Novy CORNUAL CANNULATION SET, Руководство пользователя

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NOTE: If spillage of chromotubation solution or 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 14.
14. Detach the 3 ml syringe and occlude the straight arm of the side-arm fitting with the Luer lock cap.
15. 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.
16. Taking care to allow movement of the inner catheter, tighten the Tuohy-Borst adapter on the side-arm
fitting to form a gas tight seal around the inner catheter.
17. 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.
18. 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 is
observed directly by laparoscopy and video display of the proximal oviduct or by characteristic arching
of the tubal isthmus. Advancement may be facilitated by displacing or straightening the fallopian tube
with an instrument under laparoscopic guidance.
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.
19. 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 either the proximal or distal 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.
20. Remove the wire guide and attach a 3 ml syringe filled with chromotubation solution or dilute contrast
medium (25% solution).
21. Inject the chromotubation solution or contrast medium into the tubal ostium while observing
laparoscopically for spillage from the fimbrial portion of the tube. If such spillage is observed, tubal
patency is confirmed.
SUGGESTED INSTRUCTIONS FOR USING NOVY CORNUAL CANNULATION SET WITH
FLUOROSCOPY
1. Remove the stiffening obturator (if included) from the introducing catheter and occlude the straight arm
of the fitting with the Luer lock cap provided. This port is used for irrigation or suction and injection of
contrast medium into the uterine cavity.
2. Loosen the Tuohy-Borst adapter on the inner catheter and introduce the wire guide into it, positioning
the distal tip of the wire guide evenly with the tip of the catheter. Tighten the Tuohy-Borst adapter to fix
the position of the wire guide.
3. Loosen the Tuohy-Borst adapter on the side-arm of the introducing catheter fitting and advance the
inner catheter, with the wire guide in place, through the introducing catheter until both catheter tips
are even. For future reference, note the position of the proximal distance markings on the inner catheter
with respect to the Tuohy-Borst adapter on the side-arm fitting. The first marking should be flush with
the Tuohy-Borst adapter.
4. Remove the inner catheter and wire guide from the introducing catheter, and tighten the Tuohy-Borst
adapter on the side-arm fitting to seal it and prevent leakage.