The ureter can be felt between your index finger and the Deaver retractor.
Begin by ensuring that the bladder is empty and placing a Deaver retractor at the 12 o'clock position.
Bi-valved vaginal speculum and Deaver retractor
were used to dis-impact the rim on three sides.
The ureters can be palpated with the index finger at 2 o'clock or at 10 o'clock (for the left and right ureter, respectively) against a curved Deaver retractor placed outside the peritoneal cavity on the lateral vaginal wall (Images 3 and 4).
Essential in a vaginal hysterectomy instrument tray are modified deep Deaver retractors that provide additional retraction and visualization particularly in cases of bleeding from pedicles that have retracted to the pelvic sidewall (Image 1).
However, if I substitute a small Deaver retractor, which is narrower, I gain more workspace.
Before entering the peritoneal cavity, create a right angle with the Jacobs tenaculum and Deaver retractor in relation to the surgical field (FIGURE 1, page 32).
In patients with large buttocks or an upper vaginal ring, consider using a narrow Deaver retractor
to gain access to the posterior cul de sac, Dr.
Insert scissors through the peritoneal defect, spread the tips widely, and place the anterior Deaver retractor intraperitoneally (FIGURE 6, page 40) so that bowel can be visualized (FIGURE 7).
A weighted speculum with Deaver retractors at 3, 9, and 12 o'clock provide good visualization if assistants are available.
should be avoided because they increase risk of bladder injury, he said.
The self-retracting blades are also significantly narrower than the weighted speculum and deaver retractors