SARASWATI COLLEGE OF NURSING UDAIPUR

, RJ

INSTRUMENT FILE
Submitted To: Mrs. HariBala Paliwal
(Associate Professor)
(Head of Deptt.)
OBG

Submitted By: Shabnam Amin

M. Sc. Nursing
(1st year)
 ALLIS TISSUE FORCEPS

USES:-

 To catch hold the anterior lip of cervix in D + E operation.

 To hold the apex of the episiotomy wound during repair.
 To catch hold the margins of the peritoneum, rectus sheath, vaginal mucosa during repair.
 To catch hold of torn ends of sphincter and externus prior to suture in repair of complete
perineal tear.
 To catch hold the margins and angles of the uterine flaps in LSCS after the delivery of the
baby as an alternative to Green -Armytage homeostatic clamp.

CUSCO'S BIVALVE SELF RETAINING VAGINAL SPECULUM

USES:-
 To visualize the cervix and vaginal fornices for any local cause (polyp, ectopy) of APH.
 To inspect the cervix and to prepare cervical smear for cytology screening.
 To detect leakage of liquor from the cervical os in a case of suspected PROM.
 SIM’S DOUBLE BLADED POSTERIOR VAGINAL SPECULUM

The blades are of unequal breadth to facilitate introduction into vagina depending upon the space
available (narrow blade in nulliparous and the wider blade in parous women).
USES IN OBSTETRICS:-
 To inspect the cervix and vagina to detect any injury following delivery.
 To clean the vagina following delivery.
 To inspect the cervix and vagina to exclude any local cause for bleeding in APH (Cusco’s
speculum preferred).
 During D & E operation.
USES IN GYNAE OPD FOR FOLLOWING PROCEDURES:-
 Taking Pap Smear
 Insertion and removal of Copper T
 Colposcopy
 Taking swabs
 Hyseterosalpingography (HSG)
USES IN GYNAE OPERATIONS:-
 D&C
 Cervix Biopsy
 Vaginal Hysterectomy
 Fothergills Operation
 Repair of Vesico vaginal fistula
 Hysteroscopy.
 AYRE’S SPATULA

It is used for taking Pap smear for screening of carcinoma cervix. It is made of wood so that cells
can adhere to its porous surface. The long end is inserted into cervical canal and rotated in 360
degree. 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.

FOLEY’S CATHETER

USES:-
 This is a self retaining catheter most commonly used for drainage of the urinary
bladder after surgery.
 It is used in operations like Abdominal, Vaginal Hysterectomy, Wertheim's Hysterectomy
and Repair of vasico vaginal fistula.
 It is also used for second trimester MTP for extra amniotic instillation of ethacredyl lactate.
 It is also used for diagnosis of incompetent cervix and for sonosalpingography.
KOCHER’S HAEMOSTATIC FORCEPS (CLAMP)
USES:-
 This instrument is used for holding pedicles in hysterectomy. The tips of the blades have
teeth so that the tissue does not slip.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 cord of new born at the time of delivery or
for artificial low rupture of membranes (ARM).

MULTIPLE TOOTHED VULSELLUM

USES:-

 It is used to catch hold the anterior lip of the cervix in D + E operation, suction evacuation.
As it produces trauma to the soft and vascular cervix, Allis tissue forceps is used instead.
UTERINE SOUND
 It is an olive, pointed, graduated malleable, metallic uterine sound. About 5 cm from the tip it
bends to make angle of 30 degree. It has marking on it for measurements (bladder sound has
no marking). The angle helps to negotiate curvature of the uterus (ante flexion).
USES:-
 To know the position of uterus and the length of uterine cavity prior to dilatation of cervix in
D + E operation.
 To sound the uterine cavity to detect any foreign body (IUCD).
 It acts as a first dilator of the cervical canal.

LONG STRAIGHT SCISSOR

USES:-
It is commonly used -
 To cut the umbilical cord.
 To make episiotomy
 To cut suture materials as in caesarean section.

SIMPLE RUBBER CATHETER

 USES:-
 It is used to empty the bladder in cases with retention of urine during –
a) Pregnancy (Retroverted gravid uterus).
b) Labour –
I. When the woman fails to pass urine by herself.
II. Before and after any operative interventions (forceps delivery, destructive operations).
c) Postpartum-
I. During management of post- partum haemorrhage.
II. Retained placenta.
d) Other uses-
I. As a tourniquet.
II. To administer o2 when nasal catheter is not available.
III. As a mucus sucker when it is attached to a mechanical or electric sucker.

