Master Series Rubber Coated Stainless Steel Jennings Gag

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Anesthesiologists are responsible for maintaining the patient's respiration and other vital functions during surgery. Mouth gags are sometimes used to hold the patient's mouth open for dentistry, oral surgery and anesthesia. Notes: Jennings JE. The complete removal of the tonsil in its capsule (Sluder method) by means of a new tonsillotome. Medical Fortnightly. 1914; 45:56-58. One was introduced in 1914 by St. Louis physician John Ellis Jennings (1863-1935). Jennings' gag is a modification of the Whitehead gag, which had been introduced some fifty years earlier. Jennings removed the built-in tongue depressor of Whitehead's gag, and simplified the mechanism for adjusting it. The Whitehead gag has two spring-loaded ratchets. The Jennings gag has a single ratchet that can be operated by the finger and thumb of one hand. Squeezing the handles together opens the gag. To close it, the ratchet is depressed and the handles pushed apart. Both the Whitehead and Jennings gags are still being made today. Exhibit History In 1897, Snow [ 6] emphasized, that slipping of mouth gags may embarrass the operator and often seriously deteriorating his results. Therefore, this might present difficulties during surgery and may lead to an interruption of the operation process.

All instruments are for Human Surgical use only, if looking for Veterinary Instruments, please visit St. Louis physician John Ellis Jennings (1863-1935) introduced a new tonsillectome (an instrument for removing tonsils) in 1913; in that article he does not mention the use of any mouth gag. The following year he published another article about the use of the instrument, which included an illustration of “the Jennings mouth gag”. The Jennings gag is a modification of the gag introduced in the 1860s by William R. Whitehead, M.D. (1831-1902). Jennings removed the built-in tongue depressor of the Whitehead gag, and simplified the mechanism for opening and closing it. The Whitehead gag has two spring-loaded ratchets. The Jennings gag uses a single ratchet, located on the operator’s right, that can be manipulated by the finger and thumb of one hand. Squeezing the handles together opens the gag. To close it, the ratchet is depressed and the handles pushed apart. Both the Whitehead and Jennings gags are still being made today.

Whitehead gag: invented in 1877 by Walter Whitehead (1840-1913), a surgeon in Manchester, England, [1] consists of two hinged metal frames that wrap around the front of the patient's head and which have sections bent to fit between the front teeth. When spread apart, the frames separate the jaws, holding the mouth open. The desired degree of separation is set and maintained by a ratchet mechanism on each side of the frame. Notes: Leow A-M, Lun-Jou L. Palatoplasty: evolution and controversies. Chang Gung Med J. 2008;31(4):335-345.

Notes: Austrian Difficult Airway/Intubation Registry, Virtual Museum of Equipment for Airway Management. http://www.adair.at/eng/museum/equipment/mouthgags/whiteheadobject01.htm. Accessed June 13, 2017. a Inserting the gag with placing the hole of the pad to the cusp of the canine, b fixation of the pad to the interproximal area with a stop for additional hold Manufactured in premium grade stainless steel with a fine satin finish that reduces glare. Author NameNotes: Whitehead, WR. Report on the best methods of treatment for different forms of cleft palate. Transactions of the American Medical Association, Volume XX. Philadelphia: Collins, 1869. For this purpose, the instrument features a slim wire design that easily accommodates to the face contour. In addition, the device is available in sizes that range from 10.5 to 16.5cm to accommodate pediatric and adult patients. Notes: Tiemann, George, & Co. Catalogue of Surgical Instruments. New York: George Tiemann & Co. 1876:60. The Jennings Mouth Gag offers a wide range of surgical advantages. Its principal use is to provide an atraumatic way to open the mouth without damaging the temporomandibular joint. Notes: Powers & Anderson. Illustrated Catalogue of Surgical Instruments and of Allied Lines. Richmond, Virginia: Powers & Anderson, Inc., 1917:355.

It was obvious from the early beginning, that a reliable mouth gag was needed to keep the mouth open continuously. Besides the fact that some of the different models also fixate the tongue, other models showed a more or less tendency to slip, slide away and finally to dislocate. Especially disadvantages of single-sided mouth gags are sliding as well as the dislocation within use [ 3]. Notes: One mouth gag; Consists of two sculpted, horizontal bars, hinged together at each end, and connected on the right side to a mechanism for adjusting the space between the bars; The mechanism consists of two handles that are hinged so as to stand perpendicular to the bars; These handles hold a ratchet between them; The end of each handle is scored by hatching on its exterior side (for improved grip); In the short physical description the gag is measured in the fully open position; When the gag is fully closed, the height is 8.5 centimeters; Both bars, and both handles, are marked on the interior with the number: “25”; The lower handle is also marked with the logo, consisting of a circle enclosing the letter “J” superimposed on the letter “S”. Until now, mouth gags have been widely used in surgery. A variety of different mouth gags is described and distributed today (Table 1) [ 2– 5, 9]. Already Colt mentioned in 1907, that the number of gags in the market was large, but the number of those, which combine in one instrument all the essentials, is rare [ 4]. Many years later, on a Caribbean work trip, Dingman considered his mouth gag as “happiness” for a surgeon operating on cleft palate, but Millard stated in his book in 1976, that he experienced a couple of difficulties with that gag, mostly with its adaptability to fit to irregular alveolae [ 9]. Notes: The first year in date range is based on the date of Jennings’ original description of the gag. The second year in the date range is based on the date that the gag was received by the WLM, but it’s fragility suggests that it is more likely to have been manufactured in the first half of the 20th century. Interestingly, in early 1907, Colt already mentioned, that there were enough reasons for bringing forward the subject of a mouth gag designed to suit the needs of the general practitioner, surgeon, dental surgeon and anaesthetist. In those times, he already remarked besides the large number of different gags on the market, that a single perfect gag was missing, which supplies all needs [ 4].

Notes: Austrian Difficult Airway/Intubation Registry, Virtual Museum of Equipment for Airway Management. http://www.adair.at/eng/museum/equipment/mouthgags/jenningsobject01.htm Accessed June 13, 2017. Notes: Anesthesiologists are responsible for maintaining the patient’s respiration and other vital functions during surgery. Mouth gags are sometimes used to hold the patient’s mouth open for dentistry, oral surgery and anesthesia. Surgical procedures for the repair of cleft palate began in the 18th Century. The first successful cleft palate surgery in the United States was performed in 1820 by John Collins Warren (1778-1856). Since the mid-19th Century, many mouth gags have been designed specifically for these surgeries.