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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 th...
Uses 
•Use in GynaeOPD for following procedures: Taking Pap Smear , Insertion and removal of Copper T , Colposcopy ,Taking...
Cuscosbivlavedself retaining speculum 
•Retract anterior & posterior walls of cervix 
•Disdv 
•Obscures vaginal walls so l...
Retractor 
tony 2010 mbbs 6
Doyens’ retractor 
•Nontraumaticblunt 
•Depress bladder in CS 
tony 2010 mbbs 7
Doyens retractor 
•This instrument is used for retracting bladder during abdominal operations like LSCS , abdominal hyster...
Kellys retractor 
tony 2010 mbbs 9
Abdominal wall retractor self retaining 
tony 2010 mbbs 10
Forceps 
tony 2010 mbbs 11
Artery forceps 
tony 2010 mbbs 12
Artery forceps 
•This is a hemostat. Used for clamping bleeding vessels. It is also used for grasping tissue at the time o...
tony 2010 mbbs 14
Mosquito 
Small artery forceps 
tony 2010 mbbs 15
Needle Holder 
•This instrument is used for grasping needle at the time of suturing. The inner surface of tip has crisscro...
Volsellum forceps 
•To hold 
•anterior lip of Cx 
•posterior lip of Cx 
•Cervical stump in subtotal hysterectomy 
Its a lo...
•Insertion of IUCD , CxBiopsy D&C, First trimester MTP with Suction Evacuation. CxBiopsy , Fothergillsoperation, Vaginal H...
Allis tissue forceps 
•Interlocking teeth catch and lock 
•To hold 
•peritoneum rectus sheath 
•Anterior lip of Cx 
•Traum...
Tenaculum forceps 
•Long with single tooth at tip 
•Catch present 
•Major gynaecprocedures like abdominal hysterectomy 
•C...
Babcock's Forceps 
The tip is atraumatic as there are no sharp tooth 
This instrument is used for grasping tubular structu...
Sponge holding forceps 
•Hold the pregnant uterus (less traumatic than volsellumforceps ) 
•In traumatic PPH 
•(walking ar...
Green ArmytageForceps 
This forceps is used as a hemostatin caesarean operation. As the tips are broad wide area can be 
c...
Kocher's Forceps ( Clamp) 
The tips of the blades have teeth so that the tissue does not slip 
This instrument is used for...
Ovum Holding Forceps 
removing the products of conception in inevitable , incomplete abortion and in MTP operations. 
No c...
Dissecting forceps non toothed 
tony 2010 mbbs 26
myoma screw 
•To hold the fundus of uterus in myomectomy & hysterectomy 
tony 2010 mbbs 27
Towel clip 
•Hold towels 
tony 2010 mbbs 28
Leech Wilkinson cannula 
•Hydrotubationfor tubal patency 
•It is straight instrument with conical tip. This cone is screwe...
Scissors 
tony 2010 mbbs 30
Mayo scissors 
Straight mayo scissors 
Curved mayo scissors 
tony 2010 mbbs 31
Episiotomy Scissors. 
tony 2010 mbbs 32
catheter 
tony 2010 mbbs 33
Malecots catheter 
tony 2010 mbbs 34
Foleys catheter 
•Continousbladder drainageafter surgery 
•Abdominal , Vaginal Hysterectomy , Wertheim's Hysterectomy, Rep...
Metal catheter 
•Intermittent drainage as in vaginal hysterectomy 
tony 2010 mbbs 36
D&C 
tony 2010 mbbs 37
Uterine sound 
Its a long instrument with blunt tip ( To avoid perforation) About 5 cmsfrom the tip its bend to make angle...
Uterine Curette 
Blunt endobstetric 
Sharp gynaec 
Use for scraping endometrial cavity to obtain sample for histopatholo...
Hegar'sDilator 
Dilate cervix 
long rod like instrument with gentle curve and tapering tip. 
It is used for dilatation of ...
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 c...
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
tony 2010 mbbs 48
tony 2010 mbbs 49
tony 2010 mbbs 50
tony 2010 mbbs 51
tony 2010 mbbs 52
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 w...
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...
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 lapa...
Varies Needle 
•putting Air or CO2 in the peritoneal cavity) for laparoscopy.. 
tony 2010 mbbs 64
tony 2010 mbbs 65
tony 2010 mbbs 66
Operative vaginal delivery 
tony 2010 mbbs 67
VaccumExtractor(Ventouse). 
tony 2010 mbbs 68
Cup for vacuum extraction 
tony 2010 mbbs 69
tony 2010 mbbs 70
tony 2010 mbbs 71
tony 2010 mbbs 72
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 ...
tony 2010 mbbs 75
others 
tony 2010 mbbs 76
Pinard'sFetalStethoscope. 
auscultation of fetalheart. 
tony 2010 mbbs 77
Umbilical cord clamp 
tony 2010 mbbs 78
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Instruments obstetrics & gnaecology ppt pap smear ayres spatula cervical brush D&C uterine sound cervical dilators,abdominal wall retractor self retaining family planning devices cut 380 method condoms balloon tamponade doyens retractor green armytage forceps

