Allis Forceps in Obstetrics and Gynecology

What is an Allis Forceps?

• Toothed, interlocking jaws - serrated or sharp teeth that grip tissues firmly
• Ratchet locking mechanism - maintains constant grip without continuous hand pressure
• Ring handles - similar to scissors, allowing easy control
• Length - typically 15-23 cm

Uses in Gynecology

1. Cervical Stabilization / IUD Insertion

• Used to grasp and stabilize the cervix during intrauterine device (IUD) insertion
• Has the advantage of causing less bleeding than the traditional tenaculum (which pierces the cervix), as Allis clamps grip the cervical tissue without puncturing it
• Assists in cervical manipulation during diagnostic or operative procedures

2. Episiotomy Repair

• Grasps the edges of the episiotomy wound precisely, aligning them for suturing
• Provides firm grip on the perineal skin/mucosa edges to facilitate layer-by-layer closure
• Helps identify landmarks and maintain tissue alignment during repair

3. Vaginal Wall Surgery (Posterior Colporrhaphy / Rectocele Repair)

• Two Allis clamps placed at the level of the hymen along the posterior wall to identify the lateral margins of the plication
• Used to test the degree of vaginal narrowing by bringing them together to ensure the introitus accommodates two to three fingerbreadths before incision
• A third Allis clamp grasps the proximal end of the rectocele in the midline
• The three clamps form triangle corners to guide the incision of the posterior vaginal wall epithelium
• Elevates and retracts epithelial edges during dissection off fibromuscular tissue
  (Hinman's Atlas of Urologic Surgery)

4. Hysterectomy (Abdominal, Vaginal, or Laparoscopic)

• Grasps the uterus, adnexa, or broad ligament for traction and manipulation
• Holds the vaginal cuff edges during closure after uterine removal
• Securely holds uterine or adnexal tissues without puncturing them during pelvic dissection

5. Cesarean Section

• Holds and stabilizes tissues to allow precise uterine incisions
• Assists in grasping uterine edges and peritoneum during uterine closure

6. Anterior Colporrhaphy / Cystocele Repair

• Grasps the vaginal wall just above the incision to provide upward traction and improve visualization
• Holds vaginal mucosa during its incision and dissection off the underlying bladder fascia

7. Vaginal Prolapse Repair (e.g., Vault Prolapse)

• Used to hold vaginal vault tissues during uterosacral ligament suspension and other apical prolapse repairs
• Provides exposure and traction during complex dissection

8. Bartholin Cyst / Abscess Surgery

• Grasps the cyst wall during marsupialization or excision

9. Colposcopy and Cervical Biopsy

• Holds and stabilizes the cervix or vaginal walls during directed biopsies

Why Allis Forceps are Preferred in OBG

Allis vs. Other OBG Forceps

Important Caution

• Tissues to be excised
• Tissues requiring firm traction/retraction (vaginal edges, fascial planes)
• Surfaces where a secure grip is more important than atraumatic handling