Lecture On Dilation & Curettage (D&C) | Gynaecology Instruments & Procedure Explained | MBBS скачать в хорошем качестве

Lecture On Dilation & Curettage (D&C) | Gynaecology Instruments & Procedure Explained | MBBS

Master the critical gynaecological procedure of Dilation and Curettage (D&C) and Dilation and Evacuation (D&E) with this in-depth MBBS class from Santiniketan Medical College. This comprehensive video provides a step-by-step guide to the procedure, focusing on the correct use of essential instruments and vital safety protocols. What you'll learn in this detailed lecture: Initial Steps of D&C/D&E [00:00]: Posterior Vaginal Wall Retraction: The first step involves retracting the posterior vaginal wall. Bladder Evacuation: How to confirm and evacuate the patient's bladder using a metallic catheter [00:14], ensuring proper insertion technique with the U-shaped curve facing downwards [00:44]. Examination Under Anesthesia (EUA): Performing a per-vaginal examination to assess uterine size (e.g., 8-week size uterus), its position (anteverted/retroverted), and to identify any obstructing pelvic masses or fibroids [01:01]. Holding the Cervix [02:12]: Instrument Selection: Understanding why instruments like Toothed Vulsellum and Allis Tissue Holding Forceps are generally avoided in pregnant patients due to increased cervical vascularity, which can lead to trauma and bleeding [02:53]. Optimal Choice: The Sponge Holding Forceps is the preferred instrument for holding the anterior lip of the cervix to straighten the cervical canal, as its serrated but toothless ends prevent injury [04:22]. Measuring Uterine Size [04:54]: Uterine Sound: Introduction to the metallic, malleable, graduated, olive-tipped uterine sound [05:09]. Safety Features: Learn why the olive tip is crucial to prevent uterine perforation during insertion [06:00], and how malleability allows adjustment for uterine curvature (anteverted/retroverted) [06:25]. Accurate Measurement: How to accurately measure the uterine size by inserting the sound until it touches the uterine fundus [06:52]. Cervical Dilation [07:24]: Hegar's Dilators: Step-by-step use of Hegar's uterine dilators, which come in graduated sizes (e.g., from 4mm upwards) [07:59]. Technique: The importance of gradual dilation to open the internal and external os, preventing trauma, and measuring the insertion depth with the uterine sound to avoid perforation [09:03]. Evacuation of Uterine Contents [09:39]: Ovum Holding Forceps: Correct use of the Ovum Holding Forceps for removing products of conception or blood clots [09:53], highlighting its design without a catch to minimize uterine injury [10:28]. Karman's Cannula: Explanation of plastic Karman's cannulas, available in various sizes corresponding to gestational age (e.g., 8mm for 8 weeks) [12:24]. Suction Aspiration: How these cannulas are attached to a suction machine for vacuum aspiration, with a back-and-forth motion to effectively remove uterine contents [13:32]. Completion Check: Identifying completion of the procedure through the appearance of bubbles and absence of further tissue [16:02]. Uterine Curettage [14:01]: Uterine Curette: Differentiating between blunt-ended and sharp-ended uterine curettes [14:01]. Application: Blunt curettes are used for surgical evacuation in pregnant patients to clear placental clots or products of conception [14:12]. Sharp curettes are reserved for diagnostic gynecological procedures like endometrial biopsies [14:37]. Confirmation: The procedure is considered complete when a 'gritty sensation' is felt on all uterine walls, indicating no remaining products of conception [15:34]. This class is indispensable for medical students and practitioners seeking to deepen their understanding of safe and effective D&C/D&E procedures. SANTINIKETAN MEDICAL COLLEGE & HOSPITAL Real Classroom Demonstration/Lecture On: OBSTETRICS & GYNAECOLOGY by Dr. Inisha Sarkar (MBBS Batch: 2023-24) Conducted on: 28-10-25