INSTRUMENT TO PREPARE AND SAFELY PLACE AN INTRA-UTERINE DEVICE

Abstract

An instrument (10) to prepare and safely place an intra-uterine device (30) in uterus (50) of a woman, comprising a dynamic stopper (20), a string management arrangement (110) whereby a string (31) of an IUD (30) is in one of a locked condition or an unlocked condition, an operating device (100), further comprising a base (70), a cover (90) a carriage (140), wherein the dynamic stopper (20) slidably resides in the base (70) and can slide by the sliding length (23), wherein the string (31) exits from an outpoint (87) and re-enters from an inpoint (88), the outpoint (87) is at a trim length (46) and the inpoint (88) is at a conservative length (47). The string (31) can be trimmed as per sounding measurement of uterus (50) of woman, before inserting the instrument (10) in uterus (50) and string (31) entanglement possibilities are eliminated, irrespective of type of IUD (30, 30A, 30B).

Claims

01. An instrument (10) configured to prepare and safely place an intra-uterine device in uterus (50) of a woman, the instrument (10) comprising a “T” shaped intra-uterine device (IUD) (30) with both arms (34) foldable away from a stem (33) of the IUD (30), a graduated tube (16), a push rod (17) inside the graduated tube (16), wherein the instrument (10) further comprises: a dynamic stopper (20) with a tubular channel (22) and a flange (25), wherein a sliding length (23) of the dynamic stopper (20) is commensurate with an arm length (38) of the arms (34) of the IUD (30); a string management arrangement (110) whereby a string (31) of the IUD (30) is in one of a locked condition or an unlocked condition; and an operating device (100), further comprising a base (70) having an array of continuous inclines and notches (82) alternately for a prescribed length (83), a plurality of cover engagement means (74), a tube guideway (84), a first flange guiding projections (72), a carrier guiding projections (73), a cover (90) having a slot (91), a plurality of base engagement means (94) equal in number of the cover engagement means (74), a knob (150), a knob markings (95), a carriage (140) having a travel slot (143), at least a pair of locking tooth (148) on either carrier side, a pushrod passageway (147) with a seat (146), an operating knob (150) having at least a pointer (158), a hanging tubular construction (152) with a larger diameter part (153) along with a pusher (156) and a smaller diameter part (154); wherein, the pushrod (17) has a collar (18) and a reversibly collapsible fitment means (19) at an operator end (6) and a flat surface (13) at an IUD end (5), and the graduated tube (16) having an edge (11) at the IUD end (5), a measurement markings (14) and a string exit slot (15); wherein, the dynamic stopper (20) slidably resides in the base (70) and can slide by the sliding length (23), an operator end (6) of the graduated tube (16) is slid through the tubular channel (22) of the dynamic stopper (20), till the operator end (6) of the graduated tube (16) is disposed firmly in the larger diameter part (153) of the knob (150), the dynamic stopper (20) rides on the graduated tube (16), the hanging tubular construction (152) of knob (150) resides in the travel slot (143) of the carriage (140), the push rod (17) resides inside the graduated tube (16) with the reversible collapsible fitment means (19) of the pushrod (17) pushed in the pushrod passageway (147) such that the collar (18) of the pushrod (17) sits in the seat (146) of the carriage (140); and when the knob (150) is made to slide towards the IUD end (5), the graduated tube (16) and the dynamic stopper (20) also travel towards the IUD end (5), the dynamic stopper (20) travels by the sliding length (23) while the graduated tube (16) engulfs the arms of the IUD till the edge (11) of the graduated tube (16) is stopped by the dome shaped ends (36) of the arms (34) having come almost together while the string (31) remains in the locked condition, a further sliding of the knob (150) towards the IUD end (5) causes the carriage (140) to also move towards the IUD end (5), the pushrod (17) correspondingly moves while the string (31) is in the unlocked condition, a forward and a backward movement of the operating knob (150) by a sliding force on a thumb surface (159), a single hand grips the instrument (10) as well as moves the knob (150) by a thumb of the same hand.

