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Instruments O&G 
tony 2010 mbbs 1
Specula tony 2010 mbbs 2
Sims bivalvedspeculum 
•2 blades & handle 
•Adv 
•retracts posterior vaginal wall 
•The groove in the centeralso drains the secretion or bleeding thus keeping the area dry 
•Disadv 
•Not self retaining (need an assistant to hold speculum ) 
•Enter laterally 
•PGE1 introduction 
•Uterine prolapse 
•FC,D&C,cervicalpunch bipsy 
•Pap smear 
•Push bladder in VH 
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Uses 
•Use in GynaeOPD for following procedures: Taking Pap Smear , Insertion and removal of Copper T , Colposcopy ,Taking swabs, Hyseterosalpingography(HSG) Use in GynaeOperations:D&C , Cervix Biopsy , Vaginal Hysterectomy , FothergillsOperation, Repair of Vesicovaginal fistula, Hysteroscopy. Use in Obstetrics: For inspection ( Bluish discoloration in early pregnancy, local cause for threatened abortion, local cause in APH), First trimester MTP by suction curettage . In second trimester MTP by EthacredylLactate. Osthighteningor cervical encircalage, Removal of osthighteningstitch at the onset of laboror at 38 wks. Inspection for suspected rupture of membranes. After forceps delivery to trace for cervical tears. 
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Cuscosbivlavedself retaining speculum 
•Retract anterior & posterior walls of cervix 
•Disdv 
•Obscures vaginal walls so lesion may be missed 
•Insert /remove IUD 
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Retractor 
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Doyens’ retractor 
•Nontraumaticblunt 
•Depress bladder in CS 
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Doyens retractor 
•This instrument is used for retracting bladder during abdominal operations like LSCS , abdominal hysterectomy , laparotomy. 
•The smooth edge and the curvature retracts the bladder and protects it during surgery 
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Kellys retractor 
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Abdominal wall retractor self retaining 
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Forceps 
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Artery forceps 
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Artery forceps 
•This is a hemostat. Used for clamping bleeding vessels. It is also used for grasping tissue at the time of operation. ( Opening and closing peritoneum) . It is also used to hold stay sutures. It comes in two shapes straight and curved. 
•Usually straight is used for rough work like stay and curved is used as hemostat. 
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Mosquito 
Small artery forceps 
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Needle Holder 
•This instrument is used for grasping needle at the time of suturing. The inner surface of tip has crisscross serrationsand a small grove for firm grasp of the curved needle. 
•The box joint is placed very close to tipto give adequate pressure because of the lever effect. 
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Volsellum forceps 
•To hold 
•anterior lip of Cx 
•posterior lip of Cx 
•Cervical stump in subtotal hysterectomy 
Its a long instrument with gentle curve so that the line of vision is not obstructed. The tip of the blades have 3-4 teeth 
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•Insertion of IUCD , CxBiopsy D&C, First trimester MTP with Suction Evacuation. CxBiopsy , Fothergillsoperation, Vaginal Hysterectomy Posterior lip of the cervix is grasped for post. colpotomy. 
•Since the teeth are sharp it is not used in pregnancy as it may cause cervical tares and lacerations. Instead sponge holding forceps is used to grasp the cervix 
tony 2010 mbbs 18
Allis tissue forceps 
•Interlocking teeth catch and lock 
•To hold 
•peritoneum rectus sheath 
•Anterior lip of Cx 
•Traumatic arrest hge 
Sterilization: By Autoclaving 
This instrument is used for grasping tough structures like Rectus sheath or fascia in operations like tubectomy,LSCS 
,abdominal hysterectomy. tony 2010 mbbs 19
Tenaculum forceps 
•Long with single tooth at tip 
•Catch present 
•Major gynaecprocedures like abdominal hysterectomy 
•Catch hold of vault/cervix 
•Traumatic hold fimstructures like cervix 
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Babcock's Forceps 
The tip is atraumatic as there are no sharp tooth 
This instrument is used for grasping tubular structures like fallopian tube in tubectomyin modified Pomeroy's operation , 
ureter ,appendix etc. 
