BACKGROUND
Scissors have been one of the most important tools of a surgeon's armamentarium for many centuries. Scissors are routinely used for the dissecting and cutting of tissues as well as sutures. Ligation of tissues or vascular pedicles is usually performed by a separate manoeuvre using sutures, clips, electrocautery or, more recently, ultrasonography.
TECHNIQUE
A simple modification of the Metzenbaum scissors consisting of a lmm indentation in each blade at lcm from the scissors’ tip (Fig 1) allows the suture to be passed in the indentation grooves and around the pedicle intended to be ligated (Fig 2), without the need for using other instruments. Closing the blades enables the suture to be passed around the intended pedicle. With the suture around the desired pedicle, Iigation can be performed manually with surgical ties. The modified scissors can complete the Iigation manoeuvre by cutting the ligated pedicle.
Figure 1.
Modification of the Metzenbaum scissors
Figure 2.
Suture passed in the indentation grooves
DISCUSSION
The modification of the Metzenbaum scissors is cheap and relatively easy to perform. This modification is extremely useful in procedures where there is an abundance of vascular pedicles requiring Iigation such as thyroid or axillary dissections. With these modified scissors the combined manoeuvre of dissection and Iigation can be performed with essentially one instrument. It may also be useful when more expensive Iigation options or surgical assistance are not available.
References
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