INSTRUMENTS OF OBSTETRICS
& GYNAECOLOGY
BY ARITRA MONDAL (BMCH 2017-18)
KARMAN’S PLASTIC CANNULA
OBSTETRIC USES: SUCTION AND EVACUATION OF THE PRODUCT OF
CONCEPTION
CUSCO’S BIVALVE, SELF RETAINING,
ADJUSTABLE, METALLIC,VAGINAL SPECULUM
USES:
OBSTETRIC USES- 1. FOR COLLECTION OF CELLS FROM CERVIX FOR
PAP SMEAR
2. TO SEE DRIBBLING OF LIQUOR THROUGH EXTERNAL OS
3. TO DETECT INCOMPETENCE OF CERVIX
4. TO SEE ANY LESION OVER CERVIX
GYNAECOLOGICAL USES-
DIAGNOSTIC: 1. TO SEE THE LESIONS OVER CERVIX LIKE CERVICAL
EROSION, CHRONIC CERVICITIS, CERVICAL POLYP, CIN, CA CERVIX,
CERVICAL TEAR, BACTERIAL & FUNGAL CERVICITIS
2. LESIONS OVER LATERAL VAGINAL WALL.
THERAPEUTIC: DIATHERMY CAUTERY
SIM’S DOUBLE BLADED POSTERIOR VAGINAL
SPECULUM
USES:
OBSTETRIC USES- 1. IN EARLY PREGNANCY: D&E OPERATIONS AND
CERCLAGE OPERATIONS
2. TO INSPECT ANY DRIBBLING OF AMNIOTIC FLUID IN SUSPECTED
PROM
3. IN DELIVERY: INSPECTION AND REPAIR OF CERVICAL TEAR,
INSPECTION OF ANTERIOR AND LATERAL VAGINAL WALL TEAR &
PARAURETHRAL TEAR
4. EXPLORATION OF UTERUS : IN PPH & SEPTIC ABORTION
GYNAECOLOGICAL USES- DIAGNOSTIC: 1. TO VISUALISE ANY LESION
OVER CERVIX AND ANTERIOR VAGINAL WALL
2. CERVICAL BIOPSY & PAP SMEAR
THERAPEUTIC: ANY VAGINAL OPERATION OR PROCEDURE
OTHER THAN OPERATION ON PERINEUM E.G. DIATHERMY,
CRYOCAUTERY, IUCD INSERTION, ANTERIOR COLPORRHAPHY,
VAGINAL HYSTERECTOMY, FOTHERGILL’S OPERATION,
HYSTEROSCOPY
LONG HEMOSTATIC FORCEPS
USES:
OBSTETRIC USES- USED AS A CLAMP FOR
HYSTERECTOMY
EPISIOTOMY SCISSORS
USES:
OBSTETRIC USES-
1. EPISIOTOMY
2. CUTTING OF UMBILICAL CORD
MYOMA SCREW
USES:
GYNAECOLOGICAL USES-
1. IN MYOMECTOMY, TO HOLD THE MYOMA DURING
ENUCLEATION
2. IN HYSTERECTOMY IN FIBROID UTERUS TO HOLD
& FIX THE UTERUS
SPONGE HOLDING FORCEPS
USES:
OBSTETRIC USES-
1. ANTISEPTIC DRESSING OF ABDOMINAL OPERATIONS LIKE
CAESAREAN SECTION AND HYSTEROTOMY
2. ANTISEPTIC DRESSING FOR VAGINAL OPERATIONS LIKE D&E, S&E,
NORMAL DELIVERY, INSTRUMENTAL DELIVERY, ENCIRCLAGE
OPERATIONS
3. TO GRASP THE LIP OF CERVIX FOR DIAGNOSIS AND REPAIR OF
CERVICAL TEAR
4. TO REMOVE THE MEMBRANES IN NORMAL DELIVERY OR
FOLLOWING CAESAREAN SECTION
5. TO HOLD THE LIPS OF CERVIX IN ENCIRCLAGE OPERATION
INSTEAD OF ALLIS TISSUE FORCEPS.
GYNAECOLOGICAL USES-
1. ANTISEPTIC DRESSING IN ABDOMINAL AND VAGINAL
OPERATIONS
2. PACKING OF ROLLER GAUZE IN SECONDARY HEMORRHAGE
FOLLOWING VAGINAL OR ABDOMINAL HYSTERECTOMY
3. POLYPECTOMY
4. TO OCCLUDE THE OVARIAN VESSELS DURING MYOMECTOMY
OVUM HOLDING FORCEPS
USES:
1. TO REMOVE THE PRODUCT OF CONCEPTION IN
D&E OPERATION
2. TO REMOVE THE RETAINED BITS OF PLACENTA AND
MEMBRANES
* OVUM HOLDING FORCEPS DOESN’T HAVE A CATCH
BECAUSE PRESENCE OF CATCH WILL BREAK THE
PRODUCT OF CONCEPTION & THERE WILL BE
DIFFICULTY IN REMOVING
DOYEN’S RETRACTOR
USES:
OBSTETRIC USES- 1. DURING CAESAREAN SECTION,
JUST AFTER OPENING THE ABDOMEN IT IS
INTRODUCED TO RETRACT THE LOWER CUT MARGIN
OF THE PARIETIES AND TO EXPOSE THE LOWER
UTERINE SEGMENT
2. IT IS REINTRODUCED AFTER DELIVERY OF THE FETUS
CRANIOTOMY SCISSOR
NOT USED NOWDAYS
USED IN CRANIOTOMY WHICH IS A DESTRUCTIVE OPERATION
WHERE THE FETAL HEAD IS PERFORATED AND EXTRACTED
THROUGH VAGINA.
