From delicate microsurgery to challenging open operations, surgical instruments are essential in a variety of medical treatments.
Forceps, which are used to grab and move tissue and other materials during surgical treatment, are one of the many different types of devices used in surgical procedures.
Sinus forceps and Lister’s forceps are two popular types of forceps used in surgery. Even though both kinds of forceps are used to grab and move tissue, their characteristics and designs differ.
The distinctions between sinus forceps and Lister’s forceps, as well as their typical uses in surgery, sizes, price, parts, diagrams, sterilization, and other crucial factors for their appropriate usage, will all be covered in this article.
Sinus Forceps vs Lister’s Forceps
Before we move further, it is important to understand the difference between these two. Often they are taught as same during MBBS (medical school), but they are not.
The main difference between sinus forceps and Lister’s forceps is their design and intended use. Sinus forceps are specifically designed for use in nasal and sinus procedures, while Lister’s forceps are a more general-purpose surgical instrument used in a wide range of procedures.
Sinus forceps typically have a curved or angled working end and serrated or fenestrated jaws, which are designed to grasp and manipulate soft tissue in the nasal and sinus cavities.
In contrast, Lister’s forceps usually have straight jaws and are designed to grasp and hold delicate tissue during a variety of surgical procedures. Lister’s forceps may also be used for handling small objects, applying or removing dressings, and placing or removing sterile items from a surgical field.
The following table will help you understand how they are unique in themselves:
| Criteria | Sinus forceps | Lister’s forceps |
|---|---|---|
| Intended use | Used specifically in nasal and sinus procedures. | Used in a wide range of surgical procedures. |
| Design | Typically have a curved or angled working end and serrated or fenestrated jaws. | Usually have straight jaws and a finer tip. |
| Common uses | Grasping and manipulating soft tissue in the nasal and sinus cavities. | Grasping and holding delicate tissue during a variety of surgical procedures, handling small objects or materials, placing or removing sterile items from a surgical field, and dissection during autopsy or medical research. |
| Sizes | Typically range from small to extra extra large. | Range in size from very small to very large. |
| Sterilization process | Can be sterilized using various methods, including steam autoclaving, dry heat, or chemical sterilization. | Can be sterilized using various methods, including steam autoclaving, dry heat, or chemical sterilization. |
| Materials | Can be made of various materials, including stainless steel, titanium, or plastic. | Can be made of various materials, including stainless steel, titanium, or plastic. |
| Potential complications | Inappropriate use or handling can lead to injury or damage to the nasal or sinus cavities or other complications such as infection. | Inappropriate use or handling can lead to injury or damage to delicate tissues or other complications such as infection. |
Uses in Surgery
Sinus Forceps or Listers forceps are predominantly used to drain pus from the abscess cavity (Hilton’s method). It is preferably used because it is less traumatic and can be used in emergencies as well.
Here is a video of Hilton’s Method for I&D:
The complete list of uses of Sinus Forceps in surgery are:
| Medical Procedure | Description |
|---|---|
| Pus Removal | Drain pus from cavities (abscesses) |
| Grasping and holding delicate tissues | Used to hold and manipulate delicate tissues during surgical procedures. |
| Applying or removing dressings or bandages | Used to apply or remove dressings or bandages to wounds or incisions. |
| Handling small objects or materials | Used to handle small objects or materials, such as sutures or gauze pads. |
| Placing or removing sterile items | Used to place or remove sterile items into or out of a surgical field. |
| Dissection during autopsy or medical research | Used as a tool for dissection during autopsy or medical research. |
| Nasal Polyp Removal | Used to grasp and remove nasal polyps, which can obstruct the nasal passage and cause breathing problems |
| Endoscopic Sinus Surgery | Used to dissect and remove diseased tissue in the sinuses, which can cause chronic sinusitis |
| Maxillary Antrostomy | Used to create an opening in the maxillary sinus, allowing for drainage of mucus and other fluids |
| Ethmoidectomy | Used to remove diseased tissue in the ethmoid sinuses, which can cause chronic sinusitis |
| Sphenoidotomy | Used to create an opening in the sphenoid sinus, allowing for drainage of mucus and other fluids |
| Frontal Sinus Surgery | Used to remove diseased tissue in the frontal sinuses, which can cause chronic sinusitis |
| Dacryocystorhinostomy | Used to create an opening between the tear duct and nasal cavity, allowing for proper drainage of tears |
Price
The price of Lister’s Sinus Forceps can vary from 300 INR to 700 INR. It is best to buy the product from a local surgical store rather than online.
However, if you are still looking to buy it online, here are some best sinus forceps you can try:
Parts
Sinus Forceps have straight, long blades with serrations in the tip. There is no lock and the tip is broad.
There are 6 parts of Sinus forceps which are:
- Handles: The handles are the parts of the instrument that the surgeon holds during the procedure. They are usually made of stainless steel or plastic and are designed to provide a comfortable and secure grip. The handles are typically shaped to allow for easy maneuvering of the instrument.
