Artery Forceps and Surgical Clamps: Pean, Kocher, Halsted (Mosquito) Compared

Artery forceps are part of every basic surgical instrument set. They close bleeding vessels, hold tissue or secure drapes and tubing. Yet there are important differences between Pean, Kocher and Mosquito forceps – above all in the design of the jaws. This guide explains the common surgical clamps, their features and when each medical clamp makes sense.

Key facts at a glance

• Artery forceps (also haemostatic forceps or haemostats) close vessels temporarily. A ratchet lock keeps them closed.
• Pean forceps have no teeth and are cross-serrated – for vessels and tissue bundles.
• Kocher forceps have 1x2 teeth at the tip and hold tough, slippery tissue; they are deliberately traumatic.
• Halsted Mosquito forceps are small and fine – for small vessels and fine dissection.
• Kelly and Crile differ in the length of the serrations.
• DeBakey clamps are atraumatic and used in vascular surgery for clamping; towel clamps secure drapes.

How artery forceps are built

Artery forceps consist of two shanks joined by a box joint. At the front are the jaws that grasp the vessel or tissue. At the back are the ring handles and the ratchet (lock). It consists of interlocking teeth on both shanks. Depending on which ratchet step the forceps are closed on, the pressure in the jaws changes. To open them, the handles are moved slightly against each other until the ratchet releases.

The jaws decide the use: whether they are cross-serrated, longitudinally serrated or toothed, straight or curved, and how long they are. Curved forceps keep the tip visible and make subsequent ligation easier.

The main clamps compared

Pean forceps

Pean forceps have blunt, toothless jaws with cross-serrations along their full length. They hold vessels and tissue bundles securely without perforating them. They are among the most frequently used clamps in general surgery. A longer version is the Rochester-Péan artery forceps.

Kocher forceps

Kocher forceps are also cross-serrated but have 1x2 teeth at the tip. This lets them hold fascia, tendons and tough, slippery tissue that a toothless clamp cannot hold. The teeth injure the tissue – so they are not suitable for vessels that must be preserved. One example is the Kocher-Ochsner artery forceps.

Halsted Mosquito forceps

Mosquito forceps are the smallest standard artery forceps. Their slim, cross-serrated jaws grasp the smallest vessels without crushing surrounding tissue. They are used in fine dissection, plastic surgery, paediatric surgery and oral surgery. They come straight and curved, without and with 1x2 teeth, for example the Halsted Mosquito artery forceps.

Kelly and Crile forceps

Kelly and Crile forceps are medium-sized artery forceps and look very similar. The difference is the serration: on the Crile artery forceps the jaws are cross-serrated along their full length, which spreads the pressure evenly. On the Kelly artery forceps only the front half of the jaws is serrated, so you grasp precisely with the tip.

Towel clamps

Towel clamps secure drapes at the surgical field and keep the sterile covering in place. The common Backhaus pattern has sharp, crossed tips that grip through several layers of drape – for example the Backhaus towel clamp 11 cm. Towel clamps are not used on vessels.

DeBakey vascular clamps

For vessels that are closed only temporarily and need blood flow afterwards, there are atraumatic vascular clamps. The DeBakey serration consists of fine longitudinal grooves with an intermediate row. It holds the vessel securely while protecting the vessel wall. One example is the DeBakey occlusion clamp; variants such as Satinsky allow partial side clamping.

Comparison chart: artery forceps and surgical clamps

What to look for when choosing

• Tissue: use toothless clamps for vessels and toothed clamps for tough tissue. For vessels that must be preserved, use atraumatic clamps.
• Size: the finer the vessel, the smaller the clamp. Mosquito forceps suit fine work, Pean and Kocher larger structures.
• Shape: curved clamps improve visibility and ligation, straight clamps make grasping along the axis easier.
• Ratchet: the ratchet must engage cleanly and must not open by itself. Check this regularly.

Artery forceps or clamp: terms in everyday use

The terms are not used consistently. “Artery forceps”, “haemostatic forceps” and “haemostat” usually mean the same thing: a clamp with ring handles and a ratchet that temporarily closes a vessel. “Medical clamp” or “surgical clamp” is the umbrella term that also includes towel clamps, kidney clamps, intestinal clamps and occlusion clamps. When reordering a specific clamp, the name of the pattern (e.g. Pean, Kocher, Crile) together with length and shape is the safest information.

After haemostasis, a suitable needle holder is needed for suturing. More in our guide needle holders compared. Matching scissors are covered in surgical scissors overview.

FAQ

What are artery forceps?

A clamp with a ratchet that temporarily closes a blood vessel until it is ligated or coagulated.

What is the difference between Pean and Kocher?

Both are cross-serrated. Kocher forceps also have 1x2 teeth at the tip and hold tough tissue; Pean forceps have no teeth and are gentler.

What are Mosquito forceps used for?

For small vessels and fine dissection, for example in plastic surgery or oral surgery.

What does atraumatic mean for a clamp?

The clamp holds tissue without crushing or piercing it. The DeBakey serration is typical.

How do you care for clamps correctly?

Clean clamps open, lubricate the joints with instrument oil and sterilise them open or on the first ratchet step. Details in our guide to instrument reprocessing.

All models are in our clamps and clamping forceps category. Our instruments are CE marked.