Novy CORNUAL CANNULATION SET, Manual, Page: 8 / 68

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5. Introduce the appropriate uterine access device into the cervix and affix it in position either on the
cervix or within the uterine cavity.
6. Insert the introducing catheter through the uterine access device and advance the catheter until its
distal tip is positioned in the lower portion of the uterine cavity.
7. Remove the Luer lock cap from the straight arm of the side-arm fitting and attach a syringe filled with
half-strength contrast medium. With fluoroscopic visualization, inject contrast medium through the
introducing catheter to aid visualization of the uterine cavity and tubal ostium.
8. Detach the syringe and introduce a .035 inch Safe-T-J® wire guide (order number: J-SCF-350903) through
the introducing catheter and into the uterine cavity. With the wire guide leading and under fluoro-
scopic guidance, advance the wire guide and catheter together toward the tubal ostium, and wedge the
tip of the catheter in the tubal ostium.
9. Remove the wire guide from the introducing catheter and attach a syringe filled with full-strength
contrast medium. Inject 2 to 10 ml contrast medium into the tubal ostium while observing
fluoroscopically for spillage from the fimbrial portion of the tube. If such spillage is observed, tubal
patency has been confirmed and the procedure is completed.
NOTE: If spillage of contrast medium from the fimbrial portion of the tube into the peritoneal
cavity is not observed, it will be necessary to introduce the inner catheter into the proximal
fallopian tube to confirm tubal blockage or rule-out a false positive result due to temporary tubal
spasm. Please proceed with step 10.
10. Detach the syringe and occlude the straight arm of the side-arm fitting with the Luer lock cap.
11. Loosen the Tuohy-Borst adapter on the side-arm fitting and advance the inner catheter, with the wire
guide in place, through the introducing catheter until the first proximal marking on the inner catheter is
flush with the Tuohy-Borst adapter. The distal tip of the inner catheter should now be even with that of
the introducing catheter.
12. Taking care to allow movement of the inner catheter, tighten the Tuohy-Borst adapter on the side-arm
fitting to form a fluid tight seal around the inner catheter.
13. Cannulation of the intramural portion of the fallopian tube with the wire guide and inner catheter is
begun by first advancing the wire guide (Figure A). The flexibility of the wire guide tip will increase as
the length exiting the catheter tip increases.
14. Advance the wire guide beyond the utero-tubal junction and into the tubal isthmus unless significant
resistance is met (Figure B). Advancement of the wire guide through the utero-tubal junction may be
observed fluoroscopically.
NOTE: If resistance is met and it is not possible to easily advance the wire guide into the tubal
isthmus, exchange the wire guide included in the set for a .015 inch wire guide (order numbers:
J-SMGC-150601 or J-SMGC-150901) and try again.
15. Coaxially advance the inner catheter over the positioned wire guide for a short distance or until
resistance is felt (Figures C and D). The distance the catheter passes into the tubal isthmus may be
determined by observing the distance markings on the proximal portion of the catheter.
WARNING: If significant resistance is felt, do not attempt to advance the catheter.
WARNING: Advancement of the catheter or wire guide beyond the tubal isthmus should not be
attempted.
16. Remove the wire guide and attach a syringe filled with full-strength contrast medium.
17. Inject the contrast medium into the tubal ostium while observing fluoroscopically for spillage from the
fimbrial portion of the tube. If such spillage is observed, tubal patency is confirmed.
CAUTION: Federal (U.S.A.) law restricts this device to sale by or on the order of a physician.