Tenaculum

What is a tenaculum?

A tenaculum is a surgical tool healthcare providers use to grasp or clamp an object. It’s typically classified as a type of forceps. These instruments help healthcare providers perform tasks during medical procedures similarly to how tongs or tweezers help you with tasks at home.

What does a tenaculum look like?

A tenaculum has a scissor-like appearance. The top, or handle part, of the device has two holes to place your fingers through (like scissors). The bottom part is slender with a sharp, pointed or flat hook at the tip. This hook is what helps grasp and grip objects during surgery.

It’s usually made of stainless steel but can be made of other metals or medical-grade plastic. The design isn’t super complex and it’s easy to use.

Types of tenaculum forceps

There are several different types of tenaculum forceps. Each one has a slightly different, unique feature that makes it better suited for certain types of tissue. For example, one type may be better for very delicate tissue while one is better at grasping thick tissue.

• Pozzi tenaculum: This is the most common type. It has one sharp hook at the end. It grasps tissues in your cervix and uterus but can also be used in general surgery or for wound care.
• Single tooth tenaculum: This has one hook at the end, but it’s straighter and duller than a Pozzi tenaculum. The blunt end helps it grasp more fragile tissues.
• Double tooth tenaculum: As the name implies, this type has two hooks at the top. This can help it grab thick tissue or polyps.
• Allis tenaculum: This type has a jagged end, like a saw. An Allis tenaculum may cause less bleeding than a Pozzi tenaculum and achieve similar results.
• Cervical tenaculum: This type has a loop at the end and is made for your cervix.

What is a tenaculum used for?

Its main job is to hold tissues and other objects in a specific place during a surgical procedure. For example, it can help a surgeon hold back an area of tissue to better visualize the area they’re operating on. A tenaculum can also help clamp or tie off blood vessels or arteries to prevent excessive bleeding during surgery.

A tenaculum is most prevalent in gynecology and obstetrics (female reproductive health). It helps your provider stabilize (keep still) your cervix for various procedures like:

• Inserting an intrauterine device (IUD).
• Performing a biopsy.
• Hysterectomies.
• Tubal ligation.

How painful is a tenaculum?

You may feel discomfort when your provider inserts a tenaculum, especially for a gynecological procedure you’re awake for like IUD insertion. The ends of a tenaculum are sharp and made to grasp objects securely. While it can be uncomfortable, the firm hold on your cervix is usually necessary to complete the procedure. Some people describe it as a strong pinch.

Discuss your options for minimizing discomfort with your healthcare provider. Some providers may offer a local anesthetic like lidocaine to help numb your cervix, but this is rare. Instead, you could take over-the-counter (OTC) pain relievers like ibuprofen before the procedure to help with pain.

Can an IUD be inserted without a tenaculum?

Most healthcare providers prefer to use a device to steady your cervix during an IUD insertion. A tenaculum helps make the insertion process easier because it holds back the cervix to allow your provider to accurately place the IUD into your uterus. If you have concerns about this process, talk to your provider about alternatives or if it’s possible to insert an IUD without a tenaculum.

What are the disadvantages of a tenaculum?

A tenaculum is safe, but it can come with risks. Some of the risks are that it can:

• Cause bleeding complications.
• Accidentally damage your cervical tissue.
• Be slightly invasive and uncomfortable.

If you have concerns about your provider using a tenaculum, ask them if there are other tools they could use in its place.

Does a tenaculum pierce the cervix?

Yes, it works by slightly puncturing the tissue of your cervix to better grip it. The hooks on the end of the tenaculum grasp objects or tissue to keep a steady hold on them.

What is the difference between a speculum and a tenaculum?

A speculum is a device your healthcare provider uses to open and widen your vaginal walls. It helps them better examine your cervix, especially during a pelvic exam or Pap smear.

A note from Cleveland Clinic

A tenaculum is a medical device that’s been around for centuries. It recently gained popularity because more people are using IUDs as a form of pregnancy prevention. It’s common for providers to use a tenaculum during this procedure to steady your cervix before inserting the IUD. If you’re unsure about what to expect for an IUD insertion or any other gynecological procedure, talk to your healthcare provider. They can let you know what to expect and what your options are.