How I Do it? - SRS Needle for vaginal hysterectomy by Dr. Sudhir Shah ( Rajkot)

Dr. Sudhir Shah

SRS Needle

Easy Step in Non Descent Vaginal hysterectomy


One of the most dramatic change in the route of removal of the uterus during the last few years is switching over from Abdominal to Vaginal irrespective of the decent of the uterus, volume (fibroids, Adenomyosis) or previous surgeries on it. While doing Non Descent Vaginal Hysterectomy, apart from opening Anterior and Posterior pouch most challenging and time consuming step is transfixation of Uterosacral , Mackenrodts ligaments and ligation of Uterine Pedicle with available 40 mm half circle needle as the space is narrow and pedicle is deep in Vagina.
With 40 mm Half Circle Needle the problem starts from
(1) Where to catch the needle in the Needle holder.
(2) At which angle needle is to be inserted in to the pedicle
(3) Some time tip of needle is lost and can not found on the other side of clamp

Repetitive unsuccessful attempt causes distressing and disturbing expressions on Surgeon and more so on Assistants.
To overcome this disturbing situation I thought of trying short straight needle instead of half circle. I designed new 15 mm short straight needle to make these steps comfortable and easy.

Technique After cutting the pedicle the SRS needle is inserted from below upwards, as shown in the image, so the tip of the needle emerges anteriorly in vision and it can be very easily caught and handled. It can also be inserted from above and to catch from below. Since last 4 years we are using this needle in NDVH. We have done last 1000 Vaginal Hysterectomy with this types of straight needle and was found convenient, easy, time savings and with least wrist joint movement

The SRS needle in now available in market by Dolphine Sutures as PETCRYL* SRS FS 2545.
Comparision of Short Straight Needle –SRS Needle with 40 mm half circle Needle .

40 mm Half Circle Needle

15 mm SRS Needle

Technically Difficult

Technically Very Easy

Movement Difficult

Movement Easy

Surrounding structures may injured

Surrounding structures not injured

Difficult in transfix Pedicle

Easy in transfix Pedicle

More space required to handle the needle

Less space required to handle the needle


Since the incidence of Vaginal hysterectomy is increasing day by day and more and more gynec surgeons are adopting this route for the removal of uterus we have to find out more and more easy and safe steps for the surgery. This new technique is very easy for ligating pedicles apart from its high safety.



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