Medical forceps

A medical forceps (10) for removal of tissue from the human or animal body, has two jaw parts at the end nearest the patient which can be moved relative to one another via grip elements at the end remote from the patient, said jaw parts having blades which coact in cutting fashion as said jaw parts are closed. There is releasably mountable on at least one of said jaw parts an adapter which has a blunt support surface, extending at least over a portion of said one jaw part on which it is mountable, which braces in planar fashion against said other jaw part as said jaw parts are closed when said adapter is mounted, so that said blades can no longer coact in cutting fashion as said jaw parts are closed. In a medical forceps whose jaw parts butt against one another in blunt fashion upon closing in order to grasp tissue, there is releasably mounted on at least one of said jaw parts an adapter which has an edge or a blade which, as said jaw parts are closed, coacts in cutting fashion with an edge of the other jaw part or with a blade of a second adapter releasably mounted on said other jaw part.

BACKGROUND OF THE INVENTION 
The present invention relates to a medical forceps for removal of tissue 
from the human or animal body, having two jaw parts at the end nearest the 
patient which can be moved relative to one another via grip elements at 
the end remote from the patient, the jaw parts having blades which coact 
in cutting fashion as the jaw parts are closed. 
The invention further relates to a medical forceps for removal of tissue 
from the human or animal body, having two jaw parts at the end nearest the 
patient which can be moved relative to one another via grip elements at 
the end remote from the patient, the jaw parts butting against one another 
in blunt fashion upon closing in order to grasp tissue. 
Forceps of this kind of the first aforementioned type for detaching tissue, 
and forceps of this kind as cited secondly for grasping tissue, are 
commonly known. 
In a surgical operation on the human or animal body, forceps for detaching 
tissue are used to detach or cut away tissue, for example organ or bone 
tissue. For this purpose, the forceps have at their end nearest the 
patient two jaw parts which have blades, i.e. sharpened regions with sharp 
cutting edges, which coact in order to detach the tissue. 
There is known, for example, from the German brochure "Karl Storz 
Endoskope, Endoskopische Chirurgie" [Karl Storz endoscopes, endoscopic 
surgery], section 5, page SCT 5/4A (FRANGENHEIM forceps), a forceps 
referred to as "cut-through," the jaw parts of which have cutting edges in 
the longitudinal direction of the forceps or of the jaw parts, as well as 
front cutting edges running transverse to the longitudinal direction. 
"Cut-through" means that during cutting, a movable jaw part is moved 
through an immovable one, the blades moving past one another and detaching 
a piece of tissue grasped between them. 
Also known, however, are forceps for the detachment of tissue which have 
only blades running in the longitudinal direction, which thus cut into the 
tissue in the manner of a scissors. 
Also known are so-called "spoon forceps," whose two jaw parts each have a 
blade which butts against the other as the jaw parts are closed but do not 
move past one another, thus coacting in cutting fashion. 
All the forceps of the afore-mentioned kinds can be used only to detach 
tissue. It is not possible with these forceps to grasp the detached tissue 
and remove it from the human body. 
The forceps provided for removal of tissue samples are so-called grasping 
forceps, i.e. forceps of the type cited secondly above, the jaw parts of 
which are configured not as cutting tools but as grasping tools, which 
thus have surfaces that butt against one another in blunt fashion, and 
between which the detached tissue can be grasped without being cut in two. 
In surgical operations in which pieces of tissue are to be removed, the 
surgeon is therefore compelled to use two forceps to detach and to remove 
the tissue, namely a cutting forceps and a grasping forceps. This has the 
disadvantage, however, that the surgeon must become familiar with the 
operation of two different forceps in order to acquire the operating 
confidence necessary in order to use them. Since, in addition, the tissue 
to be removed often cannot be detached with only a single cutting 
operation, the surgeon must switch forceps several times so as to remove 
from the body with the grasping forceps a piece of tissue initially 
detached with the cutting forceps. The result is that during a surgical 
procedure, the surgeon must repeatedly put down one forceps and pick up 
the respective other forceps. 
A further disadvantage is the elevated cost of such known forceps, 
resulting from the fact that two complete forceps, one for detaching and 
one for grasping, must be made available with their shafts, actuation 
elements, and grip elements, although the cutting forceps and grasping 
forceps need to differ in functional terms only with regard to their jaw 
parts. 