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Sponge holding forceps 
•Hold the pregnant uterus (less traumatic than volsellumforceps ) 
•In traumatic PPH 
•(walking around cervix) 
•atleast3 sponge ( one at 12 0 clock position & other to look for trauma) holding forceps to visualize Cx 
•Cleaning & draping in surgical procedures 
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Green ArmytageForceps 
This forceps is used as a hemostatin caesarean operation. As the tips are broad wide area can be 
compressed. 
In LSCS the cut uterine edges bleed . This forceps is applied to the two angles and lower and upper edge of 
the incision. 
The common indications for LSCS are fetaldistress in first stage, CPD , abnormal presentations like 
transverse lie , brow , breech in primi,previous two scars on the uterus. tony 2010 mbbs 23
Kocher's Forceps ( Clamp) 
The tips of the blades have teeth so that the tissue does not slip 
This instrument is used for holding pedicles in hysterectomy. 
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 cordnewborn at the time of delivery or for artificial low rupture of membranes ( ARM). 
tony 2010 mbbs 24
Ovum Holding Forceps 
removing the products of conception in inevitable , incomplete abortion and in MTP operations. 
No catch 
The tip of this instrument is rounded cup like to avoid perforation and to hold large tissue. This instrument has no catch . This is to 
avoid perforation of wall. 
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Dissecting forceps non toothed 
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myoma screw 
•To hold the fundus of uterus in myomectomy & hysterectomy 
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Towel clip 
•Hold towels 
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Leech Wilkinson cannula 
•Hydrotubationfor tubal patency 
•It is straight instrument with conical tip. This cone is screwed into the cervix. Then dye is injected 
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Scissors 
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Mayo scissors 
Straight mayo scissors 
Curved mayo scissors 
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Episiotomy Scissors. 
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catheter 
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Malecots catheter 
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Foleys catheter 
•Continousbladder drainageafter surgery 
•Abdominal , Vaginal Hysterectomy , Wertheim's Hysterectomy, Repair of Vesicovaginal fistula. 
•Atonic bladder 
•EASI 
•second trimester MTP for extra amniotic instillation of ethacredyllactate . 
•sono salpingography 
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Metal catheter 
•Intermittent drainage as in vaginal hysterectomy 
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D&C 
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Uterine sound 
Its a long instrument with blunt tip ( To avoid perforation) About 5 cmsfrom the tip its bend to make angle of 30 degrees. 
It has marking on it for measurements. ( Bladder sound has no markings ) 
The angle helps to negotiate curvature of the uterus (Anteflexion). It is used for measuring uterocervicallength , length of thcervix(for diagnosing supra vaginal elongation of the cervix). To feel for any pathology inside the cavity like fibroid ( Sub mpolyp) Congenital anomalies like septa or bicornuateut. Adhesions or synachae. To feel for the misplaced IUCD. 
It can create false passage or perforation especially in soft uterus in pregnancy. 
tony 2010 mbbs 38
Uterine Curette 
Blunt endobstetric 
Sharp gynaec 
Use for scraping endometrial cavity to obtain sample for histopathology. 
Diagnostic D&C is done commonly for Menorrhagia, Endometrial Carcinoma, Infertility ,Tuberculosis of endometrium . 
It also has secondary beneficial advantage of reducing the bleeding in menorrhagia. 
tony 2010 mbbs 39
Hegar'sDilator 
Dilate cervix 
long rod like instrument with gentle curve and tapering tip. 
It is used for dilatation of the cervix in procedures like 
D&C , D& E , Fothergillsoperation , Hysteroscopy , Cervical Stenosis , Primary dysmenorrhoea. 