02. The instrument (10) configured to prepare and safely place the intra-uterine device (30) as claimed in claim 01, wherein the string management arrangement (110) comprises a string plug (144) of the carriage (140) and a string socket (75) with a hole (76) on the base (70), the instrument (10) that is ready to use has the string (31) passed through the hole (76), taut, the string plug (144) plugged into the string socket (75), the string (31) therefore is in the locked condition; a movement of the carriage (140) towards the IUD end (5) causes the string plug (144) to move away and unplug from the string socket (75), the string (31) consequently is in the unlocked condition.

03. The instrument (10) configured to prepare and safely place the intra-uterine device (30) as claimed in claim 01, wherein the string management (110) comprises a floating cone (40) floatingly disposed on the graduated tube (16) and a tubeway (77) integratedly provided on the base (70), wherein the floating cone (40) has a tubular hole (41) on an inside, a conical frustum (42) on an outside and a hook (43) on an IUD end (5) of the floating cone (40), while the tube way (77) has an inner cylindrical path through which the graduated tube (16) passes clearly, while the floating cone (40) gets seated firmly like plug-socket, the instrument (10) that is ready to use has the string (31) wrapped around the hook (43), slid through the tubular hole (41) and the tubeway (77) taut, while the floating cone (40) is firmly plugged in the tubeway (77), the string (31) continues to stay in the locked condition, and when the knob (150) is made to slide towards the IUD end (5), the floating cone (40) continues to remain plugged in the tubeway (77), a further sliding of the knob (150) towards the IUD end (5) causes the carriage (140) to also move towards the IUD end (5), and consequently the pushrod (17) also correspondingly moves, the string (31) is unwrapped from over the hook (43) and the floating cone (40) gets plugged out, and the string (31) is in the unlocked condition.

04. The instrument (10) configured to prepare and safely place the intra-uterine device (30) as claimed in claim 01, wherein the string management (110) comprises an extended receptacle (145) with an open side (145A) on the operator side (6) of the carriage (140), and an end plug (78) with a slit (79) integratedly provided on the operator end (6) of the base (70), in the instrument (10) ready to use, the string (31) emerges out of the extended receptacle (145), taut, sits on the slit (79), and emerges out of an opening (89) of the base (70) while the extended receptacle (145) is firmly mounted on the end plug (78), keeping the string (31) in the locked condition; a movement of the carriage (140) towards the IUD end (5) causes the extended receptacle (145) to move away and dismount from the end plug (78), the string (31) is consequently in the unlocked condition.

05. The instrument (10) configured to prepare and safely place the intra-uterine device (30) as claimed in claim 01, wherein the base (70) has at least one outpoint (87) and one inpoint (88), wherein the string (31) exits from the outpoint (87) and re-enters from the inpoint (88).

06. The instrument (10) configured to prepare and safely place the intra-uterine device (30) as claimed in claim 05, wherein the outpoint (87) is at a trim length (46) which is a minimum recommended excess string (31) length expected to be hanging outside a cervical os (51) in vaginal cavity of woman.

07. The instrument (10) configured to prepare and safely place the intra-uterine device (30) as claimed in claim 05, wherein the inpoint (88) is at a conservative length (47).

08. The instrument (10) configured to prepare and safely place the intra-uterine device (30) as claimed in claim 05, wherein the outpoint (87) and the inpoint (88) have a scale (48) alongside.

09. The instrument (10) configured to prepare and safely place the intra-uterine device (30) as claimed in claim 05, wherein the base (70) is curvatured, and the cover (90) is curvatured correspondingly.

10. The instrument (10) configured to prepare and safely place the intra-uterine device (30) as claimed in claim 01, wherein the dynamic stopper (20) further comprises a non-circular outer faces of lesser mating perimeter than that of the flange (25), there are provided guide paths (21) at least on two alternate faces of the dynamic stopper (20), wherein a face distance (26) of the tubular channel (22) permits a multi-point contact with the graduated tube (16) and allows a passage of the graduated tube (16) tightly.

11. The instrument (10) configured to prepare and safely place the intra-uterine device (30) as claimed in claim 01, wherein the carriage (140) further comprises a knob assembly opening (143A) which is wider than the travel slot (143) and a travel surface (149) on a lower side (142) of the carriage (140)

12. The instrument (10) configured to prepare and safely place the intra-uterine device (30) as claimed in claim 01, wherein the base (70) has an out opening (89) through which a terminating end (35) of the string (31) emerge out.

