Paean to the pean

March 14, 2008 § 7 Comments

Pean artery forceps

Hemostat, artery forceps, hemostatic clamp, artery clamp – this beautiful surgical instrument has many names. In Scandinavia it’s simply called a “peang” (pronounced [piaŋ]). For a long time I’ve wondered why we call it that. Here’s the story.

There are several different types of artery forceps. You got the Kelly, the Halsted, the Kocher, the Crile and so on. All of which are named after (famous) surgeons. And then you have the Péan forceps. One of which is pictured above (photo credit).

The free online medical dictionary defines Péan forceps as “compression forceps with ratchet handles and long, wide, slightly bowed blades with longitudinal grooves.” These forceps are named after the French gynecologist and surgeon Jules-Émile Péan (1830-1898). Amongst other things he is credited with performing the first successful removal of an ovarian cyst (ovariotomy) i 1864, and the first elective splenectomy in 1867.

So he invented one type of hemostatic forceps, but why did his name end up as a name for all hemostatic forceps in Scandinavia? According to this article Péan was the first surgeon who systematized the use of hemostatic forceps by multiplying models and technically improving them.

Péan’s forceps were the first who could be clamped on an artery and stay there for several hours without the need for immediate ligation of the vessel. Earlier models were either spring operated or had a slide-catch mechanism. Both of which could only be used to grasp and hold the artery while a ligature was applied. Péan’s model was the first which incorporated a toothed locking mechanism in the handle.

Dr Pean operating, 1891-1892, by Henri de Toulouse-Lautrec

"Dr. Péan operating" by Henri de Toulouse-Lautrec (image credit). The painting is from 1891. Notice the forceps in his ungloved hand. Surgical gloves were not introduced until 1894 by William S. Halsted.

So it can be argued that Dr. Péan was important in the development of modern hemostasis, and this could be the reason that his name is forever linked with the forceps in some European countries. His name, however, is not spelled with a “g”. Neither is it pronounced [piaŋ], but [pia’]. When and why the “g” was added, both in spelling and pronunciation, remains a mystery to me.

Now for the paean part. I started out calling the instrument “beautiful”. One of the many fascinating aspects of surgery is that operations are basically carried out with the same instruments today as 200 years ago. OK, so we got electrocautery now and even some robots, but most surgery is still done using forceps, scissors, scalpels, needle and thread. This legacy is astonishing, and says a lot about the simple design, yet versatile quality of the basic surgical instruments. That’s the beauty of it.

I love the quiet sounds of steel against steel in the OR, and the clicks as the hemostats are locked. The very essence of the meticulous work being done. To grasp this essence I’ve actually got a pair of artery forceps myself (the Péan type of course). I use them all the time for all kinds of domestic stuff. It maybe sounds strange, but I somehow think this make me able to get deeper under the surgeon’s skin, understanding the art of surgery better, and ultimately make better videos.

References

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