CRANIOTOMY INDICATIONS-
1. IUFD
2. IN AFTERCOMING HEAD OF THE BRECH WHERE THERE IS
OBSTRUCTION & BABY IS DEAD
3. IN A LIVING FETUS LIKE IN HYDROCEPHALUS
OBSTETRIC FORCEPS
USES:
OBSTETRIC USES- [Link] EXTRACTION OF THE
FETAL HEAD AND HELPING THE DELIVERY OF THE
FETUS.
2. IN FEW CIRCUMSTANCES, IT CAN BE USED
THROUGH ABDOMINAL ROUTE DURING CAESAREAN
SECTION
ALLIS TISSUE FORCEPS
USES:
OBSTETRIC USES-
1. IN D&E OPERATIONS TO GRASP THE ANTERIOR LIP OF THE
CERVIX.
2. TO HOLD THE LIPS OF THE CERVIX IN CERCLAGE OPERATIONS
3. IN CAESAREAN SECTION: IN SKIN TO HOLD THE SKIN MARGINS,
TO HOLD THE PERITONEAL MARGINS, FOUR ALLIS FORCEPS ARE
USED TO HOLD THE CUT MARGINS AND TWO ANGLES OF UTERINE
WOUND.
GYNAECOLOGICAL USES-
1. TO HOLD THE LIP OF CERVIX IN VAGINAL SURGERY INSTEAD OF
VULSELLUM E.G. IUCD INSERTION,VAGINAL HYSTERECTOMY,
FOTHERGILL’S OPERATION
2. TO HOLD THE TOUGH STRUCTURES LIKE RECTUS SHEATH,
PERITONEUM
3. TO HOLD THE VAGINAL CUFF DURING VAULT TRANSACTION &
DURING REPAIR OF VAGINAL CUFF
FOLEY’S CATHETER AND METAL CATHETER
USES OF FOLEY’S CATHETER
OBSTETRIC USES- 1. IN RETENTION OF URINE FOR CONTINUOUS DRAINAGE
2. FOLLOWING OBSTRUCTED LABOUR TO PREVENT OBSTETRIC VESICOVAGINAL
FISTULA
3. FOR INDUCTION OF LABOUR AS A MECHANICAL METHOD AND INDUCTION OF
ABORTION
4. AMNIOINFUSION
GYNAECOLOGICAL USES- 1. FOR CONTINUOUS DRAINAGE OF URINE FOLLOWING
GYNAECOLOGICAL SURGERY LIKE PELVIC FLOOR REPAIR,VAGINAL HYSTERECTOMY,
WERTHEIM’S OPERATION, REPAIR OF VESICO VAGINAL FISTULA & VAGINOPLASTY
2. TO MONITOR OUTUPUT IN ILL PATIENTS WHERE IT IS REQUIRED
3. AS TAMPONADE IN ABNORMAL UTERINE BLEEDING
4. SONOSALPINGOHYSTEROGRAPHY WITH 8-0 SIZE
USES OF METALLIC CATHETER-
GYNAECOLOGICAL USES-
1. EVACUATION OF BLADDER ROUTINELY BEFORE VAGINAL OPERATION
2. RETENTION OF URINE
3. TO DIAGNOSE VESICOVAGINAL FISTULA
4. TO DIFFERENTIATE BETWEEN VESICOVAGINAL AND URETEROVAGINAL FISTULA
5. TO NOTE THE LIMIT OF BLADDER DURING ANTERIOR COLPORRHAPHY OPERATION
METAL CATHETER IS NOT ROUTINELY USED IN OBSTETRICS
CERVICAL DILATOR
USES:
OBSTETRIC USES- TO GRADUALLY DILATE THE CERVIX-
1. IN D&E, D&C OPERATIONS.
2. TO FACILITATE DRAINAGE OF INTRAUTERINE COLLECTION
3. TO FACILITATE ENTRY OF OTHER INSTRUMENTS, DEVICES,
SCOPES
GYNAECOLOGICAL USES-
1. TO CHECK PATENCY OF CANAL AFTER AMPUTATION OF
CERVIX.
2. TO DILATE THE URETHRA IN URETHRAL STRICTURE.
KOCHER’S ARTERY FORCEPS
USES:
OBSTETRIC USES- 1. FOR ARTIFICIAL LOW RUPTURE OF MEMBRANES
2. FOR CLAMPING OF THE UMBILICAL CORD
3. FOR REMOVAL OF MEMBRANES IN VAGINAL DELIVERY OR
CAESAREAN SECTION
4. IN HYSTERECTOMY OPERATION
COPPER T
AYRE SPATULA
USES:
GYNAECOLOGICAL USES-
USED FOR TAKING CERVICAL CYTOLOGY
(CYTOLOGICAL STATUS OF GENITAL CANCER,
CYTOHORMONAL STUDY, DETERMINATION OF SEX
CHROMATIN) AND VAGINAL CYTOLOGY
(CYTOHORMONAL STUDY)
BLUNT AND SHARP CURETTE
USES:
OBSTETRIC USES- BLUNT END IS USED IN D&E AND S&E OPERATION
GYNAECOLOGICAL USES- SHARP END IS USED IN CURETTING OF
ENDOMETRIAL CAVITY
MALLEABLE SILICON RUBBER
SUCTION CUP
USES:
OBSTETRIC USES-
THIS CUP IS INTRODUCED INSIDE THE VAGINA AND PLACED OVER
FETAL SCALP WHERE VACUUM IS CREATED IN BETWEEN SCALP AND
SUCTION CUP. THE CUP IS ATTACHED WITH A GLASS BOTTLE BY
CONNECTING TUBES WHERE NEGATIVE PRESSURE IS CREATED BY
PUMP & THEN BY GIVING TRACTION FETAL HEAD IS DELIVERED.