Instruments

Multiple Toothed
Valsellum
Uses & Indications
This instrument is used for grasping the
cervix
The tip of the blades have 3-4 teeth to
hold & steady the cervix in procedures
like Insertion of IUCD, Cx Biopsy, D&C,
Fothergills operation, 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
Single Toothed
Valsellum
Uses & Indications
To hold the cervix after opening the
vault of vagina and to give traction while
the remaining vault is being cut in total
abdominal hysterectomy
To hold new cervical stump after
amputation of the cervix and
fothrergill's operation
To hold the cervical stumps left after
subtotal hysterectomy
Sometimes to hold anterior lips of
multiparous cervix in operation of D+C
 Sponge Holder
Uses & Indications
This instrument is used for holding
sponge or a gauze piece for painting the
area before operation.
This also used for grasping the cervix is
obstetrics in Os tightening operation.
Second trimester MTP ( to hold the
cervix before insertion of Foleys
catheter).
In exploring cervix after forceps delivery
(three sponge holding forceps are
used).
Ovum Holding Forceps
Uses & Indications
This instrument is used for removing
the products of conception in
inevitable , incomplete abortion and in
MTP operations.
The tip of this instrument is rounded
cup like to avoid perforation and to
hold large tissue.
 Artery Forceps
Uses & Indications
It can be used as a hemostat used for
clamping bleeding vessels during
haemorrhage.
It is also used for grasping tissue at
the time of operation(Opening and
closing peritoneum)
It is also used to hold stay sutures.
 Allis’ Forceps
Uses & Indications
This instrument is used for grasping
tough structures like Rectus sheath
or fascia in operations like tubectomy,
LSCS (lower segment caesarean
section), abdominal hysterectomy.
 Babcock’s Forcep
Uses & Indications
This instrument is used for grasping
tubular structures like fallopian tube
in tubectomy in modified Pomeroy's
operation, ureter ,appendix etc.
The tip is atraumatic as there are no
sharp tooth.
Punch Biopsy Forceps
Uses & Indications
To take biopsy from the cervix
The biopsy is taken as an outdoor
procedure without anaesthesia
The site of biopsy is either from the
suspected area or schiller's iodine or
colposcopy directed
Green Armytage
Forceps
Uses & Indications
This forceps is used as a haemostat in
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.
 Ayre’s Spatula
Uses & Indications
Is Used for taking Pap Smear for
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 Koplicks jar
which contains ether and alcohol in
equal amount.
The other broad end is used for
obtaining cells from lateral vagina for
knowing the hormonal status.
 Cusco’s Spetulum
Uses & Indications
AKA Duck’s Spetulum
Self retaining double bladed vaginal
speculum.
Used in OPD for routine examination.
Because of limited opening only few
procedures like taking of Pap smear ,
insertion and removal of Copper T can
be done.
 Doyen’s Retractor
Uses & Indications
This instrument is used for retracting
bladder during abdominal operations
like LSCS, abdominal hysterectomy,
laparotomy.
 Metal Catheter
Uses & Indications
To empty the bladder prior to major
vaginal operations
It minimizes the injury to the bladder
To confirm the diagnosis of Gartner's
cyst from cystocele
It is not used in obstetrics to avoid
trauma
Hagar’s Dilator Hawlin Ambler Dilator
Uses & Indications
Its a 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, Hysteroscopy, Cervical Stenosis , Primary dysmenorrhoea.
It can cause perforation if too much force is used. Very large
dilatation can cause cervical incompetence.
 Purandare’s Dilator
Uses & Indications
This cervical dilator has a guard and
long tapering end.
The guard helps in preventing
insertion beyond that length and
protect against perforation.
Numbers (2,3,4,5) represent diameter
in mm from the tip to the guard.
Sim’s Anterior Vaginal
Wall Retractor
Uses & Indications
This instrument is used with Sim's
Speculum. Its a long instrument with
blunt loops at both the ends making
an angle for easy visualization of
cervix and vagina, especially useful in
case of cystocele.
 Sim’s Speculum
Uses & Indications
Sims Speculum is used for inspection
of vagina and cervix in the OPD. It
retracts posterior vaginal wall.
For complete visualization anterior
vaginal wall retractor must be used.
Used in Gynae OPD: Taking Pap Smear,
Insertion and removal of Copper T,
Colposcopy ,Taking swabs
Use in Gynae Operations : D&C, Cervix
Biopsy, Vaginal Hysterectomy, Repair of
Vesicovaginal fistula, Hysteroscopy.
 Sim’s Speculum
Uses & Indications
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 Ethacredyl Lactate. Os thightening or cervical
encircalage , Removal of os thightening stitch at the onset of labor or at 38 wks.
Inspection for suspected rupture of membranes.
After forceps delivery to trace for cervical tears.
Advantage : Wide area for inspection. Instrumentation is easy
Disadvantage : Needs assistant (Not self retaining), Must bring pt to edge of the
table
Uterine Curette Sharman’s Curette
Uses & Indications
Use for scraping endometrial cavity to obtain sample for
histopathology.
The tip is angled by about 15 degrees for easy scraping.
The tip comes in two shapes. Sharp and Blunt.
Sharp curate is used in gynecology and blunt in pregnancy check
curettage.
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.
Pinard’s Foetal
Stethoscope
Uses & Indications
This is used for auscultation of fetal
heart. The tapering rim is applied to ear
and the other side to mothers
abdomen.
With other instruments available for
auscultation of fetal heart, this is now
rarely used.