The dilators are numberdas per outer diameter ( No 8 means outer diameter of 8 mm) For D&C dilation up to 8 is 
Done For MTP dilatation up to 12 may be required. Very large dilatation can cause cervical incompetenceperforation tony 2010 mbbs 40
Mathew duncansdilator 
tony 2010 mbbs 41
Papsmear 
tony 2010 mbbs 42
Cevixsampling devices 
tony 2010 mbbs 43
Ayre's Spatula 
•Made of wood so that cells can adhere to its porous surface. 
•Use for taking Pap Smearfor screening of carcinoma cervix. 
•The long end is inserted into cervical canal and rotated in 360 degrees. 
•The exfoliated cells obtained are smeared on glass slide and fixed in Koplicksjar which contains ether and alcohol in equal amount. or by hair spray. 
•The other broad end is used for obtaining cells from lateral vagina for knowing the hormonal status & buccal smear 
tony 2010 mbbs 44
Cervical brush 
Pap smear 
tony 2010 mbbs 45
Family planning 
tony 2010 mbbs 46
Copper t 
•380 A (380SAof copper)}commonly used 
tony 2010 mbbs 47
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tony 2010 mbbs 53
Female condom 
tony 2010 mbbs 54
Male condom 
tony 2010 mbbs 55
Balloon tamponadewith condoms for PPH 
tony 2010 mbbs 56
Karman cannula- plastic 
It is of different sizes and the approximate size required for a 
particular case equals to the weeks of pregnancy to be terminated 
The plastic cannula has got advantages over a metallic one- 
as it causes less damage to the uterine wall and the products 
sucked out can be visible. The vacuum must be broken before 
withdrawal 
tony 2010 mbbs 57
Karman cannula -Metallic 
Suction evacuation 
MTP 
To remove products of conception 
Missed abortion 
tony 2010 mbbs 58
tony 2010 mbbs 59
Karman's Syringe ( Menstrual Regulation) 
Menstrual Regulation and endometrial aspiration. 
The capacity is 50 ml. The tip has a rubber 
attachment with valve. 
tony 2010 mbbs 60
tony 2010 mbbs 61
Laparoscopy 
tony 2010 mbbs 62
Trocar and cannula 
Used for Laparoscopy 
Trocar is put in to the cannula and then inserted into abdominal cavity for laparoscopy. It is also called port ( port of entry to telescope and other instruments.) It is numbered as per outer diameter. 10 mm is used for operative telescope, 7 mm is used for Band Applicator for Tubal Ligation, 5mm is used for other hand instruments like grasper etc. A Reducer sleeve is available to use large size port for small instrument. It has a trumpet valve to prevent gas leak. On one side there is opening for connecting it to gas ( CO2 or Air) 
tony 2010 mbbs 63
Varies Needle 
•putting Air or CO2 in the peritoneal cavity) for laparoscopy.. 
tony 2010 mbbs 64
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Operative vaginal delivery 
tony 2010 mbbs 67
VaccumExtractor(Ventouse). 
tony 2010 mbbs 68
Cup for vacuum extraction 
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Wrigley's outlet Forceps 
tony 2010 mbbs 73
•Obstetric forceps for out let forceps delivery. It has pelvic curve. Parts of the forceps are blades ( which has windows or fenestrate 
•for firm grip of the head) ,Shank , Lock( English lock for Wriglysforceps) , Handle. 
•Simson's Short forceps is straight forceps with only cephalic curve and no pelvic curve. 
•Some of the Pre requisite for forceps application : Dilatation of the cervix must be full (10cm) Station of Vertex at plus 2 or plus 3 (for outlet forceps),membranes should be ruptured , pelvis must be adequate. Uterine contractions must be good. Rotation of vertex near complete. Local anesthesiaand episiotomy must be given. 
tony 2010 mbbs 74
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others 
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Pinard'sFetalStethoscope. 
auscultation of fetalheart. 
