JODHPUR

INSTRUMENTFILE

SUBMITTEDTO SUBMITTEDBY
[Link] GEETADHAKA
HODOBG [Link].
GCON, JODHPUR
 ALLISTISSUE FORCEPS

USES:-

 To catch hold the anterior lip of cervix in D+E operation.

 To hold the apex of the episiotomy wound during repair.
 To catch hold the margins of the peritoneum, rectussheath, vaginal mucosa during repair.
 To catch hold of torn ends of sphincter ani externus prior to suture in repair of complete
perineal tear.
 To catch hold the margins and angles of the uterine flaps in LSCS after the delivery of the
baby as an alternative to Green -Armytage haemostatic clamp.
 CUSCO'S BIVALVE SELF RETAINING VAGINAL SPECULUM

USES:-
 To visualize the cervix and vaginal fornices for any local cause (polyp, ectopy) of APH.
 To inspect the cervix and to prepare cervical smear for cytology screening.
 To detect leakage of liquor from the cervical os in a case of suspected PROM.
 SIM’S DOUBLE BLADED POSTERIOR VAGINAL SPECULUM

The blades are of unequal breadth to facilitate introduction into vagina depending upon the space
available (narrow blade in nulliparous and the wider blade in parous women).
USES IN OBSTETRICS:-
 To inspect the cervix and vagina to detect any injury following delivery.
 To clean the vagina following delivery.
 To inspect the cervix and vagina to exclude any local cause for bleeding in APH (Cusco’s
speculum preferred).
 During D& E operation.
USES IN GYNAE OPD FOR FOLLOWING PROCEDURES:-
 Taking Pap Smear
 Insertion and removal of Copper T
 Colposcopy
 Taking swabs
 Hyseterosalpingography (HSG)
USESINGYNAE OPERATIONS:-
 D&C
 Cervix Biopsy
 Vaginal Hysterectomy
 Fothergills Operation
 Repair of Vesico vaginal fistula
 Hysteroscopy.
 AYRE’SSPATULA

It is used for taking Pap smear for screening of carcinoma cervix. It is made of wood so that cells can
adhere to its porous surface. The long end is inserted into cervical canal and rotated in 360 degree.
The exfoliated cells obtained are smeared on glass slide and fixed in Koplicks jar which contains
ether and alcohol in equal amount. The other broad end is used for obtaining cells from lateral
vagina for knowing the hormonal status.
 FOLEY’S CATHETER

USES:-
 This is a self retaining catheter most commonly used for drainage of the urinary bladder
after surgery.
 It is used in operations like Abdominal, Vaginal Hysterectomy, Wertheim's Hysterectomy
and Repair of vasico vaginal fistula.
 It is also used for second trimester MTP for extra amniotic instillation of ethacredyl lactate.
 It is also used for diagnosis of incompetent cervix and for sonosalpingography.
 KOCHER’S HAEMOSTATIC FORCEPS (CLAMP)

USES:-
 This instrument is used for holding pedicles in hysterectomy. The tips of the blade shave
teeth so that the tissue does not slip. The blades can either be straight or curved.
 This instrument is used in hysterectomy to clamp pedicles which are then transfixed.
 It is also used for salpingectomy in ectopic or oophorectomy in ovarian mass.
 This can also be used for clamping umbilical cord of new born at the time of delivery or for
artificial low rupture of membranes (ARM).
 MULTIPLETOOTHEDVULSELLUM

USES:-

 It isused to catch hold the anterior lip of the cervix in D+E operation, suction evacuation.
As it produces trauma to the soft and vascular cervix, Allis tissue forceps is used instead.

UTERINE SOUND
 It is an olive, pointed, graduated malleable, metallic uterine sound. About5 cm from the tip it
bends to make angle of 30 degree. It has marking on it for measurements (bladder sound has
no marking). The angle helps to negotiate curvature of the uterus (ante flexion).
USES:-
 To know the position of uterus and the length of uterine cavity prior to dilatation of cervix in
D + E operation.
 Tosoundtheuterine cavitytodetectanyforeignbody (IUCD).
 Itacts asafirstdilatorofthecervicalcanal.

LONGSTRAIGHTSCISSOR

USES:-
Itiscommonlyused-
 Tocuttheumbilical cord.
 Tomake episiotomy
 Tocutsuturematerialsasincaesarean section.