Since surgeons regard the switching of forceps as disadvantageous, they 
occasionally attempt to grasp the piece of tissue detached by the cutting 
forceps using the jaw parts of the cutting forceps; this entails the risk, 
however, that the piece of tissue being grasped will be separated into two 
parts as the forceps is being withdrawn, and the parts will remain in the 
body. 
U.S. Pat. No. 4,711,240 furthermore discloses a surgical instrument with 
which tissue can be resected from soft, spongy organs, for example from 
the kidneys or the liver, without thereby damaging blood vessels present 
in those organs. For this purpose, the known instrument has at the end 
nearest the patient detachment tools configured in comb fashion which are 
closed toward one another, the blunt comb teeth engaging into one another 
and resecting the tissue from both sides of the organ. The comb-like 
detachment tools do not, however, coact in cutting fashion. Instead, when 
the detachment tools are closed, the tissue of the organ is crushed 
between the comb teeth and can then be flushed out. With this instrument 
it is not possible to grasp the resected tissue. An attachment having a 
smooth surface can be sticked on one of the two detachment tools and can 
then be used if tissue is to be resected from the organ from one side 
only, for example to remove kidney stones. 
Also known, from EP-A-0 598 607, is a surgical forceps which is not 
cutting, but rather is used for atraumatic grasping of organs or blood 
vessels in order to move them aside so as to expose the operative area 
concealed behind them. For this purpose, the jaw parts are equipped with 
atraumatic, releasably mountable cushions, which do not traumatize or even 
damage the grasped organs or vessels when the jaw parts are closed. These 
known forceps cannot, however, be used as a cutting tool. 
Even with the instruments cited above, there still exists the disadvantage 
that they have only one function, i.e. either only detaching tissue or 
only grasping tissue. 
SUMMARY OF THE INVENTION 
It is therefore the object of the invention to improve a medical forceps of 
the first kind cited initially, and a medical forceps of the kind secondly 
cited initially, in such a way that the operations of detaching and 
grasping or removing tissue can be performed successively, without 
requiring the surgeon for that purpose to put the forceps down and pick up 
another forceps. 
According to the present invention, the object is achieved in terms of the 
forceps first cited initially in that there is releasably mountable on at 
least one of the jaw parts an adapter which has a blunt support surface, 
extending at least over a portion of the one jaw part on which it is 
mountable, which braces in planar fashion against the other jaw part as 
the jaw parts are closed when the adapter is mounted, so that the blades 
can no longer coact in cutting fashion as the jaw parts are closed. 
According to the present invention, the object is achieved in terms of the 
forceps secondly cited initially in that there is releasably mountable on 
at least one of the jaw parts an adapter which has an edge or a blade 
which, as the jaw parts are closed, coacts in cutting fashion with an edge 
of the other jaw part or with a blade of a second adapter releasably 
mounted on the other jaw part. 
The forceps according to the present invention differs from the known pure 
cutting forceps or pure grasping forceps in that if the jaw parts are 
configured as cutting tools, it can be used as grasping forceps after 
attachment of the adapter provided according to the present invention, and 
operates as a cutting forceps with the adapter removed; or, if the jaw 
parts of the forceps are configured as grasping tools, can operate as a 
cutting forceps after the adapter is attached. The forceps according to 
the invention thus alternately has the function of a cutting forceps and a 
grasping forceps. 
If the jaw parts of the forceps according to the present invention are 
configured as cutting tools, when a tissue removal is performed the 
forceps according to the invention is first introduced with its jaw parts 
into the operative area without the adapter, in order to detach or cut 
through the tissue to be removed. Once the tissue piece has been detached, 
the forceps is withdrawn from the operative area. The adapter provided 
according to the present invention is then mounted on at least one of the 
jaw parts. The surgeon does not need to put the forceps down for this 
purpose, but rather can continue to hold the forceps in the same hand, and 
with the other hand can mount the adapter on the jaw part. For sterility 
reasons, this can also be done by a different person, so that the surgeon 
holds the forceps appropriately but does not release the forceps. Once the 
adapter has been mounted, the forceps can then be introduced with its jaw 
parts back into the operative area, so as then to grasp the detached 
tissue with the jaw parts that have been reconfigured by the adapter to 
function as grasping tools, and remove it from the operative area. Since 
the jaw parts are now functional purely as grasping tools, the surgeon 
does not need to carefully modulate his or her hand force, since there is 
no risk of cutting through the tissue piece being grasped. 
