Department of obstetrics and
gynaecology
instruments
Sims bivalved vaginal speculum
uses
Obstetrics uses - Visualising the Cervix and to see any cervical
tears,while suturing Episiotomy,to inspect vagina in case of
vaginal laceration and in traumatic PPH,to retract vagina when
instilling Dinoprostone gel
Gynaec uses - in OPD to visualise vagina, to retract vagina while
doing Pap smear,in GOT during Vaginal Hysterectomy and
Fothergill’s surgery to retract vagina, during Fractional Curettage
with cervical biopsy to retract vagina,in DHL,in LAVH
Family planning - to retract vagina while inserting or removing
Cu-T,during MTP or Manual vaccum aspiration
Cusco’s self retaining vaginal speculum
uses
Advantage over Sims speculum is that it needs no assistant to
hold it because it is self retaining
It is also used in colposcope,VIA,VILI,during cryosurgery for
cervix,and while doing IUI
Disadvantage not able to visualise vaginal walls
Ayre’s spatula
uses
It is used to take Pap smear
It is made of wood so cells can adhere to porous
surface
The long end of the spatula is inserted into
cervical canal and rotated 360 degree and the
cells are obtained in the spatula
Uterine currette
uses
It has blunt and sharp end
Blunt end for pregnant uterus and sharp one for non
pregnant uterus
Obstetrics uses – evacuation of vesicular mole,
evacuation of POC in incomplete abortion,curettage of
RPOC
Gynaec uses – curretage before fothergill’s surgery,
currettage following DHL , fractional curettage with
cervical biopsy
Family planning – to remove Cu-T, MTP
Uterine sound
USES
it has handle at its end
used to measure the length of the uterus from fundus to
the external os
gynaec uses – to measure the size of the uterus bofore
fractional curettage with cervical biopsy,measure size of
uterus in fibroid
family planning – to measurev the size of the uterus
before MTP and before inserting Cu-T and also used to
diagnose misplaced IUCD
Mathew duncan’s dilator
uses
it has knob at its end
Obstetrics – no use
Gynaec uses
to dilate the cervix before fractional curettage with cervical biopsy,fothergill’s
surgery,DHL with chrompertubation where we need to dilate the cervix to
insert the hysteroscope and to inject the dye into the uterus to see tubal patency
To dilate the cervix to manipulate the uterus is to antevert,retrovert,lateralize in
LAVH,LS,rarely in lap cystectomy to mobilize the uterus away from the cyst
Family planning – dilating the cervix brfore inserting Cu-T when os is tight,to
manipulate uterus during LS
Hegar’s dilator
uses
Used to dilate cervix in pregnant uterus
It has no anteversion or retroversion curve since
in pregnancy these are corrected
No 8 size dilator if passes easily into the cervix it
is diagnostic for cervical incompetence
Metal suction cannula
USES
It is used to remove products of conception In
case of MTP in first trimester and incomplete
abortion
Evacuation of uterus in vesicular mole
In is now replaced by MVA (Manual Vacuum
Aspirator) Syringe with karmans cannula
MVA syringe
The vacuum is created in the syringe and the
intrauterine contents are evacuated
Female metal catheter
uses
Used to evacuate urine intermittently during all
gynaec procedures
Doyen Myoma screw
uses
This is screwed into the myoma and the fibroid is
enucleated in myomectomy
Also screwed into the uterus in total abdominal
hysterectomy
Vaginal Ring pessary
uses
It is used as a treatment for prolapse uterus in
patient who is very old, who are not fit for
surgery and the patient who are not willing for
hysterectomy
These are changed in 3 months
Another one called hodge pessary also used
Sponge holding forceps
uses
Used to hold cotton and gauge while
cleaning the operative site before
surgery
To hold cervix after delivery to walk
around cervix in case of traumatic PPH
and in instrumental deliveries to check
for cervical tears
To hold cervix in pregnant uterus
Hold cevix in procedures like cervical
cerclage,instillation of cerviprime gel
Needle holder
uses
Used to hold the suture
needle during suturing
the tissue
It has groove and
serrations for grip in the
inner side
Allis forceps
uses
Used to hold tissue in
C section
To hold upper and lower lips of uterus after
delivering the baby before the closure
Used to hold rectus sheath
Used in vaginal hysterectomy and
abdominal hysterectomy to hold the
vaginal vault till closure
Can be used to hold cervix instead of
vulsellum
Babcock’s forceps
The end has a big fenestration and there
is no teeth ,it has a flat surface
Uses
it is used to hold soft tissues without
causing injury fallopian tubes and
intestines
Used in surgeries like tubectomy,
tuboplasty,TAH
Cervical four quadrant Punch biopsy
forceps
uses
It has four quadrants and
biopsy is taken as a punch
in the squamocolumnar
junction or suspicious area
in [Link] or colposcopy
Vulsellum forceps with teeth at its end
USES
Used to hold upper or lower cervix lip
Obstetrics – no use because teeth will tear
the soft pregnant cervix
Gynaec use – fractional curettage with
cervical biopsy,vaginal hysterectomy,LAVH,
DHL and ls to hold cervix for manipulation
and VTT in OPD
Family planning – inserting and removing
Cu-T ,in MTP while doing dilatation and
curettage
wrigley’s Outlet forceps
Pre-requistites - informed consent, cervix fully dilated and
effaced,membranes should be absent,head should be engaged,
rectum and bladder should be empty, cephalic presentation,no
cpd,Saggital suture should be in ap diameter
indication - foetal distress,maternal exhaustion or delayed
second stage,heart disease,anaemia,eclampsia,vbac,cord
prolapse
contraindication - incomplete dilatation of cervix, obstructed
labour,unengaged head
Complication – maternal and fetal trauma
Ventouse
Minimal trauma than forceps delivery
Pressure of 0.2 – 0.8 kg/cm^2 or 760mmhg over 8-10 min
Cup is placed 3 cm anterior to posterior fontanelle as the
flexion point , negative pressure is created inside the cup and
artificial caput is formed called chignon
Indications - same as forceps delivery
Contraindication - face presentation,after coming head in
breech,premature baby
Complications - cephalohematoma,intracranial hemorrhage
All the best…