“Hemostat forceps” a simple and useful adjuvant to clip applicator forceps for clipping saccular cerebral aneurysms – Technical note

摘要

Despite technical and technological advances in Neurosurgery, in the last four decades, there has been no significant reduction, in the dimensions of the, aneurysm clip applicator forceps. This can be challenging, even to the most experienced neurovascular surgeon, especially when the surgical corridor created remains narrow, despite all possible measures to widen it. The author describes one such situation, where an anterior communicating artery aneurysm was clipped successfully using a simple “hemostat” forceps. The author describes the advantages and disadvantages of a hemostat forceps, when used as a clip applicator. He also explains how a “custom made” hemostat forceps, can overcome these pitfalls. The author concludes that, though a standard clip applicator forceps is the instrument of choice, to clip aneurysms, a “custom made” set of hemostat forceps can prove superior to conventional clip applicators, in select situations, where the surgical corridor is too narrow and the relatively large dimensions of the clip applicator itself, obliterates visibility of the local anatomy. Highlights ? Narrow surgical corridor to access the aneurysm due to refractory brain swelling. ? Failure of conventional clip applicator forceps. ? Successful clip application with hemostatic forceps. ? Custom made hemostatic forceps, cannot replace conventional clip applicator forceps, but may be useful in select situations.