tony 2010 mbbs 77
Umbilical cord clamp 
tony 2010 mbbs 78

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instruments ostetrics and gynaecology ppt

  • 1. Instruments O&G tony 2010 mbbs 1
  • 3. Sims bivalvedspeculum •2 blades & handle •Adv •retracts posterior vaginal wall •The groove in the centeralso drains the secretion or bleeding thus keeping the area dry •Disadv •Not self retaining (need an assistant to hold speculum ) •Enter laterally •PGE1 introduction •Uterine prolapse •FC,D&C,cervicalpunch bipsy •Pap smear •Push bladder in VH tony 2010 mbbs 3
  • 4. Uses •Use in GynaeOPD for following procedures: Taking Pap Smear , Insertion and removal of Copper T , Colposcopy ,Taking swabs, Hyseterosalpingography(HSG) Use in GynaeOperations:D&C , Cervix Biopsy , Vaginal Hysterectomy , FothergillsOperation, Repair of Vesicovaginal fistula, Hysteroscopy. Use in Obstetrics: For inspection ( Bluish discoloration in early pregnancy, local cause for threatened abortion, local cause in APH), First trimester MTP by suction curettage . In second trimester MTP by EthacredylLactate. Osthighteningor cervical encircalage, Removal of osthighteningstitch at the onset of laboror at 38 wks. Inspection for suspected rupture of membranes. After forceps delivery to trace for cervical tears. tony 2010 mbbs 4
  • 5. Cuscosbivlavedself retaining speculum •Retract anterior & posterior walls of cervix •Disdv •Obscures vaginal walls so lesion may be missed •Insert /remove IUD tony 2010 mbbs 5
  • 7. Doyens’ retractor •Nontraumaticblunt •Depress bladder in CS tony 2010 mbbs 7
  • 8. Doyens retractor •This instrument is used for retracting bladder during abdominal operations like LSCS , abdominal hysterectomy , laparotomy. •The smooth edge and the curvature retracts the bladder and protects it during surgery tony 2010 mbbs 8
  • 9. Kellys retractor tony 2010 mbbs 9
  • 10. Abdominal wall retractor self retaining tony 2010 mbbs 10
  • 11. Forceps tony 2010 mbbs 11
  • 12. Artery forceps tony 2010 mbbs 12
  • 13. Artery forceps •This is a hemostat. Used for clamping bleeding vessels. It is also used for grasping tissue at the time of operation. ( Opening and closing peritoneum) . It is also used to hold stay sutures. It comes in two shapes straight and curved. •Usually straight is used for rough work like stay and curved is used as hemostat. tony 2010 mbbs 13
  • 15. Mosquito Small artery forceps tony 2010 mbbs 15
  • 16. Needle Holder •This instrument is used for grasping needle at the time of suturing. The inner surface of tip has crisscross serrationsand a small grove for firm grasp of the curved needle. •The box joint is placed very close to tipto give adequate pressure because of the lever effect. tony 2010 mbbs 16
  • 17. Volsellum forceps •To hold •anterior lip of Cx •posterior lip of Cx •Cervical stump in subtotal hysterectomy Its a long instrument with gentle curve so that the line of vision is not obstructed. The tip of the blades have 3-4 teeth tony 2010 mbbs 17
  • 18. •Insertion of IUCD , CxBiopsy D&C, First trimester MTP with Suction Evacuation. CxBiopsy , Fothergillsoperation, Vaginal Hysterectomy Posterior lip of the cervix is grasped for post. colpotomy. •Since the teeth are sharp it is not used in pregnancy as it may cause cervical tares and lacerations. Instead sponge holding forceps is used to grasp the cervix tony 2010 mbbs 18
  • 19. Allis tissue forceps •Interlocking teeth catch and lock •To hold •peritoneum rectus sheath •Anterior lip of Cx •Traumatic arrest hge Sterilization: By Autoclaving This instrument is used for grasping tough structures like Rectus sheath or fascia in operations like tubectomy,LSCS ,abdominal hysterectomy. tony 2010 mbbs 19
