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This is the last of five manuscripts reviewing the historical origins of some of the more commonly used surgical instruments and takes ''time out'' to remind current surgeons about the surgical pioneers on whose shoulders they now stand and whose inventions they now use.
C OUNTERINTUITIVELY, COMMON clamps and hemostats were among the last surgical instruments to evolve as a result of the complexities of constructing a hinged pivot articulating, stabilizing, and connecting two limbs.1 With only the opposing thumb and index finger as a model, the evolution of metal clamps and hemostats had to wait on advancements in metal smelting and forgery. However, Egyptian hieroglyphics in the tomb of Thebes in Egypt (1500 B.C.) depict images of primitive organic clamps.1, 2 In addition, a variety of bronze pivot-controlled surgical instruments were used as bone sequestrum forceps, crushing forceps for uvulectomies, and hemorrhoidectomies by Roman surgeons in 79 A.D. However, the malleability of bronze instruments made them a poor choice during surgical application because of the risk of bending and breaking, and they were later replaced with iron instruments. 1 Blacksmiths began using large metal tongs with central pivots in the sixth century and during the ninth century, smaller versions of blacksmith tongs were developed by Albucasis for dental and arrow extraction procedures.1
These pivot-controlled surgical instruments provide a stable yet mobile union of two pieces of metal while transferring manual power efficiently to the jaws. A variety of clamps and hemostats have been developed over the years providing an extension to the surgeon's hands, allowing crushing and hemostasis, compression and clamping, holding and extraction.
The predecessor to the modern hemostat, called bec de corbin (because of its crow's beak shape), was developed by Ambroise Paré, the famous French surgeon. 3 Hemostats, also known as hemostatic clamps, arterial forceps, or ''peang,'' were initially used primarily to control bleeding by clamping a vessel before securing it with a ligature.3 The name ''peang'' stems from the French surgeon, Jules-Émile Péan (Fig. 1) to whom we give credit for creating the first of the modern hemostats.4
Halsted
William Stewart Halsted (1852 to 1922) was born in New York City, New York.(Fig. 2). His father,William Mills Halstead, Jr., was a successful businessman and principal partner of a department...