Greenberg James A
Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
JSLS. 2006 Jan-Mar;10(1):129-30.
Although the ubiquitous Graves speculum (open-sided or closed) is versatile and familiar, its shortest length is often too long for comfortable manipulation of the newer, pliable, flexible hysteroscopes. The Greenberg speculum is a modification of a Graves speculum with an open side to allow for the removal of instruments while they are still in the vagina. Whereas a standard mediumsized, open-sided Graves speculum measures 110 mm in maximum length, the Greenberg speculum measures only 74 mm. Although the difference between the speculums is only 36 mm in maximum length, this alteration can add considerable ease to placement of both flexible and rigid hysteroscopes in the office or operating room. In this study, we sought to quantify the benefit of this new device by demonstrating that this speculum brings the patient's cervix closer to the provider and reduces the length of unsupported hysteroscope shaft entering the cervical canal.
We measured the intraspeculum distance from the operator-side opening of the speculum to the external cervical os by using first a standard medium open-sided Graves speculum and then a Greenberg speculum.
Use of the Greenberg speculum reduced the mean minimum intraspeculum distance from the extended fingertips grasping a hysteroscope to the external cervical os by an average of 28 mm or 34% compared with a Graves speculum.
We believe this new speculum offers a subtle but distinct advantage over standard speculums for hysteroscopy.
尽管无处不在的格雷夫斯窥器（开放式或封闭式）用途广泛且广为人知，但其最短长度对于操作新型的、柔韧的、可弯曲的宫腔镜来说往往过长，操作起来不够舒适。格林伯格窥器是对格雷夫斯窥器的一种改良，有一侧开口，以便在器械仍在阴道内时取出。标准的中型开放式格雷夫斯窥器最大长度为110毫米，而格林伯格窥器仅为74毫米。尽管两种窥器的最大长度差异仅为36毫米，但这一改变能极大地便于在诊室或手术室中放置柔性和刚性宫腔镜。在本研究中，我们试图通过证明这种窥器能使患者的宫颈更靠近术者，并减少进入宫颈管的无支撑宫腔镜镜杆长度，来量化这种新器械的益处。
我们先用标准的中型开放式格雷夫斯窥器，然后用格林伯格窥器测量窥器内从术者侧开口到宫颈外口的距离。
与格雷夫斯窥器相比，使用格林伯格窥器可使从握住宫腔镜的伸展指尖到宫颈外口的平均最小窥器内距离平均减少28毫米，即减少34%。
我们认为这种新型窥器在宫腔镜检查方面比标准窥器具有细微但明显的优势。
