Obstectrical instruments and their uses

Obstectrical instruments and their uses

1. Obstetrical Instruments and Their Uses

2. Introduction Success of a case of dystocia depends upon the quality of instruments available with the obstetrician.in cases of delayed dystocia the birth passage becomes dry and emphysematous. Under such circumstances it becomes necessary tot use the available instruments to relieve the case. The instruments must be sterilized before taking inside the uterus of the animal for their use to relieve the case. The instruments must be sterilized by autoclaving, boiling or by using antiseptic solutions.

3. Categories of the instruments Instruments used for traction or extraction of fetus. Instruments used for incising or excising. Instruments used for repulsion and rotation.

4. Instruments used for traction or extraction of fetus Obstetrical snares/ Moore’ chainsMoore’s chain handle Moore’s chain handle Traction bar Anal hook Obermayer’s anal hook Krey-Schottler’s Hook Eye hooks

5. Obstetrical snares/ Moore’ chains These are use to apply traction on the fetal parts. These are to be lubricated before taking to the uterus and are to be applied above the joints. There should be no fetal membrane in between the snare and the fetal part. Acrylic or purlon ropes are desirable. Moore’s chains are of different lengths and can be used as per necessity. In cattle, usually 60-inch long snare or chain is used for securing the fetal extremities.

6. Moore’s chain handle It is used to have proper grip and to apply traction to the chains.

7. Traction bar It is used to apply traction to the chains/snares.

8. Anal hook Anal hook is used to apply traction after applying at the brim of fetal pelvis. It is used only on the dead fetus. Care should be taken while taking it inside the uterus and during traction to avoid its sudden slipping and accidental damage to the genital tract. Obermayer’s anal hook   It has similar functions as normal anal hook except that it is smaller in size.

9. Krey-Schottler’s Hook Used to apply traction when no fetal extremity is available. Always apply it on the bony Portions of the fetal body after fixing it with a snare.

10. Eye hooks These can be sharp or blunt. Sharp eye hook is used in dead fetuses while blunt eye hook is used in live fetus. Eye hook is attached to a snare and is applied in the inner canthus of the fetus. Eye hooks are used only for correction of malpresentation and not for traction on the fetal head. Various types of eye hooks are- Freyberger eye hook, Russian eye hook. Eye hook with concealed spring and Robert’s eye hook.

11. Instruments used for incision or excision Embryotomy Knives Heavy scalpel & Long cutting chisels Foetotome and wire saw Wire introducer/Wire saw threader Wire saw handles Leader or calving rope carrier (CRC)

12. Embryotomy Knives They are used for incising and cutting fetal parts. Example: Charles Roberts’s knife, Colien’s knife, Linde’s Embryotomy Knife, Coles pattern knife, Single and Double ring knives, knives with guarded blade, knives with sliding blade, etc. Charles Roberts’s Embryotomy knife Linde’s Embryotomy Knife

13. Heavy scalpel & Long cutting chisels To chisel through bony parts.

14. Thygesen Fetatome and Parts (Disassembled) Thygesen fetatome shown disassembled into two pieces (for ease of transportation). Additional components required (top row from left to right): Krey hook (obstetrical tongs), wire handles, a coil of fetotomy wire, wire cutters; to the right, a coiled-up flexible wire threader with a cleaning brush; underneath, a removable handle (and chain anchor) and a wire guide.

15. Foetotome and wire saw Like Utrecht or Holland type fetotome (Single piece with two concealed barrels for the saw wire and has various parts as head, fixation plates and handle) and Thygeson’s fetotome (Two separable pieces with two barrels for the wire saw. These two parts can be separated, cleaned and boiled easily in the sterilizer). Fetotomy wire is used saw the fetus, hence also named as wire saw. It should be strong and flexible and having rough surface to cut through the soft and bony tissues of the fetus. Approximately 10 feet of wire is used at one time for the amputation of a fetal part. Many cuts can be given with a good quality wire saw. However, frequent checks for the breakage of wires need to be done to avoid saw wire breaking in between the procedure when the same wire is being used for more than one cut.

16. Wire introducer/ Wire saw threader It is in three pieces that can be screwed to assemble it. It is used to pass the wire saw through the barrels of fetotome . CRC is used to pass the wire saw over the fetal parts for quick and easy fetotomy . The wire is to be tied in the smaller eye of the CRC. These are of two types (Sand Pattern flexible CRC and Schriever’s CRC). Wire saw handles These are used to have a good grip on to the wire saw while sawing otherwise the wire can cut through the hands of the operator. Various types of wire saw handles include-T-Shape, Ball Shaped, Grid pattern, Palson’s handle and Siemens wire saw handle. Leader or calving rope carrier (CRC)

17. Instruments used for repulsion and rotation of fetus Kuhn crutch repeller Caminerer’s detorsion fork

18. Kuhn crutch repeller It is used to repel the fetus in the uterus to create space for easy manipulations of the fetus.

19. Caminerer’s detorsion fork It is used to rotate the fetus along its longitudinal axis in cases of uterine torsion.

20. Miscellaneous equipment Prolapse clamp Flessa vulva suture Vulva suture needle Protective clothings (Coverall, Sleeves, Rubber boots and Gloves)  Local anesthetics Clean hot water and soap  Obstetrical lubricant, Funnel, Rubber tube  Drugs like oxytocin, calcium borogluconate Hypodermic syringes and needles  Intravenous infusion apparatus  Sterile gauze  Cotton wool  Surgical spirit / antiseptic solution Suture material with needles

21. Miscellaneous equipment Prolapse clamp Vulva suture needle Syringes Needles Protective clothing (Coverall) Protective clothing ( Sleeves)

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