ws be seen to close
upon the foreign body. The impulse to seize the object as soon as it
is discovered must be strongly resisted. A careful study of its size,
shape, and position and relation to surrounding structures must be
made before any attempt at extraction. The most favorable point and
position for grasping having been obtained, the closed forceps are
inserted through the bronchoscope, the light reflex obtained, the
forceps blades now opened are turned in such a position that, on
advancing, the foreign body will enter the open V, a sufficient
distance to afford a good grasp. The blades are then closed and the
foreign body is drawn against the tube mouth. Few foreign bodies are
sufficiently small to allow withdrawal through the tube, so that tube,
forceps and foreign body are usually withdrawn together.

[FIG. 78.--Proper hold of forceps. The right thumb and third fingers
are inserted into the rings while the right index finger has its place
high on the handle. All traction is made with the index finger, the
ring fingers being used only to open and close the forceps. If any
pushing is deemed safe it may be done by placing the index finger back
of the thumb-nut on the stylet.]

_Anchoring the Foreign Body Against the Tube Mouth_.--If withdrawal be
made a bimanual procedure it is almost certain that the foreign body
will trail a centimeter or more beyond the tube mouth, and that the
closure of the glottic chink as soon as the distal end of the
bronchoscope emerges will strip the foreign body from the forceps
grasp, when the foreign body reaches the cords. This is avoided by
anchoring the foreign body against the tube mouth as soon as the
foreign body is grasped, as shown in Fig. 79. The left index finger
and thumb grasp the shaft of the forceps close to the ocular end of
the tube, while the other fingers encircle the tube; closure of the
forceps is maintained by the fingers of the right hand, while all
traction for withdrawal is made with the left hand, which firmly
clamps forceps and bronchoscope as one piece. Thus the three units are
brought out as one; the bronchoscope keeping the cords apart until the
foreign body has entered the glottis.

[FIG. 79--Method of anchoring the foreign body against the tube mouth
After the object has been drawn firmly against the lip of the
endoscopic tube the left finger and thumb grasp the forceps cannula
and lock it against the ocular end of the tube, the other fingers of
the