(1) The trocar of the culdoscope is inserted into the fornix behind the cervix;
the trocar is then introduced into the pelvis between the two uterosacral ligaments.
(2) The trocar is withdrawn from the sheath; the sterile culdoscope is
inserted through the sheath. The culdoscope does not touch the vaginal mucous
membrane thus reducing the possibility of infection to a minimum.
(3) The uterus, tubes, broad ligaments, uterosacral ligaments, rectal wall,
sigmoid, and small intestine may be visualized through manipulation of the scope (see
figure 2-8).
Figure 2-8. Culdoscope. Sagittal section showing culdoscopy viewing pelvic viscera.
(4) In the study of sterility, a self-retaining screw-lipped cervical cannula is
introduced in the cervical canal, and it is connected by a plastic tube to a syringe
containing a dye. If the uterine tube is patent, the dye solution is seen dripping from the
fimbriated end.
(5) The culdoscope is withdrawn, the sheath is left in place, and the patient
is placed on her side. Pressure is exerted on the abdomen to force the air out of the
peritoneal cavity, thereby eliminating postoperative discomfort and potential air
embolus. The vaginal wound is not sutured. The patient is returned to bed.
MD0928
2-27