In the case of a forceps of the kind, in which the jaw parts are configured 
as cutting tools, the advantage of the adapter is that the detached tissue 
can be securely grasped between the blunt support surface of the adapter 
and the other jaw part against which that support surface is braced, 
without thereby cutting it up. Since, when the adapter is mounted, the 
blades of the jaw parts do not come into effective engagement with one 
another when the jaw parts are closed if the adapter is mounted on the one 
jaw part, this eliminates the risk that the tissue will undesirably be cut 
in two by the sharp blades as it is being grasped. 
Although disease phenomena are inherently similar, surgeons use different 
treatment methods and surgical techniques depending on the manifestation 
of the disease and on the patient. One example that could be mentioned is 
treatment of a cyst in the field of ear, nose and throat treatment. 
Sometimes a cyst is not completely removed, but rather is only cut, and 
the emerging fluid is aspirated away. A cutting tool is needed for this. 
In some cases the entire cyst is to be removed, which requires a grasping 
tool. 
The invention now makes it possible to use both treatment methods or 
surgical methods with one and the same forceps, with the assistance of the 
adapter. 
If the jaw parts of the forceps according to the invention are configured 
as grasping tools for grasping tissue, to detach the tissue first of all 
the at least one adapter is mounted on one of the jaw parts, thus 
reconfiguring the jaw parts to function as cutting tools. The adapter is 
then removed in order to take the tissue out. Since the operations of 
detaching and removing the tissue can be performed with one forceps, the 
surgeon needs to become accustomed to the movement characteristics of only 
a single forceps. The cost of the forceps according to the present 
invention is also advantageously reduced, since instead of two complete 
cutting and grasping forceps, only one forceps, with grip elements, shaft, 
and actuation elements, is necessary, while the adapter, as a simple 
additional element, can be manufactured much more economically than a 
second complete forceps. 
In the context of the invention, provision can also be made to provide an 
adapter for both jaw parts. 
The object is thus completely achieved. 
In a further preferred embodiment of the forceps whose jaw parts have 
blades, the support surface extends over approximately the entire length 
of the blade of the one jaw part on which the adapter is mountable. 
The advantage of this feature is that when the adapter is mounted, the 
piece of tissue can be grasped with the entire region of the jaw parts 
that acts in cutting fashion without the adapter. 
It is further preferred in this context that when the adapter is mounted, 
the support surface projects out beyond the blade of the jaw part on which 
the adapter is mounted. 
Advantageously, this feature reliably ensures that when the adapter is in 
the mounted state, the blades cannot come into effective engagement with 
one another as the jaw parts close. The tissue cannot be cut in two when 
grasped, since the support surface projecting out beyond the blade of the 
one jaw part is already coming into contact with the other jaw part before 
the two blades can come into effective engagement with one another. 
In a preferred exemplifying embodiment, the one jaw part is movable and the 
other jaw part is immovable, the movable jaw part engaging into the 
immovable jaw part in order to detach the tissue, and the adapter being 
mountable on the movable jaw part. 
With a configuration of this kind of the jaw parts of the forceps according 
to the present invention, which with this jaw part design is referred to 
as a cut-through forceps, the movable jaw part which engages into the 
immovable jaw part in order to detach the tissue is narrower in 
configuration than the immovable jaw part. The fact that the adapter is 
mountable on the narrower, movable jaw part results in the advantage that 
the total width of the forceps in the region of the jaw parts is not 
increased by the adapter, which is desirable particularly in the case of 
particularly narrow forceps that are used in operative areas which are 
extremely difficult of access. In the widely practiced minimally invasive 
surgical technique, the forceps can be moved in both functional states 
(i.e. with or without adapter) through one and the same endoscope or 
trocar. 
It is preferred in this context if the movable jaw part is of concave 
configuration on a side facing the immovable jaw part. 