  • 20. Tenaculum forceps •Long with single tooth at tip •Catch present •Major gynaecprocedures like abdominal hysterectomy •Catch hold of vault/cervix •Traumatic hold fimstructures like cervix tony 2010 mbbs 20
  • 21. Babcock's Forceps The tip is atraumatic as there are no sharp tooth This instrument is used for grasping tubular structures like fallopian tube in tubectomyin modified Pomeroy's operation , ureter ,appendix etc. tony 2010 mbbs 21
  • 22. Sponge holding forceps •Hold the pregnant uterus (less traumatic than volsellumforceps ) •In traumatic PPH •(walking around cervix) •atleast3 sponge ( one at 12 0 clock position & other to look for trauma) holding forceps to visualize Cx •Cleaning & draping in surgical procedures tony 2010 mbbs 22
  • 23. Green ArmytageForceps This forceps is used as a hemostatin caesarean operation. As the tips are broad wide area can be compressed. In LSCS the cut uterine edges bleed . This forceps is applied to the two angles and lower and upper edge of the incision. The common indications for LSCS are fetaldistress in first stage, CPD , abnormal presentations like transverse lie , brow , breech in primi,previous two scars on the uterus. tony 2010 mbbs 23
  • 24. Kocher's Forceps ( Clamp) The tips of the blades have teeth so that the tissue does not slip This instrument is used for holding pedicles in hysterectomy. 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 cordnewborn at the time of delivery or for artificial low rupture of membranes ( ARM). tony 2010 mbbs 24
  • 25. Ovum Holding Forceps removing the products of conception in inevitable , incomplete abortion and in MTP operations. No catch The tip of this instrument is rounded cup like to avoid perforation and to hold large tissue. This instrument has no catch . This is to avoid perforation of wall. tony 2010 mbbs 25
  • 26. Dissecting forceps non toothed tony 2010 mbbs 26
  • 27. myoma screw •To hold the fundus of uterus in myomectomy & hysterectomy tony 2010 mbbs 27
  • 28. Towel clip •Hold towels tony 2010 mbbs 28
  • 29. Leech Wilkinson cannula •Hydrotubationfor tubal patency •It is straight instrument with conical tip. This cone is screwed into the cervix. Then dye is injected tony 2010 mbbs 29
  • 31. Mayo scissors Straight mayo scissors Curved mayo scissors tony 2010 mbbs 31
  • 34. Malecots catheter tony 2010 mbbs 34
  • 35. Foleys catheter •Continousbladder drainageafter surgery •Abdominal , Vaginal Hysterectomy , Wertheim's Hysterectomy, Repair of Vesicovaginal fistula. •Atonic bladder •EASI •second trimester MTP for extra amniotic instillation of ethacredyllactate . •sono salpingography tony 2010 mbbs 35
  • 36. Metal catheter •Intermittent drainage as in vaginal hysterectomy tony 2010 mbbs 36
  • 37. D&C tony 2010 mbbs 37
  • 38. Uterine sound Its a long instrument with blunt tip ( To avoid perforation) About 5 cmsfrom the tip its bend to make angle of 30 degrees. It has marking on it for measurements. ( Bladder sound has no markings ) The angle helps to negotiate curvature of the uterus (Anteflexion). It is used for measuring uterocervicallength , length of thcervix(for diagnosing supra vaginal elongation of the cervix). To feel for any pathology inside the cavity like fibroid ( Sub mpolyp) Congenital anomalies like septa or bicornuateut. Adhesions or synachae. To feel for the misplaced IUCD. It can create false passage or perforation especially in soft uterus in pregnancy. tony 2010 mbbs 38
  • 39. Uterine Curette Blunt endobstetric Sharp gynaec Use for scraping endometrial cavity to obtain sample for histopathology. Diagnostic D&C is done commonly for Menorrhagia, Endometrial Carcinoma, Infertility ,Tuberculosis of endometrium . It also has secondary beneficial advantage of reducing the bleeding in menorrhagia. tony 2010 mbbs 39
