[A useful technical device to improve the sampling of uterine cervical conization]

Standardized procedures regarding the sampling of cervical conization are extensively described in the Literature. The cervical cone dimension depends on the surgical technical approach and on the extension of the dysplasic/neoplastic lesion. Current sampling procedures frequently turn out to be of problematic correct realization, with special regard to small size cervical cones and to fixed material with subsequent artefactual tissue coarctation. Here we describe a simple device, which makes the cone sampling procedure easier and more accurate, allowing better oriented and better recomposed samples. Perpendicular sections to the cervical lumen allow in fact an accurate evaluation of the lesion's depth and of the status of the resection surgical borders. After conization, preventive agreements with the surgeon provide that, before fixation, a 2-3 mm in diameter smooth plastic probe is inserted into the cervical channel, from the external cervical os to the conization apex (a fragment of the handle of an endocervical cytological brush can be used). The insertion of such a "specillum" must be performed with warning gently since superficial cervical epithelium, especially if dysplasic (overall in case of severe dysplasia), is particularly subjected to mechanical abrasions. The preventive insertion of the endocervical probe makes the cone sampling more manageable, in fact the cervical channel is slightly dilated and the subsequent fixation hardens the cone tissues. After the "specillum" extraction, the cervical lumen appears clearly visible; in such a situation, the endocervical cone apex will be exactly sampled, and the subsequent seriated clockwise sampling of the residual cone will be more smoothly performed, with following preparation of adequate histological sections 4. In our experience such a simple and easy-to-apply device, proves to be useful in making the uterine cone sampling more accurate and comfortable.