.

The concept of clamping a bleeding vessel with an instrument before tying it off is generally attributed to Galen (second century AD). This method of hemostasis was largely forgotten until it was rediscovered by the French barber-surgeon Ambroise Paré in the 16th century. He made the predecessor to the modern hemostat and called it the Bec de Corbin (crow's beak) (see image below). With it he could clamp a bleeding vessel before securing it with a ligature.

Bec de Corbin

The modern hemostat is credited to several persons, the foremost of which is Jules-Émile Péan. Later surgeons (i.e. William Halsted) made minor alterations to the design.

List of hemostats

Rankin forceps
Kelly forceps
Kocher forceps
Crile forceps
Halsted Mosquito forceps
Mixter "right angle" forceps
Hartman "Gnat" forceps

References

^ N Phillips and P Sedlak (2010). Surgical Instrumentation. Clifton Park, New York: Cengage.

External links

Hemostats on Wikisurgery

UpToDate Contents

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1. Overview of topical hemostatic agents and tissues adhesives used in surgery
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English Journal

Use of topical bovine thrombin in an anti-coagulated rat model of hepatic injury.

Schmiedt CW, Köhler R, Brainard BM.SourceDepartment of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, 501 DW Brooks Dr., Athens, GA 30602, United States. Electronic address: cws@uga.edu.
Research in veterinary science.Res Vet Sci.2012 Dec;93(3):1498-503. doi: 10.1016/j.rvsc.2012.04.012. Epub 2012 May 23.
The need for surgical hemostasis in patients treated with anticoagulant medications is a concern. This study assessed a bovine-derived topical hemostat (FastAct, FA) using a partial hepatectomy hemorrhage model in anticoagulated rats. Ninety rats were randomly assigned to receive preoperative hepari
PMID 22633173

Safety and hemostatic efficacy of fibrin pad in partial nephrectomy: Results of an open-label Phase I and a randomized, standard-of-care-controlled Phase I/II study.

Nativ O, Patel B, Shen J, Batiller J, Horn S, Hart JC.AbstractABSTRACT: BACKGROUND: Bleeding severity, anatomic location, tissue characteristics, and visibility are common challenges encountered while managing intraoperative bleeding, and conventional hemostatic measures (suture, ligature, and cautery) may sometimes be ineffective or impractical. While topical absorbable hemostats (TAH) are useful hemostatic adjuvants, each TAH has associated disadvantages.
BMC nephrology.BMC Nephrol.2012 Nov 8;13(1):147. [Epub ahead of print]
ABSTRACT: BACKGROUND: Bleeding severity, anatomic location, tissue characteristics, and visibility are common challenges encountered while managing intraoperative bleeding, and conventional hemostatic measures (suture, ligature, and cautery) may sometimes be ineffective or impractical. While topical
PMID 23137020

Optimizing hemostatic practices: matching the appropriate hemostat to the clinical situation.

Neveleff DJ.AbstractAchieving hemostasis is a critical focus of clinicians working in the surgical setting, given that uncontrolled surgical bleeding is associated with increased mortality rates and higher costs of care. As principal members of the surgical team, perioperative nurses are in an optimal position to plan and direct care during a bleeding event and throughout a patient's surgical stay. This supplement includes an assessment of the clinical and economic effects of surgical bleeding, a thorough review of available therapies, and a detailed comparison of these products to demonstrate which agents are best suited for a given clinical situation. By understanding the basic science of coagulation and hemostasis and current advances in topical hemostatic agents, including their safety, efficacy, and judicious use, perioperative nurses will be empowered to better assist the surgeon in optimizing patient outcomes.
AORN journal.AORN J.2012 Nov;96(5):S1-S17. doi: 10.1016/j.aorn.2012.08.005.
Achieving hemostasis is a critical focus of clinicians working in the surgical setting, given that uncontrolled surgical bleeding is associated with increased mortality rates and higher costs of care. As principal members of the surgical team, perioperative nurses are in an optimal position to plan
PMID 23107037

Japanese Journal

脊椎内視鏡手術におけるデンプン由来の吸収性局所止血剤

柴山元英,三浦恭志,伊藤不二夫,長原正静,大塚隆信
Journal of spine research 1(8), 1466-1468, 2010-08-25
NAID 10027714486

キトサンを用いた応急救護処置のための止血剤の開発

服部秀美,川上真弘,野上弥志郎,天野嘉子,田中良弘,石原雅之
キチン・キトサン研究 = Chitin and chitosan research 16(2), 216, 2010-06-01
NAID 10026999693

The Effects of Sheet-Type Absorbable Topical Collagen Hemostat Used to Prevent Pulmonary Fistula after Lung Surgery

MIYAMOTO Hideaki,SAKAO Yukinori,SAKURABA Motoki,OH Shiaki,TAKAHASHI Nobumasa,MIYASAKA Yoshikazu,AKABOSHI Taku,INAGAKI Tomoya
Annals of thoracic and cardiovascular surgery 16(1), 16-20, 2010-02-01
NAID 10027077968

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★リンクテーブル★

リンク元	「止血剤」「止血鉗子」「hemostatic」「haemostat」
拡張検索	「hemostatic drug」「hemostatic agent」「hemostatic disorder」「hemostatic method using heater probe coagulation」