SIMPLERUBBERCATHETER
 USES:-
 Itisusedtoemptythebladderincaseswithretentionofurineduring–
a) Pregnancy(Retrovertedgraviduterus).
b) Labour–
I. Whenthewomanfails topassurineby herself.
II. Beforeandafteranyoperativeinterventions(forcepsdelivery,destructiveoperations).
c) Postpartum-
I. Duringmanagementofpost-partumhaemorrhage.
II. Retainedplacenta.
d) Otheruses-
I. Asa tourniquet.
II. Toadministero2whennasalcatheterisnotavailable.
III. Asamucussuckerwhenitisattachedtoamechanical orelectric sucker.

UTERINEPACKINGFORCEPS/DRESSINGFORCEPS

A curved forceps about 35cm in length, the curvature corresponding to axis of birth canal
foreasypacking,hasblades,handlesandfingerbows,commonlyusedingynaecologicalprocedures.
 The shanks of this instrument are slightly curved and therefore provide greater visibility when
[Link] an "S"
curve (slightly curved shanks with jaws slightly curved opposite direction) with partial
horizontal serrations and a length of 10-1/4 inches.
USES–
 Usedforvaginal packingtocontrolbleedingfromlacerationsinbirthcanalduetotrauma.
 Usedforapplicationofdrugsintotheuterine cavity.
 Usedtoswabuterinecavityfollowingdilationandcurettageprocedureswithsmallgauzepieces.
 Theyareusedfortissueremovalindilationandcurettageprocedures,intrauterinedevice
retrieval, and packing the uterine cavity.

CERVICALDILATORS

DASORHEGARDILATORS1
- DAS OR HEGAR DILATORS

They are metal rods developed by Alfred Hegarin 1879. Stainless steel Hegar dilators provide the
optionofdouble-endeddilatorsineven-millimeter increments, orfrom3to18foragreater diameter range
over the entire [Link], a set of dilators contains rods of increasing diameters, from a few
millimeters up to 26 millimeter. The rods are round, slightly curved and have a conal tip. Some sets
have conal tips at both ends, others show one end flattened for handling. Hegar dilators are marked
with a Hegar number equivalent to [Link] the sides are used with the lower number first.
HegarDouble-EndCervicalDilator
191mmstainlesssteeldouble-enddilator.Alsoavailableinasetof8orindividual sizes.
030830Hegar8pcDilatorSetSizes 3/4Fr- 17/18Fr
030831Hegar Dilator 1/2
030832 Hegar Dilator 3/4
030833 Hegar Dilator 5/6
030834 Hegar Dilator 7/8
030835 Hegar Dilator 9/10
030836HegarDilator11/12
030837HegarDilator13/14
030838HegarDilator15/16
030839HegarDilator17/18

USES-

 Das or Hegar dilators aredilatorsused to inducecervical dilation in order to gain entry to the
interior of theuterus. During the process of dilation, the cervixmay have to be stabilized with
atenaculum, and then the dilators are slowly entered into the cervical canal with a lubricant,
starting with a thin, low Hegar number rod and progressing gradually to larger numbers.

 Thedilators canalsobeusedtosoundtheuterus.

 Hegar dilators are widely used in gynecology to open up the cervix. This may be necessary
prior to a uterine curettageor biopsy. They have also found application in the managementof
vaginismus or hymenal stenosis.

 Theyarealsousedtoovercome stenosisinnon-gynecologicalsituations,suchasin urology and

proctology.

Degree of dilatation required: (i)Incomplete abortion- sufficient to introduce the index

finger (usually 16/19). (ii) In suction evacuation-one size smaller than the size of the suction
cannula. (iii) In MTPby D+E-sufficient dilatation to introduce ovum forceps (usually 9/12).

2-HAWKIN-AMBLERDILATORS
It has got 16 [Link] smallest one being 3/6 & the largest one being 18/21. The number is
arbitrary in the scale of Hawkins Ambler. The smaller one denotes measurement at the tip &
the larger one measures the maximum diameter at the base in mm.
FLUSHINGCURETTE

Flushing Curette is used to collect samples from uterus and rectum for diagnosis of cancer. It
consists of a long hollow shaft with small spoon shaped scoop. After passing it into the uterus,
sample is scraped.

Uses-
 FlushingCuretteisusedtocollectsamplesfromuterusandrectumfordiagnosisofcancer.
 It consists of a long hollow shaft with small spoon shaped scoop. After passing it into the
uterussample is scraped. This instrument is easy to use and finds application in hospitals & clinic.