The advantage of this feature is on the one hand that particularly sharp 
cutting edges can be configured at the peripheries of the movable jaw 
part, thus improving the function of the forceps according to the present 
invention for detaching the tissue; and on the other hand the detached 
tissue can be caught in the concavity as the piece of tissue is grasped, 
so that the function of the forceps according to the present invention as 
a grasping forceps is also thereby improved. 
In a further preferred embodiment of the invention, the adapter has 
snap-lock means which can be snap-locked to corresponding snap-lock means 
of the one jaw part on which the adapter is mountable. 
This advantageously creates an easily achievable and easily releasable 
joining capability between the adapter and the one jaw part, which on the 
one hand ensures reliable mounting of the adapter so that the latter does 
not undesirably detach from the jaw part in the operative area, and on the 
other hand allows easy and rapid handling when mounting and releasing the 
adapter. 
In a further preferred embodiment of the invention, the adapter has a 
U-shaped body. 
This embodiment has the advantage that the adapter can comfortably be held 
between two fingers of one hand, and can easily be slid or sticked with 
its open end onto a jaw part, thus further improving the handling of the 
forceps according to the present invention. 
It is preferred in this context if two limbs of the U-shaped body are 
joined together by a web, such that when the adapter is mounted, the web 
fits around the jaw part on which the adapter is mountable. 
The web advantageously prevents the two limbs of the U-shaped body from 
undesirably bending apart during mounting onto the one jaw part or, in the 
mounted state, while grasping or cutting the tissue. The adapter is thus 
highly stable, enhancing the operating reliability of the forceps 
according to the present invention. 
In a further preferred embodiment of the invention, the jaw part on which 
the adapter is mountable has a circumferentially arranged groove, running 
in the longitudinal direction of the jaw part, into which corresponding 
projections of the adapter engage. 
The advantage of this feature is that the adapter can always be positioned 
on the jaw part in the same position. The adapter is moreover secured, by 
the projections engaging into the groove, against undesired displacement 
perpendicular to the closing direction of the jaw parts as the jaw parts 
are closed in order to grasp or cut the piece of tissue. 
In a further preferred embodiment, the adapter is made integrally of metal. 
The integral configuration of the adapter makes possible economical 
manufacture of the adapter with a particularly simple design. Because the 
adapter is made of metal, it can be sterilized particularly easily, and 
can thus be used repeatedly. 
Further advantages are evident from the description below of the appended 
drawings. 
It is understood that the features mentioned above and those yet to be 
explained below can be used not only in the respective combinations 
indicated, but also in other combinations or in isolation, without leaving 
the context of the present invention.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS 
FIG. 1 shows a medical forceps labeled in its entirety with the reference 
character 10. Forceps 10 is used to remove tissue from the human or animal 
body. 
Provided at the end of forceps 10 remote from the patient are an immovable 
grip element 12 and a movable grip element 14, which are joined to one 
another via a hinge joint 16; movable grip element 14 is pivotable about 
hinge joint 16 constituting the rotation axis into an open position which 
is shown with dashed lines as 14'. An elongated tubular shaft 20 extends 
from an end region 18 of immovable grip element 12. Grip elements 12 and 
14 as well as shaft 20 are manufactured from a metal or from a plastic 
having comparable properties. 
An immovable jaw part 22 and a movable jaw part 24 are arranged at the end 
of shaft 20 nearest the patient. Immovable jaw part 22 is immovably joined 
to shaft 20. Movable jaw part 24 is pivotably mounted on immovable jaw 
part 22 via a pivot pin 26 constituting rotation axis 27. 
Movable jaw part 24 is joined non-positively to movable grip element 14 via 
an actuation element 28. Actuation element 28 has a wire member 29 which 
has at its end nearest the patient a pin 30 which extends perpendicular to 
wire member 29. Pin 30 is machined, together with wire member 29, from a 
solid material, specifically from a hardened steel. 
Pin 30 engages into a corresponding recess 32 (see FIG. 2) of movable jaw 
part 24, recess 32 being arranged in a widened solid section 33 (see FIG. 