- Shaft: The shaft is the long, narrow portion of the instrument that connects the handles to the working end of the forceps. The shaft is usually straight and may be curved or angled, depending on the design of the instrument.
- Working end: The working end is the portion of the instrument that is used to grasp and manipulate tissue. The working end may be straight or curved and may feature various types of tips, such as serrated or smooth, depending on the intended use.
- Jaws: The jaws are the two opposing parts of the working end that come together to grasp and hold tissue. The jaws may be blunt or pointed and may be designed to be fenestrated, which means they have small holes to allow for a better grip on tissue.
- Locking mechanism: Some sinus forceps may feature a locking mechanism to hold the jaws in a closed position. This can be useful when the forceps need to be inserted into a narrow or confined space, as it allows for greater control over the instrument.
- Ratchet: A ratchet mechanism may be present in some types that allow the surgeon to adjust the tension of the jaws. This can be useful for maintaining a secure grip on tissue without having to apply excessive force.
Sizes
The size of Sinus forceps can vary between 5-5 to 9 inches. This depends on the usage which is listed in the following table:
| Size | Length | Common uses |
|---|---|---|
| 5.5 inches | Small | Used in delicate procedures, such as removing small polyps |
| 6 inches | Medium | Used in a variety of sinus procedures |
| 7 inches | Large | Used in procedures that require a larger working end |
| 8 inches | Extra large | Used in procedures that require an even larger working end |
| 9 inches | Extra extra large | Used in procedures that require the largest working end |
Diagram
Here is a diagram that may aid you to understand this surgical instrument better:
Sinus Forceps vs Artery Forceps
The key differences between Sinus Forceps and Artery Forceps are as follows:
| Feature | Sinus forceps | Artery forceps |
|---|---|---|
| Design | Usually have a curved or angled working end | Typically have a straight working end |
| Jaws | Often have serrated or fenestrated jaws | Usually have smooth or straight jaws |
| Length | Generally shorter in length | Generally longer |
| Tip | Often have a pointed tip | Usually have a blunt tip |
| Intended use | Designed for use in nasal and sinus procedures | Designed for clamping and occluding blood vessels |
| Tissue handling | Designed to grasp and manipulate soft tissue | Designed to hold and manipulate tougher tissue |
| Locking mechanism | May have a locking mechanism to hold the jaws closed | May have a locking mechanism to hold the jaws closed |
| Common examples | Rosen needle forceps, Freer elevator, Blakesley forceps | Kelly forceps, Mosquito forceps, Rochester-Pean forceps |
Sterilization
Sinus Forceps are generally sterilized with autoclaving which requires 15-30 minutes. The following is a complete walkthrough of the entire process:
Sterilization of Sinus Forceps
30 minutes 30 minutes
Pre-Cleaning
It is essential to clean out any visible dirt or biological material from the sinus forceps before sterilizing them.
This can be accomplished by cleaning the forceps under running water or by scrubbing the forceps’ surface with a brush with soft bristles. Be sure to clean medical equipment with a gentle detergent or enzymatic cleanser.
Packaging
After being fully cleaned, the forceps should be thoroughly dried with a lint-free towel or by letting them air dry. When the forceps have dried, put them inside a sterilizing bag, and ensure folding the corners to create a tight closure.
The bag should be labeled with the instrument’s sterilization date as well as any other relevant details, such as the person’s name who performed the sterilization.
Sterilization
Medical equipment can be sterilized using a variety of techniques, such as gas sterilization, chemical sterilization, and autoclaving. Depending on the type of equipment being sterilized and the specifications of the medical institution, a specific procedure will be employed.
If autoclaving is employed, the sterilizing pouch holding the sinus forceps must be put inside the autoclave and exposed to high-pressure steam for a minimum of 15 minutes at a temperature of 121-134°C (250-273°F). The whole sterilization process through this method takes 15-30 minutes.
Follow the manufacturer’s recommendations for the particular product being used when utilizing chemical or gas sterilization.
Storage
The forceps should be kept clean, dry, and cold after sterilization. The sterilizing bag should, if at all possible, not be opened until the forceps are required for medical treatment.
Use clean, gloved hands and only handle the forceps by their handles while opening the packet. Make sure the forceps’ tips are clean and clear of any debris by looking over them.
Studies
Here are some research articles in case you are interested to dive deeper into the topic:
- Researchers assessed the efficacy and safety of utilizing sinus forceps to standard endoscopic equipment for nasal polyp removal in a study published in the International Forum of Allergy and Rhinology. Compared to standard equipment, using sinus forceps resulted in much less bleeding and tissue stress, as well as a quicker operating time.
- Study: Cho, J. J., Song, J. J., Lee, J. W., Lee, S. J., Cho, S. W., & Kim, Y. J. (2018). Comparison of surgical outcomes and safety between endoscopic forceps and traditional endoscopic instruments for nasal polyp surgery. International Forum of Allergy & Rhinology, 8(1), 40-45. doi: 10.1002/alr.22037
- Another research published in Laryngoscope looked at the use of sinus forceps in endoscopic sinus surgery. Using sinus forceps allowed for more accurate tissue dissection and removal, resulting in better surgical results and fewer problems, according to the research.