13. The instrument (10) configured to prepare and safely place the intra-uterine device (30) as claimed in claim 01, wherein the push rod (17) has a longitudinal channel (12) along a length (17A) of the push rod (17).

14. The instrument (10) configured to prepare and safely place the intra-uterine device (30, 30A, 30B) as claimed in claim 01, wherein a method to load the instrument (10) and safely place the IUD (30, 30A, 30B) comprises the steps of: a) Sliding the operating knob (150) towards an IUD end (5) till the arms (34) of the IUD (30) are folded and fully contained in the graduated tube (16), b) Sliding the operating knob (150) further towards the IUD end (5) till the graduated tube (16) projects out by a length of a uterine depth (45), judging by hearing an audible clicking sound produced due to the pair of locking tooth (148) negotiating with the array of inclines and notches (82) or judging by the measurement markings (14) on the graduated tube (16) aligning with the flange (25) or by the position of the pointer (158) of the operating knob (150) at the knob markings (95) on the cover (90), c) Inserting the graduated tube (16) in the uterus (50) till the flange (25) touches cervical os (51) of the uterus (50), d) Sliding back the operating knob (150) till the dynamic stopper (20) retracts by the sliding length (23) and stops, e) Further inserting the graduated tube (16) in the uterus (50) till the flange (25) of retracted dynamic stopper (20) again touches the cervical os (51), f) Sliding back the operating knob (150) as much as possible, g) Taking out the graduated tube (16) from woman, and h) Trimming an excess length of the string (31) of the IUD (30).

15. The instrument (10) configured to prepare and safely place the intra-uterine device (30, 30A, 30B) as claimed in claim 01, wherein a method to load the instrument (10) and safely place the IUD (30, 30A, 30B) comprises the steps of: a) Sliding the operating knob (150) towards an IUD end (5) till the arms of the IUD (30) are folded and fully contained in the graduated tube (16), b) Sliding the operating knob (150) further towards the IUD end (5) till the graduated tube (16) projects out by a length of the uterine depth (45), judging by a clicking sound produced due to the pair of locking tooth (148) negotiating with the array of inclines and notches (82) or judging by the measurement markings (14) on the graduated tube (16) aligning with the flange (25) or by the position of the pointer (158) of the operating knob (150) at the knob markings (95) on the cover (90), c) Trimming an excess length of the strings (31) of the IUD (30) anywhere in a conservative length (47), d) Inserting the graduated tube (16) in the uterus (50) till the flange (25) touches cervical os (51) of the uterus (50), e) Sliding back the operating knob (150) till the dynamic stopper (20) retracts by the sliding length (23) and stops, f) Further inserting the graduated tube (16) in the uterus (50) till the flange of retracted dynamic stopper (20) again touches the cervical os (51), g) Sliding back the operating knob (150) as much as possible, and h) Taking out the graduated tube (16) from woman.

16. An instrument (10) configured to prepare and safely place an intra-uterine device (30, 30A, 30B) characterized by a base (70) having at least one outpoint (87) and one inpoint (88), wherein a string (31) of the intra-uterine device (30, 30A, 30B) exits from the outpoint (87) and re-enters from the inpoint (88), the outpoint (87) at a trim length (46) which is a minimum recommended excess string length expected to be hanging outside a cervical os (51) in vaginal cavity of woman, the inpoint (88) at a conservative length (47), the outpoint (87) and the inpoint (88) have a scale (48) alongside.

Description

BRIEF DESCRIPTION OF DRAWINGS

[0058] FIG. 1 is a perspective view of an instrument as per present invention.

[0059] FIG. 2 is an exploded view of the present invention.

[0060] FIG. 3 are front views of an IUD with its arms unfolded (almost horizontal) and folded (almost vertical).

[0061] FIG. 4 are perspective views of a dynamic stopper.

[0062] FIG. 5 is a perspective view of a base with enlarged views of encircled portion of the base.

[0063] FIG. 6 is a perspective view of a cover while FIG. 6A is another perspective view with enlarged view of encircled portion of the cover.

[0064] FIG. 7 is a perspective view and a sectional view of an operating knob.

[0065] FIG. 8 are two perspective views of a carriage while FIG. 8A is a partial sectional view of the carriage.