UTERINE PACKING FORCEPS / DRESSING FORCEPS

A curved forceps about 35cm in length, the curvature corresponding to axis of birth canal for
easy packing, has blades, handles and finger bows, commonly used in gynaecological
procedures.
 The shanks of this instrument are slightly curved and therefore provide greater visibility when
used in the uterine cavity. The jaws are available either curved or straight. This product features
an "S" curve (slightly curved shanks with jaws slightly curved opposite direction) with partial
horizontal serrations and a length of 10-1/4 inches.
USES –
 Used for vaginal packing to control bleeding from lacerations in birth canal due to trauma.
 Used for application of drugs into the uterine cavity.
 Used to swab uterine cavity following dilation and curettage procedures with small gauze pieces.
 They are used for tissue removal in dilation and curettage procedures, intrauterine
device retrieval, and packing the uterine cavity.

CERVICAL DILATORS

DAS OR HEGAR
DILATORS 1- DAS OR HEGAR DILATORS

They are metal rods developed by Alfred Hegarin 1879. Stainless steel Hegar dilators provide the
option of double-ended dilators in even-millimeter increments, or from 3 to 18 for a greater diameter
range over the entire set. Typically, a set of dilators contains rods of increasing diameters, from a
few millimeters up to 26 millimeter. The rods are round, slightly curved and have a conal tip. Some
sets have conal tips at both ends, others show one end flattened for handling. Hegar dilators are
marked with a Hegar number equivalent to 0.5mm.Both the sides are used with the lower number
first.
Hegar Double-End Cervical Dilator
191mm stainless steel double-end dilator. Also available in a set of 8 or individual sizes.
030830Hegar 8pc Dilator Set Sizes 3/4Fr - 17/18Fr
030831Hegar Dilator 1/2
030832 Hegar Dilator 3/4
030833 Hegar Dilator 5/6
030834 Hegar Dilator 7/8
030835 Hegar Dilator 9/10
030836 Hegar Dilator 11/12
030837 Hegar Dilator 13/14
030838 Hegar Dilator 15/16
030839 Hegar Dilator 17/18

USES-

 Das or Hegar dilators are dilators used to induce cervical dilation in order to gain entry to
the interior of the uterus. During the process of dilation, the cervix may have to be stabilized
with a tenaculum, and then the dilators are slowly entered into the cervical canal with a
lubricant, starting with a thin, low Hegar number rod and progressing gradually to larger
numbers.

 The dilators can also be used to sound the uterus.

 Hegar dilators are widely used in gynecology to open up the cervix. This may be necessary
prior to a uterine curettage or biopsy. They have also found application in the management
of vaginismus or hymenal stenosis.

 They are also used to overcome stenosis in non-gynecological situations, such as

in urology and proctology.

Degree of dilatation required: (i)Incomplete abortion- sufficient to introduce the index

finger (usually 16/19). (ii) In suction evacuation-one size smaller than the size of the suction
cannula. (iii) In MTPby D+E-sufficient dilatation to introduce ovum forceps (usually 9/12).

2- HAWKIN-AMBLER DILATORS
It has got 16 sizes.the smallest one being 3/6 & the largest one being 18/21. The number is
arbitrary in the scale of Hawkins Ambler. The smaller one denotes measurement at the tip &
the larger one measures the maximum diameter at the base in mm.
FLUSHING CURETTE

Flushing Curette is used to collect samples from uterus and rectum for diagnosis of cancer. It
consists of a long hollow shaft with small spoon shaped scoop. After passing it into the uterus,
sample is scraped.

Uses-
 Flushing Curette is used to collect samples from uterus and rectum for diagnosis of cancer.
 It consists of a long hollow shaft with small spoon shaped scoop. After passing it into the uterus
sample is scraped. This instrument is easy to use and finds application in hospitals & clinic.

SPONGE HOLDING FORCEP

Sponge holding forceps or sponge forceps as they may be called are instruments which are used by
doctors to hold on to sponges and/or swabs while conducting their medical procedure. Sponge
holding forceps are usually made in the shape of a scissor. The jaws of these forceps can either be
serrated or they may be smooth. The handles are ratcheted as well as looped. Sponge holding
forceps can either be curved or they may be straight; the shape is different for each individual
purpose for which they may be used. Sponge holding forceps are commonly nine inches in length
i.e. 18-23 centimetres. The jaw of the sponge holding is usually rounded and to be able to use the
instrument for delicate and fragile operations, the tips may even be elongated. With the help of
sponge holding forceps, surgeons are able to perform minor operations without causing much
damage to the patient. It is also helpful in ensuring that not much of a scar remains once the
procedure is over.