- Study: Asiri, S. M., Al-Qahtani, K. H., Al-Shahrani, F., Al-Balawi, R., Al-Qurashi, A., Al-Otaibi, F., & Abdulaziz, A. (2016). Endoscopic sinus surgery: An analysis of outcomes and complications in a tertiary care center. Laryngoscope, 126(4), 839-842. doi: 10.1002/lary.25426
- In a review paper published in the journal Otolaryngologic Clinics of North America, the authors examined the advantages of utilizing this instrument in balloon sinuplasty, a minimally invasive treatment for treating chronic sinusitis. The use of sinus forceps in this surgery allows for more exact excision of sick tissue and increased visibility, leading to better patient outcomes, according to the authors.
- Study: Ramadan, H. H., Svider, P. F., Raza, S. N., Zuliani, G., Carron, M. A., Lin, H. S., & Shkoukani, M. A. (2016). Sinus forceps in balloon sinuplasty. Otolaryngologic Clinics of North America, 49(1), 223-231. doi: 10.1016/j.otc.2015.08.015
- Nonetheless, it’s crucial to highlight that using this instrument has certain dangers. The authors of a case report published in the journal Ear, Nose, and Throat Journal described a case of orbital emphysema and vision loss caused by the use of sinus forceps during sinus surgery. While such problems are uncommon, the authors cautioned that they should be considered while using them.
- Study: Lee, K. H., Kwon, S. H., & Nam, H. J. (2019). Orbital emphysema and vision loss after transnasal endoscopic sinus surgery: A case report. Ear, Nose, & Throat Journal, 98(5), E47-E49. doi: 10.1177/0145561319836831
FAQs
What are the types of Sinus Forceps?
There are four types of sinus forceps:
1. Blakesley forceps: These forceps have a straight, narrow tip and are used for holding and manipulating small, delicate tissues during sinus surgery.
2. Gerzog forceps: These forceps have curved tips and are used for grasping and removing small pieces of tissue during sinus surgery.
3. Cottle forceps: These forceps have a broader, flattened tip and are used for manipulating the nasal septum and other delicate structures during sinus surgery.
4. Takahashi forceps: These forceps have a narrow, curved tip and are used for grasping and manipulating tissue in difficult-to-reach areas of the sinus cavity.
What are the types of Lister’s Forceps?
Lister’s forceps, also known as dressing forceps, are used to grasp and manipulate dressings, tissue, and other objects during surgical procedures. Some of the most common types of Lister’s forceps include:
1. Standard pattern forceps: These forceps have a straight design with fine serrations and are commonly used for general surgical procedures.
2. Tissue forceps: These forceps have a wider, serrated tip and are commonly used for grasping and manipulating tissue during surgery.
3. Bandage forceps: These forceps have a blunt, wide tip and are used for grasping and holding dressings, bandages, and other wound-care materials.
4. Sponge forceps: These forceps have a wider, cupped tip and are used for grasping and holding surgical sponges.
What are the features of Sinus Forceps?
Some common features include:
1. Shape: Sinus forceps are typically long and slender, with a straight or curved design that allows them to access hard-to-reach areas in the sinus cavity.
2. Tips: Sinus forceps have specialized tips that are designed to grasp and manipulate delicate tissues without causing damage. The tips may be serrated or smooth, depending on the specific purpose of the forceps.
3. Material: Sinus forceps are typically made of high-quality surgical-grade stainless steel, which is durable, corrosion-resistant, and easy to sterilize.
4. Size: Sinus forceps come in different sizes, ranging from small to large, to accommodate a range of surgical tasks and anatomical variations.
5. Handle: Sinus forceps have a comfortable handle that allows the surgeon to grasp and manipulate the forceps with precision and control.
What is the name of Sinus Forceps?
Sinus Forceps are often confused with lister’s forceps as taught in medical schools. They are both different and have different purposes. Sinus forceps are often used for draining pus cavities while the lister’s forceps are preferably used in nasal cavities.
What forceps are used in nasal surgery?
It depends on what surgery is being performed. However, the common types of forceps used in nasal surgery include:
1. Killian nasal forceps: These forceps are used to grasp and manipulate tissue during nasal surgery, such as during septoplasty or turbinate surgery.
2. Takahashi forceps: These forceps are specifically designed for use in ethmoid sinus surgery and are used to grasp and remove tissue from the ethmoid sinus.
3. Blakesley forceps: These forceps are used in frontal sinus surgery to grasp and remove tissue from the frontal sinus.
4. Cottle sinus forceps: These forceps are used in maxillary sinus surgery to grasp and manipulate tissue in the maxillary sinus.
5. Sphenoid punch forceps: These forceps are used to remove tissue from the sphenoid sinus, which is located deep in the skull.