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instruments ostetrics and gynaecology ppt

  1. 1. Instruments O&G tony 2010 mbbs 1
  2. 2. Specula tony 2010 mbbs 2
  3. 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. 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. 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
  6. 6. Retractor tony 2010 mbbs 6
  7. 7. Doyens’ retractor •Nontraumaticblunt •Depress bladder in CS tony 2010 mbbs 7
  8. 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. 9. Kellys retractor tony 2010 mbbs 9
  10. 10. Abdominal wall retractor self retaining tony 2010 mbbs 10
  11. 11. Forceps tony 2010 mbbs 11
  12. 12. Artery forceps tony 2010 mbbs 12
  13. 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
  14. 14. tony 2010 mbbs 14
  15. 15. Mosquito Small artery forceps tony 2010 mbbs 15
  16. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 26. Dissecting forceps non toothed tony 2010 mbbs 26
  27. 27. myoma screw •To hold the fundus of uterus in myomectomy & hysterectomy tony 2010 mbbs 27
  28. 28. Towel clip •Hold towels tony 2010 mbbs 28
  29. 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
  30. 30. Scissors tony 2010 mbbs 30
  31. 31. Mayo scissors Straight mayo scissors Curved mayo scissors tony 2010 mbbs 31
  32. 32. Episiotomy Scissors. tony 2010 mbbs 32
  33. 33. catheter tony 2010 mbbs 33
  34. 34. Malecots catheter tony 2010 mbbs 34
  35. 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. 36. Metal catheter •Intermittent drainage as in vaginal hysterectomy tony 2010 mbbs 36
  37. 37. D&C tony 2010 mbbs 37
  38. 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. 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. 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
  41. 41. Mathew duncansdilator tony 2010 mbbs 41
  42. 42. Papsmear tony 2010 mbbs 42
  43. 43. Cevixsampling devices tony 2010 mbbs 43
  44. 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. 45. Cervical brush Pap smear tony 2010 mbbs 45
  46. 46. Family planning tony 2010 mbbs 46
  47. 47. Copper t •380 A (380SAof copper)}commonly used tony 2010 mbbs 47
  48. 48. tony 2010 mbbs 48
  49. 49. tony 2010 mbbs 49
  50. 50. tony 2010 mbbs 50
  51. 51. tony 2010 mbbs 51
  52. 52. tony 2010 mbbs 52
  53. 53. tony 2010 mbbs 53
  54. 54. Female condom tony 2010 mbbs 54
  55. 55. Male condom tony 2010 mbbs 55
  56. 56. Balloon tamponadewith condoms for PPH tony 2010 mbbs 56
  57. 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. 58. Karman cannula -Metallic Suction evacuation MTP To remove products of conception Missed abortion tony 2010 mbbs 58
  59. 59. tony 2010 mbbs 59
  60. 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
  61. 61. tony 2010 mbbs 61
  62. 62. Laparoscopy tony 2010 mbbs 62
  63. 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. 64. Varies Needle •putting Air or CO2 in the peritoneal cavity) for laparoscopy.. tony 2010 mbbs 64
  65. 65. tony 2010 mbbs 65
  66. 66. tony 2010 mbbs 66
  67. 67. Operative vaginal delivery tony 2010 mbbs 67
  68. 68. VaccumExtractor(Ventouse). tony 2010 mbbs 68
  69. 69. Cup for vacuum extraction tony 2010 mbbs 69
  70. 70. tony 2010 mbbs 70
  71. 71. tony 2010 mbbs 71
  72. 72. tony 2010 mbbs 72
  73. 73. Wrigley's outlet Forceps tony 2010 mbbs 73
  74. 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
  75. 75. tony 2010 mbbs 75
  76. 76. others tony 2010 mbbs 76
  77. 77. Pinard'sFetalStethoscope. auscultation of fetalheart. tony 2010 mbbs 77
  78. 78. Umbilical cord clamp tony 2010 mbbs 78
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Instruments obstetrics & gnaecology ppt pap smear ayres spatula cervical brush D&C uterine sound cervical dilators,abdominal wall retractor self retaining family planning devices cut 380 method condoms balloon tamponade doyens retractor green armytage forceps

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