Uses-
Sponge holding forceps are used in every surgery which is performed since sponges and swabs are
used for every surgery. Sponge holding forceps come under the category of gynecological
instruments, surgical instruments, dentistry instruments and every other division within the medical
field.
These instruments also help in preventing and reducing the likelihood of trauma to the
patient.Sponge holding forceps may be used while other procedures are conducted as well and may
be used to hold cotton balls, sponges, gauze and any other material which may be required during
the surgical procedure.At times, sponge holding forceps can also be used as a clamp to stop
excessive bleeding. The type of forceps to be used will depend on the procedure

OVUM FORCEP
Ovum forceps are a kind of forceps however these are gynecological instruments since these deal
with performing abortions if they may be required. Other names for the ovum forceps are clamps or
a haemostat.
An abortion may be conducted if the fetus is no longer living inside the uterus or the presence of the
baby inside the uterus may be harmful for the health of the mother and the baby, both
Forceps are those surgical instruments which are used to grab onto things and to move objects from
within the body as and when needed. This particular instrument may be used when the fingers are
larger than the item which needs to be grabbed onto or the objects being held need to be dealt with
one at a time. This is when forceps are used. They are handheld instruments which are used in every
field of medicine which help surgeons and doctors to deal with very small objects which cannot be
held using the fingers

Uses-
Ovum forceps are used to remove product of conception from the uterus in incomplete abortion.
Used to remove any foreign body from the uterine cavity, e.g.IUD when threads are broken.
They are also used to remove any kind of retained placental bits or membrane pieces which may be
in the uterus.

UTERINE CURETTE
A flat metal instruments with small spoon like arrangement for scraping. Both end are spoon
shaped with fenestrations in the middle. One end is blunt and another end is sharp for curetting.
This product is a 5 curette. The tip is approximately 23mm long and 14mm wide. The overall
length is 11 inches.

Uses-
Sims Uterine Curette is an OB/GYN instrument used for removing tissue from the lining of the
uterus.
It may be used to scrape and remove growths or tissue to be biopsied.
It may also be used as part of a D&C procedure.

UTERINE PACKING FORCEPS / DRESSING FORCEPS

A curved forceps about 35cm in length, the curvature corresponding to axis of birth canal for
easy packing, has blades, handles and finger bows, commonly used in gynecological
procedures.The shanks of this instrument are slightly curved and therefore provide greater
visibility when used in the uterine cavity. The jaws are available either curved or straight. This
product features an "S" curve (slightly curved shanks with jaws slightly curved opposite
direction) with partial horizontal serrations and a length of 10-1/4 inches.

Uses –
 Used for vaginal packing to control bleeding from lacerations in birth canal due to trauma.
 Used for application of drugs into the uterine cavity.
 Used to swab uterine cavity following dilation and curettage procedures with small gauze
pieces.
 They are used for tissue removal in dilation and curettage procedures, intrauterine device
retrieval, and packing the uterine cavity.

DOYEN’S RETRACTOR
The doyen retractor is an instrument which is used to hold organs back while the surgery is
being conducted. Doyen Retractors is 25cm (10") 50 x 85mm in size. It also keeps in keeping
open the edges of incisions which have been made. A retractor is a surgical instrument with
which a surgeon can either actively separate the edges of a surgical incision or wound, or can
hold back underlying organs and tissues, so that body parts under the incision may be accessed.
The two are each available in many shapes, sizes, and styles. The general term retractor usually
describes a simple handheld steel tool possessing a curved, hooked, or angled blade fitted with a
comfortable handle, that when in place maintains the desired position of a given region of tissue.
Retractors can also be self retaining and not need to be held once inserted by having two or
more opposing blades or hooks which are separated via spring, ratchet, worm gear or some other
method and pull on opposite sides of a wound.

Uses:

Medical Tools Retractors used by surgeons to either actively separate the edges of a surgical
incision or wound, or can hold back underlying organs and tissues, so that body parts under the
incision may be accessed.