9) of movable jaw part 24 which is received in a recess 35 (see FIG. 2) of 
immovable jaw part 22. Actuation element 28 extends, proceeding from 
movable jaw part 24, in shaft 20 through end region 18 of immovable grip 
element 12 to an end region 35a of movable grip element 14, where it is 
attached via attachment means (not shown here). As grip elements 12, 14 
are closed (dashed-line position), the opened jaw part 24 (dashed-line 
position) moves toward immovable jaw part 22 and passes through it. 
FIGS. 2 through 4 depict jaw parts 22 and 24 of medical forceps 10 at 
enlarged scale. Immovable jaw part 22 is constituted from two lateral 
limbs 36 and 38 running approximately parallel to one another, a smooth 
linear inner wall 40 of the right-hand limb 36 (looking toward the end 
nearest the patient) being visible in the sectioned representation of FIG. 
2. 
At the end nearest the patient, limbs 36 and 38 come together in 
approximately semicircular shape to form a vertex section 42. Inner wall 
40 of limb 36 thus transits continuously via a semicircularly curved inner 
wall 44 into an inner wall 46, once again running linearly, of limb 38. 
Inner walls 40, 44 and 46 are of linear configuration in the vertical 
direction, so that a substantially U-shaped open space is formed between 
limbs 36 and 38 in the region nearest the patient. 
In a center section 48, limb 36 is curved inward; the same applies to limb 
38, but limbs 36 and 38 are not joined to one another there. Only at the 
outer end remote from the patient are limbs 36 and 38 joined integrally to 
one another by an end section 50. The region between inner walls 40, 44, 
and 46 is continuously open in the vertical direction. 
Provided in end section 50 is a bore 52 with which immovable jaw part 22 
can be placed onto shaft 20 and attached securely to the shaft, for 
example by soldering. Bore 52 continues into a further, smaller-diameter 
bore 54, which is provided for the passage of actuation element 28 which 
can be attached in lossproof fashion to pin 30 in recess 32 of immovable 
jaw part 24. 
Movable jaw part 24 is arranged between limbs 36 and 38 of immovable jaw 
part 22, and is configured as a solid member whose peripheral contour in a 
region 56 nearest to the patient of jaw part 24 corresponds to the contour 
determined by inner walls 40, 44, and 46 of immovable jaw part 22. 
A lower surface 58 of movable jaw part 24, facing immovable jaw part 22, is 
of concave configuration. 
In FIGS. 2 and 3, there is mounted on medical forceps 10, and more 
precisely on movable jaw part 24, an adapter generally designated 60, by 
way of which forceps 10 operates as a grasping forceps, as shown in FIG. 
3. Without adapter 60, forceps 10 operates as a cutting forceps, as shown 
in FIG. 4. It is evident from this that without adapter 60, movable jaw 
part 24 can pass through immovable jaw part 22, and forceps 10 thus 
operates as a cut-through forceps. 
Adapter 60 is releasably mountable on movable jaw part 24, i.e. adapter 60 
can be placed on movable jaw part 24 and removed again therefrom. 
Before the function of adapter 60 in coaction with jaw parts 22 and 24 is 
discussed, the configuration of adapter 60 will first be described in more 
detail with reference to FIGS. 5 through 8. 
Adapter 60 is configured overall as a metal U-shaped body having two limbs 
62 and 64 which are integrally joined to one another via a section 66 of 
approximately semicircular configuration. Limbs 62 and 64 taper on one 
side in a wedge shape, toward the underside (FIGS. 5 and 6) of adapter 60, 
to a narrow support surface 68 which runs over the entire body of adapter 
60 on the underside of adapter 60, also in a U-shape. 
On the upper side (FIG. 7) of adapter 60, a web 70 in the form of a flat 
rectangular plate joins the two limbs 62 and 64 integrally to one another 
via vertical sidewalls 71 and 73, while free ends 72 and 74 of limbs 62 
and 64 are not joined, so that they are elastically bendable. 
In addition, the semicircular section 66 of adapter 60 has an inwardly 
directed projection 76 that is also semicircularly curved. 
Free ends 72 and 74 are equipped with snap-lock means 78 and 80, also in 
the form of inwardly directed projections, which extend over a portion of 
free ends 72 and 74 of limbs 62 and 64 and lie in the same plane as 
semicircular projection 76. 
In FIG. 9, adapter 60 is shown mounted on movable jaw part 24. 
