INSTRUMENTS USED IN
GYNAECOLOGY
Presented to
Asst Prof Dr Sruthy
Presented By Dept of Obstetrics & Gynaecology
JESSICA SHERINE
BHMS Second Year
INSTRUMENTS USED IN
GYNAECOLOGY
Uses :
• For clinical examination
• Major and minor operations
1. To retract anterior vaginal wall and expose cervix
2. To catch anterior lip of cervix
3. For dilatation of cervix
4. In vaginal gynaecological examination
I. TO RETRACT ANTERIOR VAGINAL
WALL AND EXPOSE CERVIX
1. Sims speculum and anterior vaginal wall retractor
2. Cusco’s self retaining speculum
Sterlisation:
• Autoclave
• Heat sterilisation (boiling)
• Cidex solution (glutaraldehyde)
SIMS SPECULUM AND VAGINAL WALL
RETRACTOR
Uses :
• Obtain pap smear, cervical
biopsy
• Catch lip of cervix for
operation
Disadvantage :
Needs assistant
CUSCO’S SELF RETAINING SPECULUM
Uses :
• OPD examination
• Cervical biopsy
• Pap smear
• Cervical polyp
Advantage :
No need assistant
Disadvantage :
Missed fistula on anterior or
posterior vaginal walls
II. TO CATCH ANTERIOR LIP OF CERVIX
Uses :
Hold the lip to stabilise uterus during procedure
1. Tenaculum
2. Vulsellum
3. Long Allis forceps
4. Sponge holding forceps
Sterlisation:
• Autoclave
• Heat sterilisation (boiling)
• Cidex solution (glutaraldehyde)
TENACULUM
Description :
Single pair of teeth
Use :
Grasp ant. lip of cervix when
dilatation not needed
Disadvantage :
Can cut cervix if forceful
VULSELLUM
Description :
3 - 4 pairs of teeth
Use :
Grasp ant. lip of cervix when
dilatation is needed
Disadvantage :
Cause pain, avoid in pregnancy
(cause bleeding)
LONG ALLIS FORCEPS
Uses :
Softer grip of anterior lip of
cervix, in case of pregnancy
SPONGE HOLDING FORCEPS
Uses :
• Softer grip of anterior lip of
cervix, in case of pregnancy
• To explore cervix for tear
III. FOR DILATATION OF CERVIX
Uses :
• Dilate internal os of cervix
• Access endometrial cavity
1. Metal dilators
i. Hegar
ii. Hawkins
iii. Pratt
2. Laminaria tent (Isabgol)
3. Prostaglandin gel or tablet
Uses :
HEGAR DILATORS • Gynaecological procedure
• MTP, abortion (evacuate)
• Uterine prolapse (conserve)
• Cervix cancer (management by irradiation)
Description :
• 2 rounded ends
• Various numbered diameter
• Number 7-8 – Gynaecological operation
• Number 11-12 – Hysteroscopic procedures
Disadvantage :
Painful, requires general or local anesthesia
PYOMETRA (LEFT) AND
HEMATOMETRA (RIGHT)
HAWKINS (LEFT) AND PRATT (RIGHT)
DILATORS
IV. IN VAGINAL GYNAECOLOGICAL
EXAMINATION
1. Uterine sound
2. Blunt and sharp curette
3. Tubal insufflation cannula
UTERINE SOUND
Uses :
• Confirm length and
direction of uterine cavity
• Locate misplaced copper T
Complication :
Perforation of uterus
BLUNT AND SHARP CURETTE
Description :
Has one sharp and a blunt end
Uses :
To curette (scrap) endometrium in
OBG conditions
• Blunt – soft, pregnant uterus
• Sharp – gynaecology conditions
Complication :
• Perforation of uterus
• Excessive curettage
• Hemorrhage
• Adhesion
TUBAL INSUFFLATION CANNULA (RUBIN)
Uses :
Introduce dye in uterus during
HSG and laproscopy