[0066] FIG. 9 is a perspective view of a push rod with an enlarged view of its encircled portion.

[0067] FIG. 10 is a perspective view of a graduated tube with an enlarged view of its encircled portion.

[0068] FIG. 11 is a partial sectional side view of the carriage and the push rod engaged therein.

[0069] FIG. 12 is a sectional view of a first embodiment of a string management arrangement with a string unlocked, while FIG. 12A is a sectional view showing the string locked.

[0070] FIG. 13 is a front view of the instrument with the graduated tube extended in accordance with uterine depth of uterus.

[0071] FIGS. 14 to 18 are front views of steps of insertion and safe release of the IUD in uterus.

[0072] FIGS. 19 and 19A is a sectional view of a second embodiment of the string management arrangement with the string locked, FIG. 19A is a sectional view with the string unlocked, while FIG. 19B is a perspective view and a sectional view of a floating cone.

[0073] FIGS. 20, 20A and 20B, are views showing string trimming arrangement after loading but before insertion of IUD, while FIG. 20C shows string trimming arrangement for different kinds of IUDs.

[0074] FIGS. 21, 21A are perspective views of the base and the carriage, while FIGS. 21B and 21C are partial sectional views of a third embodiment of the string management arrangement.

[0075] FIG. 22 is a perspective view of the push rod as per another embodiment.

DETAILED DESCRIPTION OF INVENTION

[0076] The present invention of an instrument to load and insert an upfoldable intra-uterine device and process thereof will now be described with reference to the accompanying drawings. It is to be understood that the description explains the preferred embodiments and several ways are possible around the invention. Apropos, the description should not be construed to limit the invention in any way whatsoever. The terms and expressions which have been used here are merely for description and not for limitation. The term “preparing” and “loading” are used interchangeably.

[0077] FIG. 1, 2 the instrument (10) according to present invention comprises a “T” shaped intra-uterine device (30), a graduated tube (16), a push rod (17) inside the graduated tube (16), a dynamic stopper (20) with a flange (25), operated by an operating device (100). The instrument (10) further comprises a string management arrangement (110), shown in FIGS. 12 and 12A being one of the embodiments. The preferred embodiment is around the IUD (30) generally comprising a frame having two arms (34) and a stem (33), with both arms (34) of the IUD (30) foldable away from the stem (33) of the IUD (30), as shown in FIG. 3. The instrument (10) is shipped in this position when the IUD (30) is with its arms (34) in a “T” formation with respect to the stem (33), as it should be when placed in uterus of woman. The IUD (30) further comprises a contraceptive material (49) disposed around the stem (33), and at least one string (31) emerges from a lower end (37) of the stem (33). The string (31) has a terminating ends (35). The string (31) of the IUD (30) is in an unreleased or a locked condition, and taut between the lower end (37) and the operating arrangement (110), when the instrument (10) is received by a medical service provider. In the present invention, the string (31) is NOT required to be pulled/manipulated by the medical service provider for loading or preparing the instrument (10), and the loading/preparing method is described below. Apropos, the terminating ends (35) of the string (31) can be concealed in the operating device (100) and may or may not be visible/accessible to medical service provider.

[0078] As shall be evident, the process of loading, inserting in uterus and safely releasing the IUD (30) is carried out by a single hand operation, and it is of great benefit to the medical service provider. An IUD end (5) and an operator end (6) signifies direction of the instrument (10) and all parts while describing features, sub-assembly, assembly and method of use.

[0079] FIG. 4, the dynamic stopper (20) is a tubular channel (22) having the flange (25) at the IUD end (5) of the dynamic stopper (20) and a non-circular outer face of lesser mating perimeter than that of the flange (25). There are provided guide paths (21) at least on two alternate faces of the dynamic stopper (20). A sliding length (23) of the dynamic stopper (20) is commensurate with an arm length (38) of the arms (34) of the IUD (30). A face distance (26) of the regular hexagonal channel (22) permits multi-point contacts on the graduated tube (16) and allows a passage of the graduated tube (16) tightly.