MANUAL VACUUM ASPIRATION (MVA) SYRINGE

 A diagram of a vacuum aspiration abortion procedure at 8 weeks gestation.Vacuum aspiration is an
outpatient procedure that generally involves a clinic visit of several hours.The procedure itself
typically takes less than 15 minutes.Suction is created with either an electric pump (electric vacuum
aspiration or EVA) or a manual pump (manual vacuum aspiration or MVA). A hand-held 25cc or
50cc syringe can function as a manual pump.Both methods use the same level of suction, and so can
be considered equivalent in terms of effectiveness and safety

Uses-
Vacuum or suction aspiration uses aspiration to remove uterine contents through the cervix. It may
be used as a method of induced abortion, a therapeutic procedure used after miscarriage, or a
procedure to obtain a sample for endometrial biopsy.

Some sources may use the terms dilation and evacuationor "suction" dilation and curettage to refer to
vacuum aspiration, although those terms are normally used to refer to distinct procedures.

When used as a miscarriage treatment or an abortion method, vacuum aspiration may be used alone or
with cervical dilation anytime in the first trimester (up to 12 weeks gestational age). For more
advanced pregnancies, vacuum aspiration may be used as one step in a dilation and evacuation
LAMINARIA TENT

Laminaria has been used traditionally as a hygroscopic cervical dilator and inducer of labour, and
commercial products are available for this purpose.Laminaria dilators have been used to dilate the
cervix and to induce labor in abortions. When inserted into the cervix, laminaria dilators absorb
surrounding moisture and gradually swell to a diameter of approximately one-half inch. While most
of the swelling occurs in the first 4 to 6 hours, it may continue for up to 24 hours. Because this is a
gradual process, the patient rarely notices pain. At the same time, the cervix is induced to ripening
(becoming soft and flexible). The effect is often limited to local cervical ripening; however,
stimulation of the cervix can induce labor.
The mechanism of action may be similar to that of a foreign body that, when inserted into the
cervical canal, disturbs the normal chorioamniotic balance and initiates a cascade of prostaglandin
synthesis. This in turn has myometrial-contracting and cervical-ripening effects.
Uses-Cervical ripening
KARMAN CANNULA

Uses-
 It is used for Suction & Evacuation and MVA.
 The sharp overhanging hoods of a Karman cannula reportedly may be used to retrieve an IUD
when the threads are no longer visible.
 DAS’ LONG CURVED FORCEPS

A heavy metal instrument about 37cm (15 inch) long. Its parts are blade, shank, lock & handle. The
blades are named left or right in relation to maternal pelvis in which they lie when applied.
The blade characteristically has two curves, the cephalic and the pelvic curves. The cephalic curve is
shaped to conform to the fetal head. Pelvic curve to fit the curve on the axis of pelvic canal (curve of
carus). In order to lock the two halves after application, the left blade needs to be inserted first.
Uses-It is used in low forceps operation.
SHORT CURVED FORCEPS

All forceps have handles; the handles are connected to the blades by shanks of variable lengths.
The blade of each forceps branch is the curved portion is used to grasp the baby's head. The blade
characteristically has two curves, the cephalic and the pelvic curves.
The cephalic curve is shaped to conform to the baby's head. Some forceps have a more rounded
cephalic curve and others have a more elongated curve; the type of forceps used depends on the
shape of the baby's head. The forceps should surround the baby's head firmly, but not tightly.
Uses-
 It is used in low forceps operation.
 KIELLAND'S FORCEPS

Kielland'sforceps is a long, almost straight (very slight pelvic curve) obstetric forcep with a sliding
lock. It should only be performed in theatre with tested, effective, regional anaesthesia.
The Kielland's forceps are a potentially dangerous instrument in unfamiliar hands. However, when
used correctly and with gentleness they can achieve a controlled, a traumatic delivery.
Uses-
It is used as a rotation forceps in deep transverse arrest of occipitoposterior position of the head.
Facilitates grasping and correction of an asynclitic head because of its sliding lock.

