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Re: Operative Vaginal Delivery--Traction Handles From: Braun, R. Daniel (rbraun@iupui.edu) Fri Feb 20 04:25:39 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Operative Vaginal Delivery--Traction Handles" Previous message: OBGYN.net Newsletter: "Benefit of Suppressive Therapy in Newly Diagnosed Genital Herpes - Online CME" You contact the college and set it up. I will be in Philadelphia and will attend. Dan R. Daniel Braun, MD "If everyone likes you, you're doing something wrong." Kinky Friedman I believe a self-righteous liberal or conservative with a cause is more dangerous than a Hell's Angel with an attitude. Andy Rooney -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of David Priver, MD Sent: Thursday, February 19, 2004 8:03 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Operative Vaginal Delivery--Traction Handles Garry, I disagree with your description of the Kjelland forceps. It has a cephalic curve like all the others, but does not have a pelvic curve, which is the angle between the shanks and the blades. That said, I agree with Robert that, although classical teaching was to rotate then replace the blades, there is no need to do that. They are a perfectly good traction forceps; just be aware of the need to lower the handles to achieve axis traction. Nice to know there some other forceps users out there. Maybe we should establish an interest group within ACOG in the (probably vain) hope of resurrecting this noble and time-honored skill. DP At Wed, 18 Feb 2004, Garry E. Siegel, M.D. wrote: > >I don't change after rotation, and enjoy using Keillands for traction. >You have to adjust for the lesser pelvic curve relative to Simpsons, >etc. > >Garry > >At Wed, 18 Feb 2004, Steve & Eryl Raymond wrote: >> >>The classic misconception about Kiellands - "they haven't a pelvic curve". Of >>course they have a pelvic curve - put a pair next to your favourite >>forceps and see. The pelvic curves are the same. What is different >>is that they have no angle between the shanks and the blades. And of >>course you have to pull down to the floor - that's the axis of the >>pelvis, and that's what the axis traction handle does = convert the >>axis of traction of an angled forceps such as Neville-Barnes into the >>right plane. Why should you rotate with Kiellands, then remove them >>and apply an angled forceps for traction - makes no sense. The >>straight forceps give you a better mechanical advantage, and ensure >>that your pull is in the right direction. The reason why they ever >>designed angled forceps was to lift the handles off the perineum when >>the head is high. As we don't do high forceps anymore what use is the >>angle nowadays? Indeed it is a disadvantage because of the >>parallelogram of forces that now has to come into play for traction. >>Steve >> >>RModugno@aol.com wrote: >> >>> In a message dated 2/17/2004 1:30:51 PM Eastern Standard Time, >>> eryl@intekom.co.za writes: >>> >>>>If you use straight forceps (Kiellands) then you don't need an axis >>>>traction handle. Steve >>> >>> Remembering that because it hasn't got a pelvic curve, one better be >>> down on one's knees pulling in the direction of the floor , lest one >>> lacerate the vagina by raising the articulated blades. I was always >>> taught that once the rotation was complete, kiellands should be >>> sustituted for a forceps with a classic blade for the actual >>> delivery. >>> >>> Robert Modugno Md MBA FACOG >>> >-- >Garry E. Siegel, M.D. >Private Practice >Roswell, GA > Next message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Operative Vaginal Delivery--Traction Handles" Previous message: OBGYN.net Newsletter: "Benefit of Suppressive Therapy in Newly Diagnosed Genital Herpes - Online CME"

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