CooperSurgical Pipelle 8200 Instrucciones De Uso página 3

is retroverted, the grasp should be applied to the posterior lip of the cervix.
If the uterus is normally positioned and the cervix is stable, it is possible
that the use of forceps or a tenaculum may not be necessary.
3. Now withdraw the speculum approximately 2 cm and apply gentle traction
to the forceps or tenaculum to straighten any cervical curvature and to
stabilize the cervix.
4. With the piston positioned at the extreme
distal end of the sheath, the Pipelle
inserted into and gently passed through the
cervical canal and into the cavity of the
uterus to a depth that corresponds to that
which was determined by uterine depth
finding (Figure 1). Slight friction can usually
be felt with the fingers as the Pipelle passes
through the internal cervical os. IN NO EVENT SHOULD FORCE BE
USED to obtain passage if resistance is encountered. Slight lubrication of
the sheath with a sterile water soluble gel may facilitate its passage in
patients with an extremely dry or narrow cervical canal. If, as is usually not
the case, negotiation of the cervical canal proves painful, brief topical use
of an anaesthetic agent may help facilitate introduction of the Pipelle.
5. When the sheath is in position within the uterine cavity, discontinue any
traction you have applied with a tenaculum of forceps. Then, while holding
the sheath in position with one hand, with the other hand rapidly pull the
piston firmly and without
interruption (with one swift
steady motion) toward the
proximal end
sheath as far as it will go
(Figure 2).
NOTE: Slow interrupted
or partial withdrawal of the
piston will not produce the amount of negative pressure (suction)
necessary to obtain the maximum tissue biopsy. An indentation in the wall
of the sheath will prevent total withdrawal of the piston from within
the sheath. This action creates a negative pressure (suction) within the
sheath that draws the tissue into the curette opening at the distal end of
the sheath and captures the separated tissue within its lumen.
6. Immediately after pulling the piston the full permissible distance, the
sheath should be continuously rotated 360° by rolling or twirling between
the fingers while moving the sheath laterally and back and forth (in and
out) between the fundus and internal os at least 3 or 4 times to obtain
sample. It should then be gently withdrawn from the uterus (Figure 3).
Examination of the sheath should then reveal a specimen of the uterine
mucosa of histologic quality clearly visible within the sheath. Bleeding, if
it occurs at all, is usually minimal.
Figure 3
®
Figure 2
of the
Figure 1
is then
For Best Results:
At least 3 or 4 slow,
spiralling passes between
the fundus and internal os
should be made before
withdrawing the Pipelle
from the uterus.
8200-DFU • Rev. A • 1/14