Graves Speculum — Large 115mm × 35mm

Graves Speculum — Large 115 × 35 mm

The 115 × 35 mm Graves is the extra-long, full-width speculum reserved for the demanding exposure: heavily parous patients with markedly redundant lateral walls, pelvic-organ-prolapse repair (anterior colporrhaphy with paravaginal repair, sacrospinous ligament fixation, Manchester repair), and the obese patient in whom a 105 mm blade cannot bring the cervix into the field even with full lateral-screw aperture.

The prolapse-repair fit

In sacrospinous fixation the surgeon needs the cervix and the apex of the prolapse displaced fully toward the introitus while the index finger palpates the ischial spine — the 115 mm blade length and full 35 mm distal width hold the redundant anterior wall back so the spine is reachable without an assistant’s second retractor. In anterior colporrhaphy the same speculum lifts the bladder base for the dissection plane.

Obesity and the cervix

BMI > 35 is the indication that pushes the operator from the 105 mm large to the 115 mm extra-long — the abdominal pannus changes the angle of approach and the cervix retreats toward the sacrum. The longer blade lets the operator reach it without the wrist contortion that compromises the rest of the operation.