Vacuum Equipment

Everything there is to know about vacuum equipment

The vacuum equipment is a surgical material used in specific procedures that functions as an aspirator for internal substances. Most commonly, this device is used in abortion. A mechanical suction is performed under general anesthesia to remove the pregnancy from the uterus. The cervix is dilated to provide access to the uterus, where the surgeon inserts a tube attached to an aspirator. Following this, the surgeon moves the tube back and forth to suck and remove all the pregnancy tissues and uses a curette application to the walls of the uterus to ensure full removal. A Cytotec agent like misoprostol is taken before the surgery to prepare the uterus for abortion. The system works automatically by an electric pump or manually by a hand-held syringe, mostly made from clear plastic to reduce the irritation and with standardized sizes.

History 

In 1958, the first aspiration abortion was done by Doctor Wu Yuantai, and this was the substitute for the traditional way that used hard metal instruments. Fifteen years later, this work was translated into English, which later became the most common method to use in obstetric settings for its safety and efficacy.

In 1967, the vacuuming method was introduced by the British Obstetrician, Dorothea Kerslake, who later published his study in the United States and further recognized his technique.

In 1849, American physician, Fredrick Hollick, invented the first medical vacuum using burning alcohol in a particular vessel to produce negative pressure.

In 1863 Scottish Physician, Sir James Simpson, developed the Fredrick invention to use it to induce delayed menstruation.

Indications to use Vacuum Equipment

This device is used for gynecological and obstetrics surgeries to perform a lot of medical indications, by providing access to the uterus and a tool to extract, aspirate, and cleanse functions needed in the following procedures.

  • Vacuum aspiration procedure

An automatic pump most commonly performs the vacuuming procedure for the uterine. Some countries still use manual devices, but it is not preferable due to the high complications profile. The system includes two vacuum bottles and the third one with a one-direction valve to protect against fluid overflow. The aspiration system should have a compatible design with plastic hoses and connections with curettes with a standard size.

Before the procedure, a dilator should be placed in the cervix to ensure a safe opening to the cervical canal. A broad-spectrum antibiotic is prescribed prophylactically to prevent infection in the surgical site, along with a Cytotec agent (misoprostol), and to prepare the uterus by softening the cervix before the surgery. The surgery takes on average of 10 to 15 minutes.

A complementary procedure of dilation and curettage (D&C) may be needed after the vacuum abortion if the pregnancy tissues are not entirely removed.

  • Endometrial Biopsy

This procedure is mostly an investigational method, which helps diagnose different uterine conditions such as uterine bleeding, endometriosis, acute pelvic inflammatory disease, cancer screening, and vaginal infections. The technique uses a catheter to take a sample of the uterus tissues by inserting the catheter equipment and twirling it to aspirate the tissue sample and preserve it in a tube for examination in a histopathology laboratory.

Complications of using vacuum equipment

  • Intraoperative and postoperative bleeding

During aspiration abortion or after surgery, excessive hemorrhage may indicate different conditions, including cervical laceration, uterine bleeding, perforation, and coagulopathy. These conditions may occur due to the irritation to the internal tissues of the cervix resulting from the dilator, the curette, or the cannula.

  • Uterine perforation

Uterine perforation is considered a severe complication that can lead to visceral injury and life-threatening hemorrhage. The perforation most commonly occurs at the junction of the cervix in the lower segment of the uterus.

  • Infection

The presence of a fever of 100.4°F (38°C) or higher after the operation indicates an infection at the surgical site. For this, the administration of a prophylactic antibiotic is recommended to avoid this complication. In the case of a detected infection, a target postoperative antibiotic should be administered.

Alternative Instruments 

Intrauterine device (IUD)

The IUD is a small device inserted and placed inside the uterus to prevent a pregnancy settlement. The IUD works by mechanical irritation to the mucosa that prevents any of the pregnancy tissues from adhering to the uterine wall, or by hormonal release for devices containing progesterone-like MERINA.

Diaphragm and cervical cap

The cervical cap is a cup-shaped device made from silicone that works with spermicide gel to kill sperms.

Combined oral contraceptive pill

An oral medication consists of combined hormonal therapy, and when taken orally every day in a constant pattern for an average of 21 days, it prevents pregnancy. 

General Specifications of vacuum equipment

The surgical vacuum equipment is made from transparent plastic material and designed to fit with the sterile system.

Vacuum suction pump system

The curettage system machine is highly reliable and easy to operate and maintain. 

The voltage of operating:  115 Vac, 60 Hz

The Leakage Current: Less than 150 µa

Type of the Pump: Double rotary vane pump

Physical Dimensions:

The width: 46.4 cm

The depth: 63.5 cm

The height: 96.5 cm

Total Weight: 50 Kg

Curette cannula

The semi-rigid thin body and circular tip design of the curette cannula serve the aspiration function with high performance and is a minimal irritant to the cervical wall.  

How They Work 

Before performing the vacuum aspiration, the cervical dilator quickly dilates the cervix to provide access to the surgeon and help insert the equipment into the cervical canal. This occurs with a pre-surgical medication called misoprostol given to induce a softer cervix. The procedure is indicated in the first trimester of pregnancy and can be in an outpatient setting or the hospital. The equipment needs to be prepared with an aseptic technique for maximum sterility when used and inserted. The cannula should avoid any touch with the vaginal walls before insertion. The cannula has several sizes, and the choice of adequate size depends on the size of the cervix. The aspiration process is performed by an electrical suction pump that works by generating a negative pressure in the pipeline connected to the surgical equipment, thus resulting in a continual flow that helps to eliminate the targeted fluids, blood, tissues, and the dead cells inside the uterus. Upon completing the abortion process, an antiseptic agent is applied to the cervix to decontaminate the site and prevent infection. 

Market Leaders

  1. Transact International
  2. FLEXICARE Medical Ltd.
  3. INVUITY
  4. IKA laboratory
  5. Chattanooga International
  6. De SOUTTER Medical Ltd
  7. MED-GYN products incorporation
  8. STERYLAB medical products
  9. MERINGER
  10. PRODIMED PLASTIMED

Conclusion 

The vacuum equipment is a surgical, functional material used in sucking out internal target body tissues, fluids, blood, and secretion. The manufacture of the curettage equipment primarily controls miscarriage in obstetric settings. These types of procedures require full eradication of the dead tissues of failed pregnancy inside the uterus performed under general anesthesia and done with equipment inserted through the cervix, after a dilation process and with the help of the pre-surgical Cytotec medication misoprostol. The manual vacuum aspiration is limited in use and prohibited in many countries due to the high risk and the significantly high complications related to the surgery. In contrast, the conventional automatic pump system is mostly used with an electric vacuum system connected to the aspiration equipment to ensure a continuous negative pressure that preserves the flow of fluids and tissues, making the process easier and faster. Also, it reduces the risk of incomplete abortion that may require further intervention.