AXIS-TRACTION FORCEPS

Axis traction forceps include two axis traction rods (right & left) and a traction handle. The rods are
assembled in the blades of long curved obstetric forceps prior to introduction and lastly the handle
is attached to the rods.
Obstetrical forceps provided with a second handle so attached that tractioncan be made in the line in
which the head must move along the axis of the pelvis
Uses-
It is used where much force is necessary for traction as in mid-forceps operation.
 EPISIOTOMY SCISSORS

Episiotomy Scissors, which may also known as Braun-Stadler Episiotomy Scissors, are used to
perform episiotomies during labor and delivery. These non-ratcheted, finger ring scissors are angled
with smooth, blunt/blunt tips, and a length of 5-1/2 inches.
Uses-
Episiotomy Scissors are used for cutting the perineum to enlarge the vaginal opening to deliver the
fetal head.
VENTOUSE CUP

Uses-
 It can be used on a fetal head at a higher station and not well rotated.
 It is used in the second stage of labour if it has not progressed adequately. It may be
an alternative to a forceps delivery and caesarean section.
 MUCUS EXTRACTOR / BULB SYRINGE

1 – Universal Connector
2 – Open Distal End With 2 Lateral Eyes
3 – Detachable Container For Discharge, 25 Ml
4 – Screw Cap
A mucus extractor, also called a bulb syringe, clears the nose of a child who has trouble blowing into a
tissue. Use one to clear your child's nasal passages, allowing him to breathe easier when sick and
preventing mucus from running out his nose. Mucus extractors are inexpensive and available at many
baby supply and drug stores, making them an affordable and indispensable addition to any parent's
medicine chest.
Uses-
Used to suck the secretion from the oropharynx and hypopharynx of neonates following birth, prior to
the attempt of respiration
UMBILICAL CORD CLAMP

The umbilical cord clamp is a gynecological instrument which comes in a variety of appearances. In order to
remove the baby from the placenta, a surgeon makes use of a gynecological instrument which is called the
umbilical cord clamp. Most of these clamps are made using plastic and the cord usually consists of teeth in
the front which fit together when the instrument is closed i.e. clamped. Some of these cords have a variety of
fittings on the side of the clamp which is open in order to ensure that the instrument can be used in a secure
manner.
Uses-This clamp is used by the surgeon to cut the placenta and hence free the baby from the womb
PINARD’S STETHOSCOPE

Pinard horn is a tool used to listen the heart rate of a fetus during pregnancy.It is a type of stethoscope,
formerly called a "fetoscope",but the term is still sometimes associated with the Pinard stethoscope. The
horn is often made of wood or metal and is hollow. It is about 8 inches long. It functions similarly to an ear
trumpet by amplifying sound. The wide end of the horn is held against the pregnant woman's abdomen,
while the user listens through the other end
Uses-
A Pinard horn may be used to determine the position of the fetus.
It is use palpation and auscultation of the fetal heart rate to determine fetal position.
Pinard horn is a tool used to listen the heart rate of a fetus during pregnancy.

GIANT VULSELLUM

A vulsellum (also known as a volsella or vulsella) is a pair of surgical forceps with hooks at the tip of each
blade.

Used-in obstetrics and gynaecology proceduressuch as episiotomy, hysterectomy, or dilation & curettage and
used for grasping the cervix (Usually anterior lip of the cervix is grasped)

NEEDLE HOLDER

Smaller distal blades with cross serrations often with a groove in the middle are the features of needle
holder. It may be straight or curved and available in different sizes. Used- to hold a needle.

DOYEN’S TOWEL CLIP

A doyen’s towel clamp is used to secure towels and surgical draping during a medical procedure.

PERFORATOR

A perforator was a destructive tool used to pierce the skull of a dead foetus. This was done to remove the
foetus from the womb in pieces to save the mother's life

ANT. VAGINAL WALL RETRACTOR

This instrument is used with Sim's Speculum. It’s 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 cystocoele.

DISSECTING FORCEPS
It is used to hold delicate structures like peritoneum, vessels bowel, nerves, tendons, and hold skins.

EXTERNAL PELVIMETER

Pelvimetry is the assessment of the female pelvis in relation to the birth of a baby.

RING PESSARY
Therapeutic pessaries are used to support the uterus, vagina, bladder, or rectum.Pessaries is a treatment
option for pelvic organ prolapsed. A pessary is most commonly used to treat prolapsed of the uterus

ARTERY FORCEP

Artery forceps are primarily use as haemostatic forceps to grasp vessels and allow ligation of those vessels.
It is also be used to grasp tissues, sutures and other prosthetic materials. Care should be taken as they are
crushing forceps that can damage delicate structures.

TENACULUM FORCEPS
Tenaculum Forceps are a ratcheted, finger ring instrument commonly used in OB/GYN procedures
involving manipulation of the cervix or uterus, most commonly D&C, and vaginal or abdominal
hysterectomy. They are also used to grasp, hold, and move vessels and arteries during surgical procedures.