SPONGEHOLDINGFORCEP
Sponge holding forceps or sponge forceps as they may be called are instruments which are used by
doctors to hold on to sponges and/or swabs while conducting their medical procedure. Sponge
holding forceps are usually made in the shape of a scissor. The jaws of these forceps can either be
serrated or they may be smooth. The handles are ratcheted as well as looped. Sponge holding
forceps can either be curved or they may be straight; the shape is different for each individual
purpose for which they may be used. Sponge holding forceps are commonly nine inches in length
i.e. 18-23 centimetres. The jaw of the sponge holding is usually rounded and to be able to use the
instrument for delicate and fragile operations, the tips may even be elongated. With the help of
sponge holding forceps, surgeons are able to perform minor operations without causing much
damage to the patient. It is also helpful in ensuring that not much of a scar remains once the
procedure is over.

Uses-
Sponge holding forceps are used in every surgery which is performed since sponges and swabs are
used for every surgery. Sponge holding forceps come under the category of gynecological
instruments, surgical instruments, dentistry instruments and every other division within the medical
field.
These instruments also help in preventing and reducing the likelihood of trauma to the
[Link] holding forceps may be used while other procedures are conducted as well and may
be used to hold cotton balls, sponges, gauze and any other material which may be required duringthe
surgical [Link] times, sponge holding forceps can also be used as a clamp to stop
[Link]

OVUMFORCEP
Ovum forceps are a kind of forceps however these are gynecological instruments since these deal
with performing abortions ifthey may berequired. Othernames for theovumforceps areclamps or a
haemostat.
Anabortion maybeconductedifthefetusisnolongerliving insidetheuterusorthepresenceofthe baby
inside the uterus may be harmful for the health of the mother and the baby, both
Forceps are thosesurgical instruments which are used to grab onto things and to move objects from
within the body as and when needed. This particular instrument may be used when the fingers are
larger than the item which needs to be grabbed onto or the objects being held need to be dealt with
oneatatime. [Link] field of
medicine which help surgeons and doctors to deal with very small objects which cannot be held
using the fingers

Uses-
Ovumforcepsareusedtoremoveproductofconceptionfromtheuterusinincompleteabortion. Used to
remove any foreign body from the uterine cavity, [Link] when threads are broken.
They arealso used toremoveanykindofretained placental bitsormembrane pieces whichmay be in
the uterus.

UTERINECURETTE
A flat metal instruments with small spoon like arrangement for scraping. Both end are spoon
shaped with fenestrations in the middle. One end is blunt and another end is sharp for curetting.
This product is a 5 curette. The tip is approximately 23mm long and 14mm wide. The overall
length is 11 inches.

Uses-
SimsUterineCuretteisanOB/GYNinstrumentusedforremovingtissuefromtheliningofthe uterus.
Itmaybeusedtoscrapeandremovegrowthsortissuetobebiopsied. It may
also be used as part of a D&C procedure.

UTERINEPACKINGFORCEPS/DRESSINGFORCEPS
A curved forceps about 35cm in length, the curvature corresponding to axis of birth canal foreasy
packing, has blades, handles and finger bows, commonly used in gynecological [Link]
shanks of this instrument are slightly curved and therefore provide greater visibility when used in
the uterine cavity. The jaws are available either curved or straight. This product features an "S"
curve (slightly curved shanks with jaws slightly curved opposite direction) with partial horizontal
serrations and a length of 10-1/4 inches.

Uses–
 Usedforvaginalpackingtocontrolbleedingfromlacerationsinbirthcanalduetotrauma.
 Usedforapplication ofdrugsintotheuterine cavity.
 Used to swab uterine cavity following dilation and curettage procedures with small gauze
pieces.
 They are used for tissue removal in dilation and curettage procedures, intrauterine device
retrieval, and packing the uterine cavity.

DOYEN’SRETRACTOR
The doyen retractor is an instrument which is used to hold organs back while the surgery is
being conducted. Doyen Retractors is 25cm (10") 50 x 85mm in size. It also keeps in keeping
open the edges of incisions which have been made. A retractor is a surgical instrument with
which a surgeon can either actively separate the edges of a surgical incision or wound, or can
hold back underlying organs and tissues, so that body parts under the incision may be accessed.
The two are each available in many shapes, sizes, and styles. The general term retractor usually
describes asimple handheld steel tool possessing acurved, hooked, or angled blade fitted with a
comfortable handle,thatwheninplacemaintains thedesiredpositionofagivenregionoftissue.
Retractorscanalsobeselfretaining andnotneedtobeheldonceinsertedbyhavingtwoormore opposing
blades or hooks which are separated via spring, ratchet, worm gear or some other method and
pull on opposite sides of a wound.

Uses:

Medical Tools Retractors used by surgeons to either actively separate the edges of a surgical
incisionorwound,orcanholdbackunderlyingorgansandtissues,sothatbodypartsunderthe incision may
be accessed.

