Caption: Figure 3: Sarcophaga third instar larva: LM image: (a) cephaloskeleton with dorsal
cornua showing window apparently 8-shaped (arrow) while the ventral
cornua window is smaller but still well developed (arrowhead).
The authors described their surgical technique, which included division of the mesosalpinx followed by transection of the fallopian tube about 0.5 to 1 cm distal to the
cornua. This process often resulted in transection of the insert, and the remaining insert was grasped and removed with gentle traction.
* Third instar has more heavily pigmented dorsal and ventral
cornua.
Usually, the patient is kept in prone position and then the
cornua is palpated and then the spinal needle is inserted 2-3 mm at an angle of 45 degrees through sacrococcygeal ligament.
At the end, was measured the distance between the apex of anterior and posterior
cornua of lateral and medial menisci.
Near the cephalad margin of the gluteal crease, sacral
cornua should be felt and sacral hiatus is present immediately inferior and in midline.
The device is not considered properly located if greater than 50% is in the cavity or if it is further than 4 cm from the
cornua. If the inserts are properly positioned but there is contrast noted beyond the distal portion of the insert, a repeat HSG at 6 months is warranted.
Such a choice is irrelevant when a flexible hysteroscope is used because the end of the scope moves freely and flexes up to 110 degrees, allowing for adequate visualization of the
cornua and the tubal ostia.
With the patient in prone position, the sacral hiatus was identified by palpating the sacral
cornua, and an epidural needle was inserted through it into the epidural space.
A correctly positioned IUD should be located at the fundus of the uterus, with the arms fully expanded and extending toward the uterine
cornua. The vertical portion of the "T" should extend straight down in the uterine corpus.
Gubernaculum ovarii is a ligamentous structure which attaches to uterine
cornua midway along its course.