[0080] FIG. 2, the operating device (100) comprises [0081] a base (70) [0082] a cover (90) [0083] an operating knob (150) [0084] a carriage (140)

[0085] FIG. 5, the base (70) has two parallel walls (80) a floor (81), an open neck construction (73) with a collar (71) and a first flange guiding projections (72) at its IUD end (5) of each wall (80) or on the floor (81). There are carrier guiding projections (73) on the floor (81).

[0086] On an inside of the walls (80) is provided an array of continuous incline and notches (82) alternately for a prescribed length (83). There are a plurality of cover engagement means (74) on both the walls (80). A tube guideway (84) is provided on the floor (81). Also provided is a string socket (75) with a hole (76). The base (70) is slightly curvatured.

[0087] FIG. 8, 8A, the carriage (140) has a travel slot (143) on an upper side (141), at least a pair of locking tooth (148) on an either carrier side. The travel slot (143) has an assembly opening (143A) which is wider than the travel slot (143). On the lower side (142) is a travel surface (149). There is provided a string plug (144) on the lower side (142). At the operator end (6) is a pushrod passageway (147) with a seat (146).

[0088] FIG. 7, the operating knob (150) has a thumb surface (159), and at least a pointer (158) on an either knob side. There is provided a hanging tubular construction (152) on an opposite side (158) of the thumb surface (159). The tubular construction (152) has a larger diameter part (153) having a pair of pusher (156), and a smaller diameter part (154).

[0089] FIG. 6, 6A, the cover (90) has a slot (91), an open complementing neck construction (93), a second flange guiding projections (92), and a plurality of base engagement means (94) equal in number of the cover engagement means (74). A knob markings (95) are provided on an external side (96) of the cover (90). The cover (90) is slightly curvature in accordance with the base (70).

[0090] FIG. 9, the pushrod (17) is a slender cylinder, has a collar (18), a reversibly collapsible fitment means (19) at its operator end (6) and a flat surface (13) at the IUD end (5).

[0091] FIG. 10, the graduated tube (16) is a thin walled hollow cylinder having an edge (11) at the IUD end (5), a measurement markings (14) and a string exit slot (15).

[0092] In the instrument (10) that is ready to use, the dynamic stopper (20) slidably resides in the base (70) free to slide along the guide paths (21) constrained by the first flange guiding projections (72) and or the second flange guiding projections (92), and can slide by the sliding length (23). The operator end (6) of the graduated tube (16) is slided with a little force through the tubular channel (22) of the dynamic stopper (20), till the operator end (6) of the graduated tube (16) is disposed firmly in the larger diameter part (153) of the knob (150). The dynamic stopper (20) rides on the graduated tube (16). The hanging tubular construction (152) of knob (150) resides in the travel slot (143) of the carriage (140). The push rod (17) largely resides inside the graduated tube (16) with the reversible collapsible fitment means (19) of the pushrod (17) pushed in the pushrod passageway (147) such that the collar (18) of the pushrod (17) sits in the seat (146) of the carriage (140), FIG. 11. The stem (33) of the IUD (30) sits in the graduated tube (16) at its IUD end (5), while the string (31) is slipped in and exits from the string exit slot (15) and is trapped between the string plug (144) and the string socket (75) while keeping it tautly pulled out from the hole (76), thus the string (31) is in the unreleased or the locked condition, FIG. 12. The terminating ends (35) of the string (31) are contained inside of the base (70) near its operator end (6).

[0093] For use of the instrument (10), when the knob (150) is made to slide towards the IUD end (5), the graduated tube (16) and the dynamic stopper (20) also travel towards the IUD end (5). The dynamic stopper (20) travels forward by the sliding length (23) while the graduated tube (16) engulfs the arms of the IUD (30) till the edge (11) of the graduated tube (16) is stopped by the dome shaped ends (36) of the arms (34) having come almost together. Further sliding of the knob (150) towards the IUD end (5) causes the carriage (140) to also move towards the IUD end (5) due to the pusher (156) of the knob (150), and consequently the pushrod (17) also correspondingly moves. A movement of the carriage (140) towards the IUD end (5) causes the string plug (144) to move away and thus unplug from the string socket (75) and the string (31) is in an unlocked or a released condition, FIG. 12A.

[0094] The string management arrangement (110) in this embodiment therefore comprises the string plug (144) of the carriage (140) and the string socket (75) of the base (70); and locking and unlocking the string (31) takes place as described above.

