Jacobs Transaxillary Dissector, Curved Shaft Breast Dissector for Axillary Approach

What the Jacobs transaxillary dissector is

The Jacobs transaxillary dissector is a hand instrument used to open and mobilize a pocket in breast surgery. Surgeons also call it a Jacobs breast dissector, a curved shaft breast dissector or a curved transaxillary dissector. It is made by Adas Instruments in high quality medical grade stainless steel, and it is reusable and fully autoclavable.

The Jacobs shaft is curved, and that is the whole difference. A straight dissector holds a straight line, which is what you want across an open plane. A curved one follows a contour, which is what you want when the path to the pocket bends and the space is tight.

The work a breast dissector does is always the same in principle. A pocket has to be opened along a plane that already exists, without cutting through it and without tearing the tissue on either side. A blunt end pushed along that plane separates it and leaves the small vessels intact, which is why the field stays dry. The width of the blade, the shape of the shaft and how far the end has to travel decide which pattern a surgeon picks up.

Key design features of the Jacobs transaxillary dissector

• Curved shaft that follows the contour of the chest wall
• Narrower working end than the wide blade patterns, for a defined path
• Blunt end that opens a plane instead of cutting it
• Reaches the breast pocket from an axillary incision
• Flat handle that shows the blade angle by feel when the end is out of sight
• High quality medical grade stainless steel, reusable and autoclavable

The handle is flat and knurled rather than round. A flat handle tells you which way the blade is facing when the working end is deep in a pocket and out of sight, and the knurling holds when a glove is wet. The shaft runs into the blade with no step, so there is no shoulder to catch on the edge of an incision and nothing for protein to sit in after a case.

Jacobs dissector sizes and build options

The build below is the one we ship. Overall length is confirmed on the quotation rather than printed here, because this pattern is made to order for OEM runs and the shaft length is set by the run. We would rather leave a figure off than print one we cannot stand behind.

Nothing is listed above that we do not hold. If a build you need is not in the table, ask, because a change of length or blade width is a tooling change rather than a new instrument.

Uses of the Jacobs transaxillary dissector by specialty

The Jacobs transaxillary dissector appears on the same trays across these specialties because the job is the same one each time, opening a plane bluntly and holding the pocket where the surgeon meant it to stop.

The specialty name and the procedure name are both worth knowing when you order, because catalogues file this pattern under whichever of the two the buyer used. An operating room manager searches by procedure and a purchasing office searches by specialty, and they are looking for the same instrument.

Tissue planes the Jacobs transaxillary dissector works in

A breast dissector handles no suture and no needle. What decides the choice of pattern is the plane it has to open, how far the working end has to travel to reach it, and how much room there is to move once it is there.

Force is the part nobody writes down. A subglandular plane in a young patient opens with almost nothing, while a capsule in a revision case needs a firm push and a stiff shaft behind it. Match the blade to the plane and the instrument does the work instead of your wrist.

How the Jacobs transaxillary dissector compares with other patterns

These four sit next to each other on a breast tray and they are not interchangeable.

Surgeons who use this pattern usually also hold the Reynolds transaxillary breast dissector, the Solz atraumatic breast dissector and the Wieslander breast dissector. The closest relative in the range is the Reynolds transaxillary breast dissector.

If you are building a breast tray from scratch, the usual answer is two dissectors rather than one. Something long for the far edge of the pocket and something shorter with more feel at the tip covers almost every case.

Materials and finish

The instrument is made in high quality medical grade stainless steel. The steel itself is made to a German specification. The working face is ground and satin finished, which cuts glare under the lights in an operating room and keeps the end readable against wet tissue. There is no coating to chip and nothing on the shaft to trap protein.

Stainless steel is chosen here for a reason that has nothing to do with appearance. A long shafted dissector is pushed hard at full extension, and a shaft that is too soft will take a set and stay bent, which throws the blade out of the plane on the next pass. A shaft that is too hard will crack at the neck instead. The grade used sits between the two.

Jacobs transaxillary dissector care and sterilization

Rinse the instrument in cool water straight after use so blood does not dry on it. Clean it with a soft brush and a neutral pH enzymatic detergent, rinse in deionized water, then dry it completely. Steam autoclave at 134 degrees Celsius. Lay it flat in the tray with nothing resting across it, because an instrument loaded sideways in a crowded tray is the one that comes back out of true.

Look at the working end against the light before every case. A blunt end should be smooth with no flat spot and no nick, and the shaft should still be straight when you sight down it. A dissector with a nick on the end is what tears a pocket two cases later, and it costs nothing to check.

Ordering and wholesale

This pattern is supplied by Adas Instruments to hospitals, surgical distributors and OEM buyers, in single units and in bulk. The item code is AN-08.17 and it is printed in the size table above so a procurement search finds it. Backorder items dispatch in 10 to 12 working days. Every instrument carries a three year replacement against manufacturing defects.

For wholesale and OEM orders, instruments ship unpackaged in bulk or individually poly bagged, and laser marking with a distributor code or a hospital asset number is available. Tell us the quantity and the marking you need and the quotation comes back with the lead time for that run rather than a stock figure.

Production is controlled under an ISO 13485 quality management system. The instrument is CE marked.

Frequently asked questions

What is a Jacobs transaxillary dissector used for?

It opens the breast pocket through an axillary incision in augmentation and reconstruction. The curved shaft is the reason it is picked up, because the route from the armpit to the pocket is not a straight line and a curved shaft follows it.

Why choose a curved shaft over a straight one?

A straight shaft holds a straight line, which is right across an open plane. A curve follows a contour, so it keeps the working end in the plane where the path bends and where a straight instrument would want to lift out of it.

What length is the Jacobs dissector?

The Jacobs length is confirmed on the quotation rather than printed here, because this pattern is made to order and the shaft is set by the run.

Is a narrower end less safe?

No, it is a different job. The narrow Jacobs end gives a defined edge where a pocket has to stop. A wide blade spreads load across an open sweep.

How do you clean and sterilize a Jacobs dissector?

Rinse in cool water straight after use, clean with a soft brush and a neutral pH enzymatic detergent, rinse in deionized water, dry fully, then steam autoclave at 134 degrees Celsius. Lay a curved shaft so nothing presses on the curve.

Related products and categories

Surgeons who work with the Jacobs transaxillary dissector usually compare it against the Reynolds transaxillary breast dissector, the Solz atraumatic breast dissector and the Wieslander breast dissector. It sits beside the Mammostat breast elevator on the same tray. The whole family sits in dissectors and elevators, and this pattern is also listed under breast surgery instruments.