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New, simple, combined instrument for uterotubal insufflation and endometrial biopsy
NEW, SIMPLE, COMBINED INSTRUMENT FOR UTEROTUBAL INSUFFLATION AND ENDOMETRIAL BIOPSY * WALTER
J.
REICH, M.D.
AND MITCHELL
J.
NECHTOW,
M.D.
Chicago, Illinois
A
T the Cook County Hospital Out Patient Gynecologic Clinic we are constantly confronted with the problem of infertility. Because of the volume of patients,
and will aIso permit easy flow of air when testing the fallopian tubes. (Figs. I and 2.) Furthermore, it will not be plugged up with inspissated blood and minerals while being
FIG. I. Combined tuba1 insufilation and endometrial biopsy cannula.
FIG. 3. Endometrial
FIG. 2. Rubin test for tubal patency.
therefore by necessity, we attempt to simplify all our diagnostic procedures and instruments. Until recently the Neal, the Jarcho and other cannulas were used for the tuba1 patency test whiIe the RandeIl or Novak endometria1 curets were used for the study of the endometrium so that two distinct and separate instruments were employed. We wish to present an instrument which embodies both features in one, that is, the curet and the tuba1 insufhation test cannu1a.t It is safe, simple, effective and Iess expensive. The handIe of the instrument makes it easier to grasp whiIe doing an endometria1 biopsy. The opening of the tip of the instrument is Iarge enough to obtain a good endometria1 specimen I Instruments manufactured by the Western Surgical Instrument
Co., Chicago,
III.
biopsy.
sterilized. The Iatter was a common occurrence with the NeaI cannuIa because the openings were too smaI1. InadvertentIy, while using the Iatter on several occasions we failed to test the apparatus before making the patency test and have had “ faIse negative” resuIts because the instrument was pIugged up and air faiIed to pass through it. The instrument is made of maIIeabIe metal so that the tip may be bent; the rubber tip “acorn ” may be removed entirely or moved away whiIe doing an endometria1 biopsy. We do not use suction and believe that it is not necessary. Wh en one scrapes the endometrium, the tissue hIIs the cannuIa with ease. It is then bIown out with the rubber tube and buIb into a biopsy specimen bottIe. (Fig. 3.) SUMMARY
AND
CONCLUSIONS
I. A combined tubal insufhation and endometria1 curet cannula is described which is safe, simple and effective. 2. We do not wish to imply that two separate tests shouId be made at the same time but that one instrument may be used for both tests at different times. 3. In searching the Iiterature we failed to find a similar instrument in use.
* From the Department of Gynecology of The Cook County Hospital, The Gynecologic Division of Fantus Clinic, The Chicago Medical SchooI and Cook County Graduate SchooI of Medicine, Chicago, III.
380
American
Journal of Surgery
J.
REICH, M.D.
AND MITCHELL
J.
NECHTOW,
M.D.
Chicago, Illinois
A
T the Cook County Hospital Out Patient Gynecologic Clinic we are constantly confronted with the problem of infertility. Because of the volume of patients,
and will aIso permit easy flow of air when testing the fallopian tubes. (Figs. I and 2.) Furthermore, it will not be plugged up with inspissated blood and minerals while being
FIG. I. Combined tuba1 insufilation and endometrial biopsy cannula.
FIG. 3. Endometrial
FIG. 2. Rubin test for tubal patency.
therefore by necessity, we attempt to simplify all our diagnostic procedures and instruments. Until recently the Neal, the Jarcho and other cannulas were used for the tuba1 patency test whiIe the RandeIl or Novak endometria1 curets were used for the study of the endometrium so that two distinct and separate instruments were employed. We wish to present an instrument which embodies both features in one, that is, the curet and the tuba1 insufhation test cannu1a.t It is safe, simple, effective and Iess expensive. The handIe of the instrument makes it easier to grasp whiIe doing an endometria1 biopsy. The opening of the tip of the instrument is Iarge enough to obtain a good endometria1 specimen I Instruments manufactured by the Western Surgical Instrument
Co., Chicago,
III.
biopsy.
sterilized. The Iatter was a common occurrence with the NeaI cannuIa because the openings were too smaI1. InadvertentIy, while using the Iatter on several occasions we failed to test the apparatus before making the patency test and have had “ faIse negative” resuIts because the instrument was pIugged up and air faiIed to pass through it. The instrument is made of maIIeabIe metal so that the tip may be bent; the rubber tip “acorn ” may be removed entirely or moved away whiIe doing an endometria1 biopsy. We do not use suction and believe that it is not necessary. Wh en one scrapes the endometrium, the tissue hIIs the cannuIa with ease. It is then bIown out with the rubber tube and buIb into a biopsy specimen bottIe. (Fig. 3.) SUMMARY
AND
CONCLUSIONS
I. A combined tubal insufhation and endometria1 curet cannula is described which is safe, simple and effective. 2. We do not wish to imply that two separate tests shouId be made at the same time but that one instrument may be used for both tests at different times. 3. In searching the Iiterature we failed to find a similar instrument in use.
* From the Department of Gynecology of The Cook County Hospital, The Gynecologic Division of Fantus Clinic, The Chicago Medical SchooI and Cook County Graduate SchooI of Medicine, Chicago, III.
380
American
Journal of Surgery