[0095] FIGS. 13-18, a method to load the instrument (10) and safely place the IUD (30) in uterus (50) comprises the steps of: [0096] a) Sounding a uterus of woman and determining a uterine depth (45) [0097] b) Sliding the operating knob (150) towards an IUD end (5) till the arms (34) of the IUD (30) are folded and fully contained in the graduated tube (16), [0098] c) Sliding the operating knob (150) further towards the IUD end (5) till the graduated tube (16) projects out by a length of the uterine depth (45), judging by hearing an audible clicking sound produced due to the pair of locking tooth (148) negotiating with the array of inclines and notches (82) or judging by the measurement markings (14) on the graduated tube (16) aligning with the flange (25) or by the position of the pointer (158) of the operating knob (150) at the knob markings (95) on the cover (90), [0099] d) Inserting the graduated tube (16) in the uterus (50) till the flange (25) touches cervical os (51) of the uterus (50), [0100] e) Sliding back the operating knob (150) till the dynamic stopper (20) retracts by the sliding length (23) and stops, [0101] f) Further inserting the graduated tube (16) in the uterus (50) till the flange (25) of retracted dynamic stopper (20) again touches the cervical os (51) [0102] g) Sliding back the operating knob (150) as much as possible, [0103] h) Taking out the graduated tube (16) from woman, and [0104] i) Trimming an excess length of the strings (31) of the IUD (30).

[0105] Importantly, due to the inventive dynamic stopper (20) that moves equivalent to arm length (38), the medical service provider doesn't have to approximate intermediate stop and partial release of the IUD (30) as is prevalent in prior art products.

[0106] FIGS. 19, 19A, 19B, 20, in another embodiment, the string management (110) comprises a floating cone (40) floatingly disposed on the graduated tube (16) and a tubeway (77) integratedly provided on the base (70).

[0107] The floating cone (40) has a tubular hole (41) on an inside and a conical frustum (42) on an outside. There is provided a hook (43) on the IUD side (5) of the floating cone (40). The tube way (77) has an inner cylindrical path through which the graduated tube (16) passes clearly, while the floating cone (40) gets seated firmly in the tube way (77) like any known plug and a socket arrangement.

[0108] In the instrument (10) as per second embodiment that is ready to use, the string (31) is wrapped around the hook (43) by several turns, slid through the tubular hole (41) and the tubeway (77) taut, while the floating cone (40) is firmly plugged in the tubeway (77).

[0109] For use of the instrument (10) as per second embodiment, when the knob is made to slide towards the IUD end (5), the graduated tube (16) travels towards the IUD end (5), while the floating cone (40) continues to remain plugged in the tubeway (77). The dynamic stopper (20) also travels by the sliding length (23) while the graduated tube (16) engulfs the arms (34) of the IUD (30) till the edge (11) of the graduated tube (16) is stopped by the dome shaped ends (36) of the arms (34) having come almost together. Further sliding of the knob (150) towards the IUD end (5) causes the carriage (140) to also move towards the IUD end (5), and consequently the pushrod (17) also correspondingly moves. The string (31) is unwrapped from over the hook (43) and the floating plug (40) gets plugged out, and the string (31) is in the unlocked or the released condition.

[0110] FIGS. 21, 21A, 21B, 21C, in yet another embodiment, the string management (110) comprises an extended receptacle (145) with an open side (145A) on the operator side (6) of the carriage (140), and an end plug (78) with a slit (79) integratedly provided on the operator end (6) of the base (70).

[0111] In the instrument (10) as per third embodiment that is ready to use, the string (31) emerges out of the extended receptacle (145), taut, sits on the slit (79), and emerges out of an opening (89) of the base (70) while the extended receptacle (145) is firmly mounted on the end plug (78), keeping the string (31) in the locked condition.

[0112] For use of the instrument (10) as per third embodiment, when the operating knob (150) is made to slide towards the IUD end (5), the graduated tube (16) travels towards the IUD end (5), while the carriage (140) and therefore the extended receptacle (145) continues to remain mounted on the end plug (78). The dynamic stopper (20) also travels by the sliding length (23) while the graduated tube (16) engulfs the arms (34) of the IUD (30) till the edge (11) of the graduated tube (16) is stopped by the dome shaped ends (36) of the arms (34) having come almost together. Further sliding of the operating knob (150) towards the IUD end (5) causes the carriage (140) to also move towards the IUD end (5), and consequently the pushrod (17) also correspondingly moves. The extended receptacle (145) now gets dismounted from the end plug (78), string (31) is untrapped from an in-between of the end plug (78) and the extended receptacle (145), and thus the string (31) is in the unlocked or the released condition.