  • 40. Hegar'sDilator Dilate cervix long rod like instrument with gentle curve and tapering tip. It is used for dilatation of the cervix in procedures like D&C , D& E , Fothergillsoperation , Hysteroscopy , Cervical Stenosis , Primary dysmenorrhoea. The dilators are numberdas per outer diameter ( No 8 means outer diameter of 8 mm) For D&C dilation up to 8 is Done For MTP dilatation up to 12 may be required. Very large dilatation can cause cervical incompetenceperforation tony 2010 mbbs 40
  • 44. Ayre's Spatula •Made of wood so that cells can adhere to its porous surface. •Use for taking Pap Smearfor screening of carcinoma cervix. •The long end is inserted into cervical canal and rotated in 360 degrees. •The exfoliated cells obtained are smeared on glass slide and fixed in Koplicksjar which contains ether and alcohol in equal amount. or by hair spray. •The other broad end is used for obtaining cells from lateral vagina for knowing the hormonal status & buccal smear tony 2010 mbbs 44
  • 45. Cervical brush Pap smear tony 2010 mbbs 45
  • 46. Family planning tony 2010 mbbs 46
  • 47. Copper t •380 A (380SAof copper)}commonly used tony 2010 mbbs 47
  • 54. Female condom tony 2010 mbbs 54
  • 55. Male condom tony 2010 mbbs 55
  • 56. Balloon tamponadewith condoms for PPH tony 2010 mbbs 56
  • 57. Karman cannula- plastic It is of different sizes and the approximate size required for a particular case equals to the weeks of pregnancy to be terminated The plastic cannula has got advantages over a metallic one- as it causes less damage to the uterine wall and the products sucked out can be visible. The vacuum must be broken before withdrawal tony 2010 mbbs 57
  • 58. Karman cannula -Metallic Suction evacuation MTP To remove products of conception Missed abortion tony 2010 mbbs 58
  • 60. Karman's Syringe ( Menstrual Regulation) Menstrual Regulation and endometrial aspiration. The capacity is 50 ml. The tip has a rubber attachment with valve. tony 2010 mbbs 60
  • 63. Trocar and cannula Used for Laparoscopy Trocar is put in to the cannula and then inserted into abdominal cavity for laparoscopy. It is also called port ( port of entry to telescope and other instruments.) It is numbered as per outer diameter. 10 mm is used for operative telescope, 7 mm is used for Band Applicator for Tubal Ligation, 5mm is used for other hand instruments like grasper etc. A Reducer sleeve is available to use large size port for small instrument. It has a trumpet valve to prevent gas leak. On one side there is opening for connecting it to gas ( CO2 or Air) tony 2010 mbbs 63
  • 64. Varies Needle •putting Air or CO2 in the peritoneal cavity) for laparoscopy.. tony 2010 mbbs 64
  • 67. Operative vaginal delivery tony 2010 mbbs 67
  • 69. Cup for vacuum extraction tony 2010 mbbs 69
  • 73. Wrigley's outlet Forceps tony 2010 mbbs 73
  • 74. •Obstetric forceps for out let forceps delivery. It has pelvic curve. Parts of the forceps are blades ( which has windows or fenestrate •for firm grip of the head) ,Shank , Lock( English lock for Wriglysforceps) , Handle. •Simson's Short forceps is straight forceps with only cephalic curve and no pelvic curve. •Some of the Pre requisite for forceps application : Dilatation of the cervix must be full (10cm) Station of Vertex at plus 2 or plus 3 (for outlet forceps),membranes should be ruptured , pelvis must be adequate. Uterine contractions must be good. Rotation of vertex near complete. Local anesthesiaand episiotomy must be given. tony 2010 mbbs 74
  • 76. others tony 2010 mbbs 76
  • 77. Pinard'sFetalStethoscope. auscultation of fetalheart. tony 2010 mbbs 77
  • 78. Umbilical cord clamp tony 2010 mbbs 78