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Minimally Invasive Therapy Unit & Endoscopy Training Centre
University Department of Obstetrics and Gynaecology
Royal Free Hospital
Pond Street
Hampstead
London NW3 2QG, UK

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LATEST NEWS

New "Easy Load" Universal Knot Pusher developed at the Royal Free - click here.

A new website for gynaecologists interested in the surgical management of fibroids is now on line.
www.fibroidsurgery.org

H Pipelle®

Until now, the only way to take an endometrial biopsy after "no touch" hysteroscopy (vaginoscopic hysteroscopy) was to use a speculum to visualise the cervix, and often a tenaculum to facilitate insertion of the biopsy instrument. In collaboration with Laboratoire C.C.D. (France), we have developed a modified version of the Pipelle de Cornier® for use at NTH, so that there is no need to instrument the vagina. The new H Pipelle® is long enough to be passed through the diagnostic sheath of the hysteroscope once the optic has been removed at the end of the hysterosocopy. The ability to obtain an endometrial biopsy without needing to instrument the vagina increases patient comfort. Owing to its length, a high suction pressure is produced and a greater volume of material is aspirated ensuring that sufficient endometrium is collected at the first attempt even after hysteroscopy using a liquid distension medium.

1. Once the hysteroscopic examination of the uterine cavity is finished, the tip of the hysteroscope is withdrawn into the lower uterine cavity.
2. The optic is unlocked and removed completely from the diagnostic sheath.
3. The H Pipelle® is threaded through the sheath into the uterine cavity and up to the fundus.
4. Once the H Pipelle® is in position in the uterus, the hysteroscopic sheath is slid along it to the outside the vagina.
5. A biopsy is then taken in the usual fashion by withdrawing the piston to the end of the biopsy cannula to create negative pressure, and rotating the H Pipelle® while gently moving it back and forth.

In the UK, H Pipelle is now available from Eurosurgical Limited.

References

Di Spiezio Sardo A, Sharma M, Taylor A, Buck L, Magos A. A new device for "no touch" biopsy at "no touch" hysteroscopy: the H Pipelle. Am J Obstet Gynecol. 2004 Jul;191(1):157-8.

Madari S, Al-Shabibi N, Papalampros P, Papadimitriou A, Magos A. A randomized trial comparing the H Pipelle with the standard Pipelle for endometrial sampling at "no touch" (vaginoscopic) hysteroscopy. BJOG 2009;116:32-7.

Dacco' MD, Moustafa M, Papoutsis D, Georgantzis D, Halmos G, Magos A. An audit of using the H Pipelle for endometrial sampling at outpatient hysteroscopy and literature review comparison with the Pipelle de Cornier. Eur J Obstet Gynecol Reprod Biol. 2012;165(2):299-301.

Every invalid is a physician.

Irish Proverb