MANUALVACUUMASPIRATION(MVA)SYRINGE
 A diagram of a vacuum aspiration abortion procedure at 8 weeks [Link] aspiration is an
outpatient procedure that generally involves a clinic visit of several [Link] procedure itself
typically takes less than 15 [Link] created with either an electric pump (electric vacuum
aspiration or EVA) or a manual pump (manual vacuum aspiration or MVA). A hand-held 25cc or
50cc syringe can function as a manual [Link] methods use the same level of suction, and so can
beconsideredequivalentintermsofeffectivenessandsafety

Uses-
Vacuumorsuction aspiration uses aspiration to remove uterine contents through the cervix. It may be
used as a method of induced abortion, a therapeutic procedure used after miscarriage, or a procedure
to obtain a sample for endometrial biopsy.

Somesources may usethe terms dilation and evacuationor"suction"dilation and curettageto referto
vacuum aspiration, although those terms are normally used to refer to distinct procedures.

When used as amiscarriage treatment or anabortion method, vacuum aspiration may beusedalone or
withcervical dilation anytime in the first trimester (up to 12 weeks gestational age). For more
advanced pregnancies, vacuum aspiration may be used as one step in a dilation and evacuation
LAMINARIATENT

Laminaria has been used traditionally as a hygroscopic cervical dilator and inducer of labour, and
commercial products are available for this [Link] dilators have been used to dilate the
cervix and to induce labor in abortions. When inserted into the cervix, laminaria dilators absorb
surrounding moisture and gradually swell to a diameter of approximately one-half inch. While most
of the swelling occurs in the first 4 to 6 hours, it may continue for up to 24 hours. Because this is a
gradual process, the patient rarely notices pain. At the same time, the cervix is induced to ripening
(becoming soft and flexible). The effect is often limited to local cervical ripening; however,
stimulation of the cervix can induce labor.
The mechanism of action may be similar to that of a foreign body that, when inserted into the
cervical canal, disturbs the normal chorioamniotic balance and initiates a cascade of prostaglandin
synthesis. This in turn has myometrial-contracting and cervical-ripening effects.
Uses-Cervicalripening
KARMAN CANNULA

Uses-
 ItisusedforSuction&EvacuationandMVA.
 The sharp overhanging hoods of a Karman cannula reportedly may be used to retrieve an
IUDwhen the threads are no longer visible.
 DAS’LONGCURVED FORCEPS

Aheavymetalinstrumentabout37cm(15inch)[Link],shank,lock&[Link]
bladesarenamedleftorrightinrelation tomaternal pelvisinwhichtheyliewhenapplied.

The blade characteristically has twocurves, the cephalic and the pelvic curves. The cephalic curve is
shaped to conform to the fetal head. Pelvic curve to fit the curve on the axis of pelvic canal (curve of
carus). In order to lock the two halves after application, the left blade needs to be inserted first.
Uses-Itisusedinlowforceps operation.
SHORTCURVEDFORCEPS

All forceps have handles; the handles are connected to the blades by shanks of variable
[Link] each forceps branch is the curved portion is used to grasp the baby's head. The
blade characteristically has two curves, the cephalic and the pelvic curves.
The cephalic curve is shaped to conform to the baby's head. Some forceps have a more rounded
cephalic curve and others have a more elongated curve; the type of forceps used depends on the
shape of the baby's head. The forceps should surround the baby's head firmly, but not tightly.
Uses-
 Itisusedinlowforceps operation.
 KIELLAND'SFORCEPS

Kielland'sforcepsis a long, almost straight (very slight pelvic curve) obstetric forcep with a sliding lock. It
should only be performed in theatre with tested, effective, regional anaesthesia.
The Kielland's forceps are a potentially dangerous instrument in unfamiliar hands. However, when used
correctly and with gentleness they can achieve a controlled, a traumatic delivery.
Uses-
Itisusedasarotationforcepsindeeptransversearrestofoccipitoposteriorpositionofthehead. Facilitates grasping
and correction of an asynclitic head because of its sliding lock.