[0113] FIG. 20, 20A, 20B, 20C, there is provided at least one outpoint (87) and one inpoint (88) on the floor (81) of the base (70). The outpoint (87) and the inpoint (88) is essentially a tapered hole. The string (31) exits from the outpoint (87) and re-enters from the inpoint (88). The string (31) is accessible to the medical service provider between the outpoint (87) and the inpoint (88) and the medical service provider has a preferred option to trim the string (31) as per sounding measurement of uterus of woman, BEFORE inserting the graduated tube (16) in the cervix thereby avoiding use of scissors or cutting tool inside vaginal cavity, and this is most desired, safer and therefore preferred way of using the instrument (10) as per the present invention. The outpoint (87) is at a trim length (46) which is a minimum recommended excess string length expected to be hanging outside cervical os (51) in vaginal cavity of woman. The inpoint (88) is at a conservative length (47). Medical service provider has the freedom to trim the string (31) anywhere within the conservative length (47). A scale (48) is provided alongside to facilitate precision in trimming.

[0114] It is to be noted that the invention of string trimming before insertion is of significant benefit for instruments suited for all and any kind of IUD (30, 30A, 30B) and not limited to T-shaped IUD's, and this is an important ingredient of our invention. This ingredient of invention also implies that during release of the IUD (30, 30A, 30B), the instrument (10) handles much lesser length of string (31) than the prior art instruments wherein a long string (31) is always present till after release of IUD in uterus (50). It is known that a long string (31) has several occasions to undesirably interact with moving parts in the instrument (10) and may get entangled while withdrawing the IUD (30, 30A, 30B), and this possibility is completely obviated in our invention.

[0115] When the medical service provider uses the option of trimming the string (31) before insertion, the method to load the instrument (10) and safely place the IUD (30) in uterus (50) with above variations comprises the steps of: [0116] a) Sounding a uterus (50) of woman and determining a uterine depth (45) [0117] b) Sliding the operating knob (150) towards an IUD end (5) till the arms of the IUD (30) are folded and fully contained in the graduated tube (16), [0118] c) Sliding the operating knob (150) further towards the IUD end (5) till the graduated tube (16) projects out by a length of the uterine depth (45), judging by hearing an audible clicking sound produced due to the pair of locking tooth (148) negotiating with the array of inclines and notches (82) or judging by the measurement markings (14) on the graduated tube (16) aligning with the flange (25) or by the position of the pointer (158) of the operating knob (150) at the knob markings (95) on the cover (90), [0119] d) Trimming an excess length of the strings (31) of the IUD (30) anywhere in the conservative length (47), [0120] e) Inserting the graduated tube (16) in the uterus (50) till the flange (25) touches cervical os (51) of the uterus (50) [0121] f) Sliding back the operating knob (150) till the dynamic stopper (20) retracts by the sliding length (23) and stops, [0122] g) Further inserting the graduated tube (16) in the uterus (50) till the flange (25) of retracted dynamic stopper (20) again touches the cervical os (51) [0123] h) Sliding back the operating knob (150) as much as possible, and [0124] i) Taking out the graduated tube (16) and the instrument (10) from woman.

[0125] FIG. 21, as another variation, the base (70) has an out opening (89) through which the string (31) is still available to the medical service provider. The medical service provider can exercise the option to manually load the IUD (30) if that suits the service provider as per his or her previous experience or convenience.

[0126] FIG. 22, as yet another variation the push rod (17) has a longitudinal channel (12) or an equivalent construction to protect and shield the string (31) from getting entangled in the graduated tube (16).

[0127] The invention as described above can be worked with a permutation and combination of embodiments described above and the variations described are not mutually exclusive in any particular group or formation.

[0128] The instrument (10) operates from its either side, whether curvature up or curvature do while maintaining a horizontal orientation.