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Singley (Singley-Tuttle) Tissue Forceps

Long, spring-action thumb forceps with fenestrated oval tips — the bowel- and peritoneum-handling forceps on every open urinary-diversion, augmentation cystoplasty, and continent-reservoir tray. The hallmark oval fenestration at each jaw tip lets serosa "mushroom" through the window, producing a secure grip at low compression — meaningfully less crush than a toothed forceps and less slippage than smooth or fine-serrated tips.[1]

Often written interchangeably as Singley or Singley-Tuttle — both names refer to the same fenestrated thumb forceps.

Design​

  • Length: ~ 23 cm (9 in) — substantially longer than Adson; matched to the deep abdominal field of open diversion and reconstruction.
  • Profile: spring-action thumb forceps; no ring handles, no ratchet.
  • Tips: oval / round fenestrated jaws that align when closed; tissue protrudes slightly through the window to lock the grip.
  • Material: surgical-grade stainless steel.

The Fenestrated-Tip Mechanism​

The fenestration is the defining feature. When the two windowed jaws appose, serosal or peritoneal tissue herniates a small distance into the oval — the protrusion is what holds the grip, not jaw-on-jaw clamp pressure. The result is the same instrument–tissue trade-off discussed for DeBakey and Gerald tips, resolved at the bowel-and-peritoneum end of the spectrum:

  • More grip than smooth or fine-serrated tips at equivalent squeeze (the tissue is mechanically captured, not just frictionally held).
  • Less focal trauma than a toothed forceps because there is no penetration of the serosa.
  • Less linear crush than a parallel-ridge DeBakey because compression is spread across the fenestration's perimeter rather than a flat platform.

This makes the Singley the default forceps for handling bowel and peritoneum during open RU work.

Reconstructive-Urology Uses​

  • Open urinary diversion: ileal conduit, orthotopic neobladder (Studer, Hautmann), continent cutaneous reservoir (Indiana, Miami, Kock) — bowel-segment isolation, mesenteric windowing, antimesenteric opening, detubularization handling.
  • Augmentation cystoplasty: ileal / ileocecal / sigmoid patch mobilization and U-shape reconfiguration.
  • Mitrofanoff and Monti channels: appendiceal handling and Yang-Monti reconfiguration without crushing the channel wall.
  • Open ureteral reconstruction: ureteral mobilization, tension-free reimplant setup, ureteroureterostomy, ileal-ureter interposition.
  • Peritoneal entry for any open RU laparotomy: tent peritoneum bilaterally with Singley forceps and incise between to keep underlying bowel out of the cut.
  • Open prolapse / fistula repair: peritoneal apex handling during high McCall / sacrocolpopexy peritoneal-flap closure, vesicovaginal-fistula peritoneal-interposition flap mobilization.
  • Packing and drape control: secondary use as a long thumb forceps for sponges and packing in deep fields.

Technique​

  • Grip: pencil grip, same as any thumb forceps.
  • Workflow: held in the non-dominant hand to tent / present tissue while the dominant hand cuts, dissects, or sutures.
  • Peritoneal entry: pick up the peritoneum bilaterally with two Singleys, lift to a tent, palpate for trapped bowel, and incise between the forceps with Metzenbaum — a textbook open-laparotomy maneuver.
  • Bowel handling: grasp serosa only, briefly, and release as soon as the segment is positioned. Avoid repeated regripping at the same spot.

Distinctions from Adjacent Forceps​

ForcepsTip designBest layer
Singley / Singley-TuttleFenestrated oval windowPeritoneum, bowel serosa
DeBakeyParallel-ridge platformVessels, ureter, bowel where DeBakey already in hand
RussianConcentric serrated cup tipsBulkier tissues, atraumatic broad grip
Adson (toothed)Fine 1×2 teethSkin, dartos
BonneyHeavy 1×2 teethRectus fascia, dense scar
Babcock clampFenestrated ring-handled clamp with ratchetSustained bowel / appendix grip when a thumb forceps would tire the hand

The Singley sits between DeBakey (vascular / fine) and Babcock (clamp with sustained grip): fenestrated, atraumatic, hand-held, no ratchet — the right tool when both hands are working and bowel needs to be held briefly without crush.

Naming​

Named after Gruver Singley, an American surgeon; sometimes hyphenated Singley-Tuttle for joint credit. Both names describe the same fenestrated thumb-forceps lineage tracked by Kirkup's history of spring forceps.[1]

See also: DeBakey, Russian, Bonney, Adson, Babcock clamp.

References​

1. 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.