The instrument is designed for uterus manipulation. This handling allows to reach in complete safety the posterior cul-de-sac of Douglas and protects the surrounding vital organs (ureters, bladder, rectum…). Moreover, the particular shape of its bodies allows to avoid carbonic gas leakage, differentiating it from other uterine manipulators.
The Hystero-swing® is intended to be general-purpose and can be adapted to the uterine anatomy. This is why, before any operation, it is necessary to make two measurements for an appropriate use.
For all the indications of total hysterectomy, and moreover for complicated cases:
-Douglas occlusions resulting of pelvi-peritonitis after-effects/sequelae,
-Cesarean section antecedents,
The Hystero-swing® will enable a wide section of the utero sacral ligaments and will protect the vaginal barrel by grinding it, allowing best visualization of the vaginal flange if necessary.
Moreover, for the finalization of the section and hemostasis of the lateral cervical ligaments near the ureters (crucial and risky step), putting the dissector or scissors between the notches of the Hystero-swing® makes it possible to divide the vagina from the inside.
Isolated rectoceles, complicated prolapsus with cystoceles, rectoceles and elytroceles.
The complete Hystero-swing® is assembled, without the cervical screw but with cervix washer
(Fig 5), to present the retro-uterine cup for the dissection of the peritoneum opening the levator ani
Moreover, pushing the Hystero-swing® unfolds the prolapsed vagina, which ensures an easy adjustment of the promonto-fixation strip.
The complete Hystero-swing® is assembled without the cervical screw but with cervix washer (Fig 5). This configuration allows the presentation of the posterior vaginal wall, which authorizes the safe
This surgery is ensured by the same way as previously described, by an easy dissection on the vaginal barrel which fits perfectly the Hystero-swing®. Please note that, in both cases, for the uterine conservation, the complete Hystero-swing® is assembled, without cervical screw, but with the cervix stop joint washer (Fig 5).
The Hystero-swing® is assembled without cervical screw and cervix washer (Fig 5). Don’t forget to withdraw Hystero-swing® before section with diathermy knife.
The selection of the body’s diameter depends on the vaginal gauge. This calibration is carried out with a speculum which allows to visualize the vaginal diameter and to deduce the use of one of the three available sizes (Ø32-36-40 mm).
The selection of the stem length is made after having used a graduated hysterometer. Before introducing the endo-uterine stem, it is necessary to expand the uterus with a 6 mm Hegar’s bougie. To choose the length of the stem, use the table 1.
1 / Once these values are determined, we can assemble the suitable body by aligning the arrows (sealing washer optional) and assemble the prehension handle.
2 / The handling axis is inserted by the proximal side of the removable prehension handle.
3 / Then, the assembly of the cervix washer only or the cervical screw and cervix washer will be done according to the operation. Turn the cervical screw to assemble the main handling axis through the cervix washer.
4 / The assembly of the Hystero-swing® will be completed with the appropriate stem determined by the hysterometry.
5 / Before Hystero-swing® positionning, it is necessary to grease the body with sterile Vaseline® in order to avoid vaginal tissues drying during surgery. The fastening of the Hystero-swing® is made speculum and Pozzi clamp on the uterine cervix. The stem is inserted in the cervical canal while the speculum is shifted. The body of Hystero-swing® is then introduced after the withdrawal of the speculum.