Adapter 60 is placed or slid onto movable jaw part 24 from the end nearest 
the patient; snap-lock means 78 and 80 in the form of projections, and 
projection 76, thereby engage into a groove 82, recessed into movable jaw 
part 24, which is arranged approximately centeredly in terms of the height 
of movable jaw part 24 and extends peripherally in a U-shape around the 
entire region 56 nearest the patient of movable jaw part 24. In the 
mounted state, web 70 fits around movable jaw part 24 on its upper side, 
as is evident from FIG. 3. 
Sections 85 and 87, more remote from the patient, of groove 82 are cut 
somewhat more deeply into movable jaw part 24, and transit via beveled 
regions 84 and 86 into the remaining portion of groove 82. The ends of 
regions 84 and 86 more remote from the patient constitute snap-lock means 
88 and 90 of movable jaw part 24. 
In order to place or slide adapter 60 onto movable jaw part 24, its free 
ends 72 and 74 are inserted with projections 78 and 80, from the end of 
movable jaw part 24 nearest the patient, into groove 82. Adapter 60 is 
then slid toward the end of movable jaw part 24 remote from the patient 
until projections 78 and 80 of adapter 60 have moved past beveled regions 
84 and 86 and come to rest in sections 85 and 87 of groove 82. In this 
state, the beveled regions constitute catches preventing the adapter from 
being pulled out, so the latter is thus snap-locked. Snap-locking is 
accomplished by the fact that free ends 72 and 74 of adapter 60 are 
initially somewhat spread apart when slid into groove 82, and after 
passing over beveled regions 84 and 86, come to rest in sections 85 and 87 
of groove 82, which are cut in more deeply. To remove adapter 60, the 
latter is pulled off from jaw part 24 toward the end of jaw part 24 
nearest the patient. 
The operation of medical forceps as a cutting and grasping forceps will be 
explained below with reference to FIGS. 3 and 4. 
FIG. 4 illustrates the case in which forceps 4 is used as a cutting forceps 
to detach tissue. In this case, jaw parts 22 and 24 coact as cutting 
tools. 
For this purpose, movable jaw part 24 has on its lower side, i.e. the side 
facing immovable jaw part 22, a U-shaped blade 92 in the form of a sharp 
edge, which coacts with a corresponding blade 94 of immovable jaw part 22 
that is constituted by the upper edge of inner walls 40, 44, and 46 of 
immovable jaw part 22. Blades 92 and 94 extend in a U-shape, corresponding 
to the configuration of jaw parts 22 and 24. In order to detach or cut 
through tissue, jaw parts 22 and 24 are closed via grip elements 12 and 14 
so that upon closing, movable jaw part 24 engages into immovable jaw part 
22, blades 92 and 94 being guided past one another and thus achieving the 
cutting effect. When jaw parts 22, 24 are configured in this fashion, 
forceps 10 is referred to as a "cut-through" forceps. 
FIG. 3, on the other hand, shows the case in which forceps 10 operates as a 
grasping forceps because adapter 60 has been mounted on movable jaw part 
24. Adapter 60 is configured, in terms of immovable jaw part 24, in such a 
way that its support surface 68 overlaps blade 92 of movable jaw part 24 
in the direction of immovable jaw part 22. Support surface 68 extends over 
approximately the entire length of blade 92 of movable jaw part 24, so 
that when adapter 60 is mounted, the entire cutting region of jaw parts 22 
and 24 is utilized as an effective region for grasping. When jaw parts 22 
and 24 are closed, support surface 68 then butts in planar, i.e. blunt, 
fashion against a periphery 96 also configured in planar fashion as a 
support surface on the upper side, i.e. the side facing movable jaw part 
24, of immovable jaw part 22, without allowing blades 92 and 94 to come 
into effective engagement with one another. With jaw parts 22 and 24 in 
the closed position, blades 92 and 94 are spaced apart from one another. 
FIG. 3 already shows the maximally closed position of jaw parts 22 and 24 
when adapter 60 is mounted on movable jaw part 24. 
The previously detached tissue can then be grasped between support surface 
68 of adapter 60 and periphery 96 of immovable jaw part 22 and retained 
securely for removal from the body, without thereby being cut in two. 
