My Experiences With SRS Needle

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Non Descent Vaginal Hysterectomy and SRS Needle use

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  • One of the most dramatic change in the route of removal the uterus during the last three-four years is switching over from Abdominal to Vaginal irrespective of its undescentness volume(fibroids,Adenomyosis) previous surgeries on it. One of the most dramatic change in the route of removal the uterus during the last three-four years is switching over from Abdominal to Vaginal irrespective of its undescentness volume(fibroids,Adenomyosis) previous surgeries on it. One of the most dramatic change in the route of removal the uterus during the last three-four years is switching over from Abdominal to Vaginal irrespective of its undescentness volume(fibroids,Adenomyosis) previous surgeries on it.
  • My Experiences With SRS Needle

    1. 1. My Experiences with SRS Needle in Non Descent Vaginal Hysterectomy <ul><li>Concept….Creation…. </li></ul><ul><li>Application…. </li></ul><ul><li>and……..Presentation </li></ul>Dr.Sudhir Shah Rajkot
    2. 2. <ul><li>One of the most dramatic change in the route of removal of the uterus during the last few years is switching over from </li></ul><ul><li>Abdominal to Vaginal </li></ul><ul><li>irrespective of its </li></ul><ul><li>descent </li></ul><ul><li>volume ( fibroids, Adenomyosis ) </li></ul><ul><li>previous surgeries on it. </li></ul>
    3. 3. Pendulum swings from Abd. To Vag.since last couple of yrs Gynecologists have started to believe that Every Uterus can be and should be removed VAGINALLY unless the route is contraindicated Previously 80% of Hyst.were Abdominal A:V 80:20 Now 70 % are Vaginal Hyst. V:A 70:30 It differs from center to center
    4. 4. Vaginal Hysterectomy ADVANTAGES Quick and easy surgery No Visible scar Faster Recovery 1 Night Hospital stay Less Convalescence Period Low Complication Cost Effective as compare to Abdominal hys.
    5. 5. Since the Incidence of NDVH surgery has increased <ul><li>It is our endeavor to find out </li></ul><ul><li>quick and comfortable operative steps </li></ul><ul><li>to make the SURGERY more COMFERTABLE and EASY </li></ul>
    6. 6. Challenging step <ul><li>In doing NDVH apart from opening </li></ul><ul><li>Anterior and Posterior Pouch </li></ul><ul><li>Most challenging and time consuming step is </li></ul><ul><li>Transfixation of Uterosacral and Mackenrodts </li></ul><ul><li>and Ligation of Uterine Pedicle with </li></ul><ul><li>available 40 mm half circle needle </li></ul><ul><li>As </li></ul><ul><li>The space is narrow and </li></ul><ul><li>pedicle is deep in Vagina </li></ul>
    7. 7. With 40 mm Half Circle Needle <ul><li>The problem starts from </li></ul><ul><li>--where to catch the needle in the Needle holder </li></ul><ul><li>-- At which angle needle is to be inserted in to the pedicle </li></ul><ul><li>--some time tip of needle is lost </li></ul><ul><li>and can not found on the other </li></ul><ul><li>side of clamp </li></ul>
    8. 8. Repetitive unsuccessful attempt causes <ul><li>distressing and disturbing expressions </li></ul><ul><li>on </li></ul><ul><li>Surgeon </li></ul><ul><li>and </li></ul><ul><li>more so on </li></ul><ul><li>Assistants </li></ul>
    9. 9. To overcome this <ul><li>We thought </li></ul><ul><li>of trying </li></ul><ul><li>short straight needle </li></ul><ul><li>instead of </li></ul><ul><li>half circle. </li></ul>
    10. 10. We designed new 20 mm short straight needle to make these steps comfortable and easy. <ul><li>we made it from 18 no Butterfly scalp vein </li></ul>
    11. 11. When we tried it……. <ul><li>It came out very easily </li></ul><ul><li>in ligating pedical and I could see </li></ul><ul><li>WOW </li></ul><ul><li>Expressions on the faces of my </li></ul><ul><li>Assistants </li></ul><ul><li>This….believe me…This </li></ul><ul><li>Encouraged me to try this needle </li></ul><ul><li>in more and more surgery of NDVH </li></ul><ul><li>and the TRIAL was more then </li></ul><ul><li>Satisfactory. </li></ul>
    12. 12. <ul><li>Technique </li></ul><ul><li>After cutting the pedicle the SRS needle </li></ul><ul><li>Is inserted from </li></ul><ul><li>below upwards so the tip of the needle </li></ul><ul><li>emerges anteriorly in vision and </li></ul><ul><li>it can be very easily catched and handled. </li></ul><ul><li>It can also be inserted from above. </li></ul>
    13. 13. Needle is inserted from below Here is the Schematic Representation
    14. 14. Schematic Represent It comes out in front..
    15. 15. Schematic Represent Pulled out…..
    16. 16. Schematic Represent Reinserted to Transfix
    17. 17. Schematic Represent Pulled out again …
    18. 18. Schematic Represent When available space above the pedicle is more then below the pedicle
    19. 19. This shows How Difficult wrist joint movement is with half Circle needle. It gives PAIN at wrist and shoulder joint
    20. 20. Here is an easy movement with short straight needle No Pain at wrist or shoulder joint
    21. 21. insertion in the the Pedicle is easy insertion in the Pedicle is difficult 20 mm Straight Needle 40 mm half circle Needle
    22. 22. Surrounding structures like lateral wall of vagina and lateral part of pedicle are not injured Surrounding structures may injured 20 mm Straight Needle 40 mm half circle Needle
    23. 23. Less space required to handle the needle More space required to handle the needle 20 mm Straight Needle 40 mm half circle Needle
    24. 24. Movement of the wrist Joint is quite Easy Movement of the wrist Joint is quite Difficult 20 mm Straight Needle 40 mm half circle Needle
    25. 25. Our Experience <ul><li>Since last 9 years </li></ul><ul><li>we are using this needle in NDVH. </li></ul><ul><li>We did more then 3000 Vaginal Hyst. </li></ul><ul><li>With </li></ul><ul><li>this </li></ul><ul><li>types of straight suture needle and </li></ul><ul><li>was found </li></ul><ul><li>convenient </li></ul><ul><li>easy </li></ul><ul><li>time savings and </li></ul><ul><li>with least wrist joint movement </li></ul>
    26. 26. Now Available in Market SRS Needle – PETCRYL- FS 2545 Dolphin Sutures

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