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Lahey Tissue Forceps

Lahey traction forceps are ring-handled, ratcheted, toothed graspers for firm traction on fibrous or specimen tissue. The Sklar 17-3562 and Teleflex 171155 are straight 3×3-tooth models, about 6–6¼ in long; do not assume every Lahey-labeled model has the same jaw. Teeth can puncture tissue and a ratchet can sustain pressure, so this is not an injury-free grasp. Frank Howard Lahey (1880–1953) is associated with modern thyroid surgery and routine recurrent-laryngeal-nerve identification.[1][2][3]

Design​

  • Ring handles at the proximal end, used with the thenar grip (thumb and ring finger in the rings, index finger along the shaft).
  • Ratcheted box lock for sustained traction without continuous hand pressure.
  • Jaw tips: the reviewed Sklar and Teleflex models have 3×3 sharp teeth for traction on fibrous tissue. Other patterns require model-specific confirmation; no comparative test establishes “highest” grip security across named forceps.
  • Jaws: the reviewed models are straight, not universally gently curved.
  • Shaft: straight, relatively slender, suitable for confined operative fields.
  • Length: the reviewed Teleflex model is 15 cm (6 in) and Sklar model is 159 mm (6¼ in); a STERIS catalog also lists 150- and 200-mm 3×3 variants. STERIS instrument catalog.
  • Material: surgical-grade stainless steel, autoclavable.

Mechanism — Traction, Not Dissection​

The Lahey is primarily a traction instrument, not a dissector. Its teeth engage tissue and the ratchet can maintain a hold while another instrument develops a visible plane. Secure traction depends on tissue, tooth engagement, and applied force; “does not slip” is not a guarantee.

The trade-off is focal puncture and crush risk. Consider the instrument only where a firm toothed grasp is acceptable, such as:

  • Tissue that will be removed (thyroid lobe, uterine specimen, urachal remnant, partial-cystectomy specimen).
  • Selected fibrous or capsular tissue where the operative goal permits that degree of surface injury.

Avoid direct toothed traction on bowel, ureter, vessels, nerves, and delicate tissue intended for preservation. If oncologic specimen integrity matters, select a handling method that avoids disrupting the tumor or capsule.

Reconstructive-Urology and Urogyn Uses​

The Lahey may be a niche traction option in RU/urogyn when a toothed grasp of expendable tissue is appropriate. The following are possible contexts, not comparative evidence that it outperforms Bonney, Allis, or other instruments:

  • Adjunctive hysterectomy specimen handling. Grasping the cervix or lower uterine segment during open or vaginal hysterectomy performed as an adjunct to pelvic reconstruction (sacrocolpopexy, complex fistula repair).
  • Partial cystectomy specimen. Tenting the cystectomy specimen during dissection at the bladder dome / urachal remnant.
  • Open radical orchiectomy specimen handling. Avoid puncturing or disrupting the tumor-bearing testis or tunica; use a specimen-handling method consistent with oncologic technique rather than routine Lahey grasp.
  • Tunica-albuginea exposure during Peyronie's surgery. A penetrating Lahey grasp is generally a poor default for tunica intended to remain intact; select tissue-preserving exposure according to the operative plan.
  • Excised LS-vulvectomy specimen, condyloma excision specimen, urethral-caruncle specimen. Traction during the final excision step.
  • Deep fascial-edge traction during re-do exposure, if the edge can tolerate sharp teeth; no comparative study here establishes a preferred instrument over Kocher or Bonney.

In thyroid surgery, the manufacturer describes the Lahey model as a grasper for fibrous tissue and thyroid glands. Lahey is credited with popularizing careful recurrent-laryngeal-nerve dissection in 1938;[2] that dissection is now a cornerstone of thyroid technique,[4][5] the forceps itself is a traction instrument, not a nerve-identification tool.

Distinctions from Adjacent Grasping Instruments​

InstrumentTypical contact patternPractical distinction
Lahey, reviewed 3×3 modelsSharp interlocking teeth, ratchetedSustained toothed traction; may puncture or crush
AllisMultiple toothed jawsRatcheted tissue hold; model and tissue matter
BabcockFenestrated jawsBroad grasp without penetrating teeth; not injury-free
KocherSerrations and tip toothStrong clamping of tissue that can tolerate it
Bonney thumb forcepsModel-specific toothed tipsHandheld, not ratcheted
Lahey-labeled tenaculumCheck the exact catalog jawName alone does not establish a one-hook pattern

Instrument names can overlap: B. Braun catalogs a “Lahey Tenaculum Forceps” with a 3×3-prong jaw, so “tenaculum” does not reliably mean one hook per jaw. Inspect the exact model before relying on a naming-based distinction. B. Braun BF310R.

Limitations​

  • Tissue trauma. The sharp teeth can puncture or crush the grasped surface; avoid use where that injury would compromise preservation or reconstruction.
  • Capsular disruption risk. Particularly relevant in oncologic specimens where capsular integrity affects staging and completeness of resection (the same caveat that governs Lahey use in thyroid cancer extends to bladder, testis, or vulvar cancer specimens).
  • Not a default for delicate / hollow viscera. Consider a suitable nonpenetrating instrument such as a Babcock, with tissue-specific pressure control.
  • Avoid direct grasp of ureter or vessel; if fine atraumatic handling is needed, a model-appropriate DeBakey may be considered without assuming it eliminates injury risk.

Historical Context — Frank Lahey and the RLN​

Frank Howard Lahey (1880–1953) is one of the “Magnificent Seven” surgeons described in the history of modern thyroid surgery.[1] Kaplan and colleagues attribute to him the popularization of careful RLN dissection during thyroidectomy in 1938.[2] He founded the Lahey Clinic in Boston in 1923; it moved to Burlington in 1980. Lahey Clinic history. For the broader history of spring forceps and surgical hooks, see Kirkup.[6]

See also: Allis Clamp, Babcock Clamp, Kocher Clamp, Bonney Forceps.

References​

1. Hannan SA. "The Magnificent Seven: a history of modern thyroid surgery." Int J Surg. 2006;4(3):187–91. doi:10.1016/j.ijsu.2006.03.002

2. Kaplan EL, Salti GI, Roncella M, Fulton N, Kadowaki M. "History of the recurrent laryngeal nerve: from Galen to Lahey." World J Surg. 2009;33(3):386–93. doi:10.1007/s00268-008-9798-z

3. Sakorafas GH. "Historical evolution of thyroid surgery: from the ancient times to the dawn of the 21st century." World J Surg. 2010;34(8):1793–804. doi:10.1007/s00268-010-0580-7

4. Serpell JW, Grodski S, Yeung M, et al. "Hemithyroidectomy: a heuristics perspective." ANZ J Surg. 2008;78(12):1122–7. doi:10.1111/j.1445-2197.2008.04764.x

5. Bliss RD, Gauger PG, Delbridge LW. "Surgeon's approach to the thyroid gland: surgical anatomy and the importance of technique." World J Surg. 2000;24(8):891–7. doi:10.1007/s002680010173

6. Kirkup J. "The history and evolution of surgical instruments. VII. Spring forceps (tweezers), hooks and simple retractors." Ann R Coll Surg Engl. 1996;78(6):544–52.