AXIS-TRACTIONFORCEPS

Axistraction forceps include twoaxistraction rods(right &left) anda traction handle. The
rodsareassembledinthebladesoflongcurvedobstetricforcepspriortointroductionandlastlythehandleisatt
ached to the rods.
Obstetricalforcepsprovidedwithasecondhandlesoattachedthattractioncanbemadeinthelineinwhich the
head must move along the axis of the pelvis
Uses-
Itisusedwheremuchforceisnecessaryfortraction asinmid-forceps operation.
 EPISIOTOMYSCISSORS

Episiotomy Scissors, which may also known as Braun-Stadler Episiotomy Scissors, are used to
perform episiotomies during labor and delivery. These non-ratcheted, finger ring scissors are angled
with smooth, blunt/blunt tips, and a length of 5-1/2 inches.
Uses-
EpisiotomyScissorsareusedforcuttingtheperineumtoenlargethevaginalopeningtodeliverthe fetal head.
VENTOUSECUP

Uses-
 Itcanbeusedonafetalheadatahigherstationandnotwell rotated.
 Itisusedinthesecondstageoflabourifithasnotprogressedadequately. Itmaybean
alternative to a forceps delivery and caesarean section.
 MUCUSEXTRACTOR/BULBSYRINGE

1 –Universal Connector
2 –OpenDistalEndWith2LateralEyes
3 –DetachableContainerForDischarge,25Ml
4 –ScrewCap
A mucus extractor, also called a bulb syringe, clears the nose of a child who has trouble blowing into a
tissue. Use one to clear your child's nasal passages, allowing him to breathe easier when sick and
preventing mucus from running out his nose. Mucus extractors are inexpensive and available at many
baby supply and drug stores, making them an affordable and indispensable addition to any parent's
medicine chest.
Uses-
Used to suck the secretion from the oropharynx and hypopharynx of neonates following birth, prior to the
attempt of respiration
UMBILICALCORD CLAMP

Theumbilical [Link] remove

the baby from the placenta, a surgeon makes use of a gynecological instrument which is called the umbilical
cord clamp. Most of these clamps are made using plastic and the cord usually consists of teeth in
thefrontwhichfittogetherwhentheinstrument [Link] fittings on
the side of the clamp which is open in order to ensure that the instrument can be used in a secure manner.
Uses-Thisclampisusedbythesurgeontocuttheplacentaandhencefreethebabyfromthewomb
PINARD’SSTETHOSCOPE

Pinard hornis a tool used to listen the heart rate of a fetus during [Link] is a type of stethoscope,
formerly called a "fetoscope",but the term is still sometimes associated with the Pinard stethoscope. Thehorn
is often made of wood or metal and is hollow. It is about 8 inches long. It functions similarly to an
eartrumpet by amplifying sound. The wide end of the horn is held against the pregnant woman's
abdomen,while the user listens through the other end
Uses-
APinardhornmaybeusedtodetermine thepositionofthefetus.
Itisusepalpation andauscultationofthefetalheartratetodeterminefetalposition. Pinard horn
is a tool used to listen the heart rate of a fetus during pregnancy.

GIANTVULSELLUM

Avulsellum(alsoknownasavolsellaorvulsella)isapairofsurgicalforcepswithhooksatthetipofeach blade.

Used-inobstetricsandgynaecologyproceduressuchasepisiotomy,hysterectomy,ordilation&curettageand used
forgrasping the cervix (Usually anterior lip of the cervix is grasped)

NEEDLEHOLDER

Smallerdistalbladeswithcrossserrationsoftenwithagrooveinthemiddlearethefeaturesofneedle holder. It may be

straight or curved and available in different sizes. Used- to hold a needle.

DOYEN’STOWELCLIP
Adoyen’stowelclampisusedtosecuretowelsandsurgicaldrapingduringamedical procedure.

PERFORATOR

A [Link] foetus from the

womb in pieces to save the mother's life

[Link]

ThisinstrumentisusedwithSim'[Link]’salonginstrumentwithbluntloopsatboththeends

makinganangleforeasyvisualization ofcervixandvagina,especiallyusefulincaseofcystocoele. DISSECTING

FORCEPS
Itisusedtoholddelicatestructureslikeperitoneum,vesselsbowel,nerves,tendons,andholdskins.

EXTERNALPELVIMETER

Pelvimetry istheassessmentofthefemalepelvis inrelation tothebirthofababy.

RINGPESSARY
Therapeutic pessaries areusedto support the uterus, vagina, bladder, or [Link] is a treatment
option for pelvic organ prolapsed. A pessary is most commonly used to treat prolapsed of the uterus

ARTERYFORCEP

Artery forceps are primarily use as haemostatic forceps to grasp vessels and allow ligation of those [Link]
is also be used to grasp tissues, sutures and other prosthetic materials. Care should be taken as they are
crushing forceps that can damage delicate structures.

TENACULUMFORCEPS
TenaculumForceps arearatcheted,fingerringinstrumentcommonly usedin OB/GYNprocedures involving
manipulation of the cervix or uterus, most commonly D&C, and vaginal or abdominal hysterectomy. They
are also used to grasp, hold, and move vessels and arteries during surgical procedures.