| Magill forceps | |
|---|---|
 Magill forceps showing the characteristic angled design | |
| Synonyms | Intubation forceps |
| Specialty | Anaesthesiology |
| Intervention | Intubation |
| Inventor(s) | Ivan Magill |
| Related items | Laryngoscope |
Magill forceps are angled surgicaltongs used to guidebreathing tubes into the windpipe or retrieve obstructions from the throat without blocking the view of thelarynx.[1] Their right-angle bend keeps the handles outside the mouth while serrated openings at the tips grip tubes or debris securely. The stainless-steel instrument comes in infant, child and adult lengths and has altered little since Sir Ivan Magill introduced it in the early 1920s. It remains standard equipment in operating theatres, emergency departments and ambulance airway kits around the world. While highly effective, the instrument requires careful technique to avoid complications such as dental trauma orsoft tissue injury during use.
Magill forceps are angled ring-handled forceps devised in the early 1920s by the Irishanaesthetist Sir Ivan W. Magill to permit manipulation of airway devices without obstructing the laryngoscopist's line of sight.[2][3] The instrument's 90-degree mid-shaft bend and serrated, fenestrated tips enable the operator to grasp objects deep in theoropharynx while the handles remain outside the mouth, reducing the risk of dental trauma and preserving vision of theglottis.[2] Standard patterns are manufactured in stainless steel and supplied in lengths of roughly 16 cm forneonates, 20 cm forpaediatric use and 24 cm for adults, allowing a size to be matched to the patient's anatomical dimensions.[2]
Contemporary airway textbooks describe three principal clinical applications: (i) advancing a nasotracheal tube from the oropharynx through thevocal cords under directlaryngoscopy, (ii) retrieving foreign material that is causing or threatens to causeupper airway obstruction, and (iii) directing nasogastric or oropharyngeal packing into the oesophagus duringhead and neck surgery.[2][3] During nasotracheal intubation the forceps are held in the right hand so that the curve follows the path of the tube; careless clamping may tear the cuff or laceratemucous membranes, prompting some authors to recommend grasping the tube above the cuff or partially inflating the cuff before engagement.[3] When foreign-body airway obstruction is encountered in pre-hospital or in-hospital settings, international resuscitation guidelines advise that "appropriately skilled healthcare providers use Magill forceps" once laryngoscopy has visualised the object, a recommendation supported by clinical evidence of high removal success and improved neurological outcome in out-of-hospital cardiac arrest patients.[4]
The instrument's efficacy is balanced by recognised hazards: poor visualisation can lead to blind clamping of soft tissue, over-zealous force may fracture teeth, and repeated attempts prolongapnoea time; therefore current training manuals emphasise limiting grasping attempts to those necessary and abandoning the technique if the object cannot be clearly seen.[2][4] Alternative or adjunct manoeuvres includecuff inflation or video-laryngoscopic guidance, yet Magill forceps remain the standard tool because they require no complex setup, fit existing laryngoscope workflows and can also besterilised rapidly between cases byautoclaving.[2] Although several modified designs—such as extra-curved or insulated tips forlaser surgery—have been marketed, the basic configuration introduced by Magill more than a century ago remains largely unchanged inoperating theatres,emergency departments andambulance services worldwide.[2][3]