Rochester-Péan Clamp
A ring-handled, ratcheted hemostatic-forceps family with full transverse serrations in the familiar patterns. Straight and curved models exist. Although a long, heavy version is common on open trays, the family also includes shorter instruments; it is not defined by a universal 16–25 cm range.[1]
Model-specific dimensions
| Manufacturer examples | Length and pattern |
|---|---|
| Pilling 182400 / 182440 | 14 cm, straight / curved; full serrations |
| Pilling 182420 / 182460 | 20.5 cm, straight / curved; full serrations |
| KMedic KM36360 / KM36362 | 30.5 cm, straight / curved |
| Extended-length Pilling 175097 / 175098 | 35.5 / 45.5 cm, curved |
The examples illustrate variation, not an exhaustive range or an instruction to use the longest instrument. Overall length, jaw length, width, curvature and closure all matter.[1]
Distinguishing adjacent clamps
| Clamp | Serrations | Tip tooth |
|---|---|---|
| Rochester-Péan | Full jaw, transverse | No |
| Péan | Full jaw, transverse | No |
| Rochester-Carmalt | Longitudinal, with a cross-serrated tip | No |
| Kocher / Rochester-Ochsner | Full jaw, transverse | Yes (1×2) |
| Kelly | Distal half, transverse | No |
| Crile | Full jaw, transverse | No |
Compare the specific instrument, because force and size cannot be inferred from the name. At the bench the Rochester-Péan is often called simply a "Péan" or a "Rochester", so request the full pattern name; "Rochester" alone is ambiguous.
Reconstructive use
A long, heavy Rochester-Péan is used when a pedicle is large, deep or both, and a tip tooth would over-crush or puncture the tissue. Typical uses in open reconstructive work include:
- Pedicles at depth, such as broad-ligament, infundibulopelvic, uterine, cardinal and uterosacral pedicles during hysterectomy performed with prolapse, fistula or sacrocolpopexy surgery, and spermatic-cord pedicles during open or salvage orchiectomy.
- Medium-sized vessels in a deep pelvic field, where a Kelly is too short and a Schnidt curve is wrong for the angle.
- Mesenteric pedicles during segment isolation for ileal conduit, neobladder, continent reservoir and augmentation cystoplasty.
- Clamp-clamp-cut-tie control of a pedicle: a clamp above and below, division between them, and replacement of the proximal clamp with a transfixion suture and tie.
- Blunt dissection through tougher planes with the closed tip, where the jaws of a Kelly would deflect.
An identified bleeding point or pedicle selected for ligation can be controlled with a suitable model. More reach does not justify taking a blind bite in a deep pelvis. For pedicle technique, use the Péan handling principles and the relevant operation; Heaney covers hysterectomy clamp-cut-ligate steps.
This is a crushing hemostat, not an atraumatic temporary vascular clamp. Vessels needed for continued perfusion or anastomosis require an appropriate vascular-control instrument.[2] Avoid routine clamping or traction on the functioning pedicle of an omental or gracilis interposition flap. During bowel-segment isolation, preservation of the selected segment's blood supply must guide which branches can be divided.
A securely ligated stump may remain in the patient; it is therefore inaccurate to prohibit use on all tissue that remains in situ. The distinction is whether the grasped tissue is being ligated or must retain function and perfusion.
Practical checks
- See the target and exclude adjacent ureter, bowel, nerves and preserved vessels.
- Match jaw capacity to tissue bulk; do not use a long clamp to force a plane open or compensate for inadequate exposure.
- Avoid fixed ratchet settings, unmeasured pressure claims and a mandatory paired-clamp arrangement. Plan control of the retained pedicle before division.
- Release in a controlled manner after definitive hemostasis, then inspect for bleeding or ligature slippage.
- Inspect the tips, joint and ratchet and follow the exact model's processing instructions.
Historical note
The instrument is named for Jules-Émile Péan (1830–1898) and for Rochester, Minnesota, where the long, heavy version is generally said to have been refined. Reviews of hemostatic-forceps history trace the lineage from the ligature forceps of Celsus (first century AD) through Paré (1582) and Heister (1743) to the modern locking clamps and, later, atraumatic vascular clamps.[3]
See also: Péan, Halsted mosquito, Kelly, Crile, Kocher, Schnidt.
References
1. Teleflex/Pilling. Surgical Instruments Catalog. Printed pages 60, 70–71 and 256: Carmalt, Rochester-Péan and extended-length patterns. Manufacturer catalog.
2. Crumplin MKH. "Vascular forceps and clamps." Br J Surg. 2023;110(7):753–756. doi:10.1093/bjs/znac380.
3. Sachs M, Auth M, Encke A. "Historical development of surgical instruments exemplified by hemostatic forceps." World J Surg. 1998;22(5):499–504. doi:10.1007/s002689900424.