Uterine manipulation with plastic suction curette at combined abortion and sterilization

Uterine manipulation with plastic suction curette at combined abortion and


A.K. Banerjee, J.O. Emembolu

Department of Obstetrics and Gynaecology, Leicester Royal Infirmary, UK

Objective: To determine the efficacy and safety of a plastic suction

curette as uterine manipulator during combined surgical abortion and

laparoscopic sterilization.

Design: A six- year prospective observational study in a university

hospital & a district hospital, fertility control and reproductive health


Method: Plastic suction curettes of sizes between 7mm and 12mm(Synevac

vacuum Curette, Berkeley Mdevices, Inc; California or Curette rigid straight,

Luneau Gynecologie; France) were used for surgical abortion up to 13 weeks in

the day care surgical unit. The curette was also used to manipulate the uterus

and demonstrate the tubes for laparoscopic sterilization. Thereafter, routine

inspection of the pelvic organs was undertaken to exclude any pathology or

iatrogenic damage. Further suction was performed to ensure that the uterus was

empty. Following this a bimanual examination confirmed it to be firm and

haemostasis secured.

Results: Between 1st January 1996 and 31st December 2002, a total of

510 laparoscopic sterilizations were performed together with surgical abortion.

No uterine perforation occurred in this series. Adequate visualization of pelvic

structures was achieved. Minimal intra-operative uterine bleeding was noted as

continued low suction maintained uterine tonicity. No patient required

hospitalization or re-admission for complications of the operation.

Conclusion: This is the first report of the use of plastic suction

curette as Uterine manipulator for laparoscopic sterilisation following surgical

abortion. This study shows that it is a safe, efficient and technically

satisfactory manipulator of a gravid uterus during the first trimester abortion.

Maintenance of suction avoids uterine atony and minimizes intra-operative blood

loss. The curette is disposable, therefore reduces any risk of hospital

cross-infection and also it is cost saving as no additional instrumentation is


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