In the exemplary embodiment of FIG. 3, limbs 36 and 38 of immovable jaw 
part 22 taper in wedge form on their exterior toward periphery 96, while 
limbs 62 and 64 of adapter 60, as already mentioned, taper on their 
exterior toward support surface 68. 
FIG. 10 shows, as a further exemplifying embodiment, an adapter 100 which 
is modified with respect to adapter 60 and is releasably mountable on 
movable jaw part 24 (which is of unchanged configuration). Limbs 102 and 
104 of adapter 100 have a lower support surface 106 which is not braced 
against periphery 96 of immovable jaw part 22 but rather fits around 
periphery 96 and braces against the beveled sides of jaw part 22. A larger 
grasping surface is thereby created. 
FIG. 11 shows a further exemplifying embodiment of the invention in which 
an adapter 110 and an immovable jaw part 112 are of modified configuration 
as compared with adapter 60 and immovable jaw part 22 of FIGS. 1 through 
9. 
Immovable jaw part 112 has limbs 114 and 116 which are configured in 
internally beveled fashion on their upper side facing movable jaw part 24, 
so that a peripheral edge 118 constitutes a cutting edge of immovable jaw 
part 112 which coacts with cutting edge 92 of movable jaw part 24. 
Adapter 110 has limbs 118 and 120 which are internally curved, 
corresponding to the curvature of internal surface 58 of movable jaw part 
24, at ends 122 and 124 facing immovable jaw part 112. This creates a 
relatively small grasping surface with which, for example, a cyst can be 
grasped and then broken off. 
According to a further exemplifying embodiment, FIG. 12 shows the end 
nearest the patient of a medical forceps 126 having a shaft 128 at whose 
end nearest the patient two jaw parts 130 and 132, configured as grasping 
tools, are mounted, and are movable relative to one another via grip 
elements (not shown here) at the end of forceps 126 remote from the 
patient, jaw part 130 being shaft-mounted and jaw part 132 being movable. 
Jaw parts 130 and 132 have at their ends nearest the patient surfaces 134 
and 136 which butt in planar fashion against one another upon closing, so 
that upon closing, jaw parts 130 and can grasp tissue that has already 
been detached, without cutting it in two. 
An adapter 138 shown with dashed lines, which is releasably mountable on 
jaw part 132, is provided for movable jaw part 132. 
For this purpose, adapter 138 has a section 140 which can be snapped into a 
window 142 provided in jaw part 132, for example via a system of grooves 
and projections (not shown here), so that adapter 138 is held on jaw part 
132 in lossproof fashion. 
Adapter 138 has an edge 144 which protrudes beyond surface 136 of jaw part 
132 and is arranged behind the latter when viewed from the end nearest the 
patient, so that when jaw parts 130 and 132 are closed, it coacts in 
cutting fashion with an edge 146 of immovable jaw part 130 to detach 
tissue. As jaw parts 130 and 132 are closed, adapter 138 engages into a 
window 148 of immovable jaw part 130 in such a way that when adapter 138 
is mounted, jaw parts 130 and 132 coact as cut-through cutting tools. 
Lastly, FIG. 13 shows the end nearest the patient of a forceps 150 which 
has a shaft 152 on whose end nearest the patent a immovable jaw part 154 
and a movable jaw part 156 are arranged. 
Jaw parts 154 and 156 are configured as grasping tools; specifically, jaw 
parts 154 and 156 have tooth sets 158 and 160 which engage into one 
another as jaw parts 154 and 156 close, and between which a previously 
detached piece of tissue can be grasped. An adapter 162 releasably 
mountable onto jaw part 154 is provided therefor, and an adapter 164 
releasably mountable onto jaw part 156 is provided therefor. For lossproof 
attachment of adapters 162 and 164, the latter have corresponding tooth 
sets 166 and 168 which, when adapters 162 and 164 are put in place, engage 
into tooth sets 158 and 160 of jaw parts 154 and 156 and are thus 
snap-locked thereto. Adapter 164 has a blade 170 which, with adapter 164 
in the mounted state, is ar ranged laterally on movable jaw part 156. As 
jaw parts 154 and 156 close, blade 170 coacts in cutting fashion, 
specifically in the manner of a scissors, with an outer edge 172 of 
adapter 162 in order to detach tissue.