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What Is a Weighted Speculum?

By Misty Wiser
Updated Mar 03, 2024
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A weighted speculum is a medical tool used to open the vagina for visual inspection during a surgical procedure. The bulbous weighted end of the speculum is inserted into the vagina prior to the start of the operation and left in place for the remainder of the procedure. There are two types of weighted speculums, the traditional model and an articulated version. Some procedures may require the surgeon to use a variety of speculum sizes during a single operation.

Traditional weighted speculums are shaped differently than the common speculum used during most gynecological exams. It has a rounded heavy end with a hollow groove that leads to the blade or spoon of the speculum, where it bends at a 90° angle. The heaviest section of the speculum is placed farthest back into the vagina, securing the speculum in place. This allows the surgeon freedom of movement to complete the procedure.

The conventional weighted speculum must be used in a specific manner to reduce the risk of the instrument falling and injuring the feet of the surgeon. Before it can be inserted into the patient’s vagina, a woman will need to lie on an examination table and place her feet into the stirrups attached to the end of the exam table. The round weighted end of the speculum is placed inside the vaginal canal while the patient is on her back, allowing the surgeon to see a clear visual of the cervix and the interior of the vagina without the speculum leaving the vagina.

An articulated weighted speculum is adjustable to the needs of the individual patient. It can be altered to achieve three different lengths and angles, eliminating the need to switch weighted speculums during a single procedure. The metal handle of this weighted speculum is sterilized in between uses on different patients. Disposable plastic ribbed blades are available in three sizes and are easily attached to the surgical steel handle during vaginal surgery. The ribbing on the blades also allows for easier insertion into the vagina, in some cases the patient may be able to relax without placing her feet into the stirrups as the articulated weighted speculum is inserted.

Another advantage of the articulated speculum is that the blades are made of plastic. Many vaginal surgical procedures require the use of electricity to cauterize the tissue as the operation proceeds. Using a metal weighted speculum may cause the electricity to make a connection, or arc, to the metal of the surgical tool and may damage the delicate vaginal tissues. The articulated weighted speculum features plastic blades that are non-conductive, removing the risk of an injury caused from unwanted electrical arcs towards the metal blades of a traditional weighted speculum.

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