Creating a hysterotomy during cesarean delivery is as basic a skill as exists in the practice of obstetrics. Unfortunately, about 0.7% to 1.9% of the time while cutting into the uterus, babies are cut as well.1,2 While at first glance that percentage may seem low, when one takes into consideration that about 1.5 million cesarean deliveries are performed every year in the United States, this small percentage amounts to about 10,500 unnecessary injuries, especially when the appropriate number should be closer to zero!
To minimize the risk of iatrogenic scalpel injuries to babies at the time of cesarean delivery, Ecomed Solutions has introduced the Sureglide cesarean delivery safety scalpel. Its straightforward design offers a stainless steel surgical blade encased in a plastic handle that extends past the blade and forms into a pointed tip. The idea is to use the plastic tip to enter the uterus and then extend the hysterotomy by cutting up and away from the baby. Not surprisingly, in trial use in the operating room, Sureglide worked exactly as expected. With the blade facing up, the tip is pushed through the serosa and myometrium. The hand holding the device is then gently rocked back and pushed forward while the blade safely and efficiently creates a hysterotomy. Easy. Quick. Safe.
On the innovation front, Sureglide is a little wanting as its doppelgänger C Safe has been on the market for several years. In my opinion the 2 devices look, feel and perform almost identically and because C Safe was first, it gets all the innovation points.
By medical device standards, Sureglide is pretty inexpensive ($18 each) but it is still more costly than a #10 scalpel blade. That said, the value play is really about how many cut babies you and your hospital are willing to tolerate.
I have opined before that I think it is time we made newborn lacerations at the time of cesarean delivery a “never” event because we have the technology to essentially eliminate the problem. While rising healthcare costs are always an issue, I am pretty confident most parents would pay for this device themselves out-of-pocket if they knew it could prevent an accidental laceration to their baby.
1. Alexander JM, Leveno KJ, Hauth J, et al. Fetal injury associated with cesarean delivery. Obstet Gynecol. 2006;108(4):885-890.
2. Smith JF, Hernandez C, Wax JR. Fetal laceration injury at cesarean delivery. Obstet Gynecol. 1997;90(3):344-436.