INSTRUMENTS IN OBSTETRICS
AND GYNAECOLOGY
Foley’s Catheter
• USES
• Continuous bladder drainage in
cases with
• Eclampsia
• Postoperatively or in case of
suspected bladder injury
• Management of Atonic PPH
• It is inserted into the uterine cavity
and the catheter balloon is inflated
with normal saline to provide
tamponade
Metal Catheter
• Intermittent drainage in vaginal
hysterectomy
Sims’ Double Bladed Posterior Vaginal
Speculum Blades of unequal breadth to
facilitate introduction into the
vagina
• Narrow blade in nulliparous and
wider blade in parous women
• Retracts posterior wall
USES
• Inspect the cervix and vagina for
any injury after delivery
• Dilatation and evacuation
• Insertion and removal of IUCD
Cusco’s Bivalve Self Retaining Vaginal
Speculum • Self retaining speculum
• Retracts anterior and posterior wall
Uses
• To visualize the cervix and vaginal
fornices for any local causes of APH
• To inspect the cervix and prepare
cervical smear for cytology screening
• To detect leakage of liquor from the
cervical os in suspected PROM
Multiple Toothed Vulsellum
• Used to catch hold of the anterior lip of
the cervix in
• Dilatation and Evacuation
• Suction Evacuation
• Cervical biopsy
• Insertion of IUCD
• Not used in pregnancy as it can cause
trauma to soft and vascular cervix
ALLIS TISSUE FORCEPS
• To grasp tough structures like rectus sheath
or fascia
USES
• To catch hold of the margins of the
peritoneum, rectus sheath, vaginal mucosa
during repair
• To hold the torn ends of sphincter ani externus
prior to suture in repair of complete perineal
tear
• In LSCS , to hold the margins and angles of the
uterine flaps
Mosquito Artery Forceps
• Haemostat to secure and clamp
bleeding vessels
Artery Forceps
• Can be straight or curved
• Uses
• Hemostat used for clamping bleeding
vessels
• Grasping tissues like peritoneum during
surgery
• Hold stay sutures
• Usually straight is used for stay sutures
and curved as haemostat.
Kocher’s Hemostatic Forceps
Uses
• For artificial rupture of membranes in
induction or augmentation of labour
• To clamp the umbilical cord
• Clamp pedicles in hysterectomy
• Salpingectomy in ectopic or oophorectomy
in ovarian mass
Sponge Holding Forceps
• To clean and drape before surgery
• Hold the pregnant uterus
• In traumatic PPH ( walking around the
cervix)
• Toileting the vulva, vagina and perineum
prior to and following delivery
• To catch hold of the cervix during
encirclage operation
OVUM FORCEPS
• Tip is rounded and cup like to avoid
perforation and hold large tissues
• Uses
• Remove products of conception in
inevitable,incomplete abortion and
MTP.
Babcock’s Forceps
• Atraumatic tip
• Uses
• To grasp tubular structures like
fallopian tube in tubectomy , ureter ,
appendix etc
Green Armytage Forceps
• Uses
• In Lower Segment Caesarian Section
• For hemostasis and to catch hold of the
margins
Needle holder
• Used for holding needle while suturing
• Inner surface of the tip has criss cross
serrations and a small groove for firm
grasp of the curved needle
MYOMA SCREW
• To hold the fundus of the uterus during
myomectomy
Episiotomy scissor
• For episiotomy
• Blade with the blunt tip goes inside
the vagina
Long Straight Scissors
• Straight scissors are used
for cutting sutures and ligatures
or trimming the skin around the
wound, hence it is also known
as 'suture scissors'.
• The curve blades are ideal to
cut tough tissue like fascia,
tendons and ligaments
Uterine Sound • Long instrument with a blunt end to avoid
perforation
• About 5cm from its tip it is bend to make
an angle of 30 degrees.
• Has markings on it for measurement
USES
• To measure uterocervical length , length of
cervix to diagnose supracervical elongation
• To know the positon of the uterus and the
length of the uterine cavity prior to dilatation
and evacuation
• To sound the uterine cavity for foreign body
(IUCD) or pathology like fibroid
Uterine Curette
• Blunt and sharp ends
• Uses
• For endometrial sampling :
Diagnostic D & C for menorrhagia ,
endometrial carcinoma .
• Therapuetic curettage in cases of
heavy menstrual bleed
Hegar’s Dilator
• Dilators are numbered as per
the outer diameter
• USES
• D&C
• D&E
• Hysteroscopy,
• Cervical stenosis
Karman’s syringe ( Menstrual regulator )
• For First trimester MTP
• Performed upto 10 weeks
• Has a handheld 50-60 mL plastic
syringe in which vacuum is
created by withdrawing the
plunger
• Syringe is connected to the karmans
cannula (6-8mm)
Towel Clip
Doyens Retractor
• To retract the bladder for
proper exposure of the lower
uterine segment during LSCS,
abdominal hysterectomy or
laparotomy
Abdominal wall self retaining retractor
Leech Wilkinson Cannula
• Straight instrument with
conical tip. The cone is
screwed into the cervix
and then the dye is injected
• Hydrotubation for tubal
patency tests
Ayre’s Spatula
• Made of wood so that the cells
can adhere to the porous
surface
• Used to take Pap smear for
cervical carcinoma screening
• Long end is inserted into the cervical
canal and rotated in 360 degrees
• The exfoliated cells obtained are
smeared on a glass slide and fixed in a
kopliks jar which contains ether and
alcohol in equl amount
• The other broad end is used for
obtaining cells from lateral vagina for
knowing hormoal status and for buccal
smear
Cervical sampling devices
Trocar and Cannula
• Used in laparoscopy
• Trocar is put into the cannula
and inserted into the abdominal
cavity
• Port of entry to telescope and
other instruments
Veress needle
• Used to create
pneumoperitoneum for
laparoscopy
Operative Vaginal Delivery
Traction Forceps Rotational Forceps
• Wrigleys Forceps (outlet) • Kielland’s forceps (Midforceps)
• Simpson’s Forceps (Low forceps) • Barton’s forceps (Midforceps)
• Elliot’s (Low forceps)
• Milne Murray’s forceps (low/mid forceps)
• Tarnier’s Forceps ( low/mid )
Short Curved Obstetric Forceps (Wrigley’s forceps)
• Short and light forceps
• Cephalic and pelvic curves
• English lock
• For simple lift out
• Used in caesarian section
Simpson’s Forceps
• Longer
• Cephalic and pelvic curves
• English Lock
Keilland’s Forceps
• Cephalic and minimal Pelvic
curves
• Sliding lock
• Used in occipitotransverse
position
• Corrects asynclitism
Piper’s Forceps
• Long shaft
• Cephalic, pelvic and perineal
curves
• English lock
• For aftercoming head in breech
delivery
Prerequisites for forceps delivery
• Head must be engaged
• Cervix must be fully dilated
• Membranes must be ruptured
• Presentation must be vertex or mentoanterior
• Position must be known
• There should be no cephalopelvic disproportion
• Bladder must be empty
• Informed consent
Vacuum Extractors
• Rigid cups
• Metal cup made of stainless steel
• Smaller diameter at the rim than above
the rim
• Shape helps to draw the scalp into the
cup to create an artificial caput
succedaneum (chignon)
• More scalp injuries
• More suitable for occipitoposterior
position, asynclitism and larger fetus
Soft Silastic cup
• Cup is funnel shaped
• Fits over the scalp without
the need for the formation
of a chignon
• Lesser scalp injuries
• More suitable for occipito
anterior positions
THANKYOU
