An improved, disposable indwelling intrauterine tube ("smit sleeve") not requiring retaining stitches for brachy-radiotherapy for carcinoma of the cervix

Abstract

Objective: The objective was to improve the design of the indwelling-intrauterine tube (IIUT) for brachy-radiotherapy of cervical cancer or sleeve, specifically one that would not require stitching to retain it properly in the uterus for periods of one to two weeks and to ensure hygiene by making them disposable, thinner, lighter, more economical, as well as more user-friendly for doctor and patient alike, and to satisfy new developments in terms of computed tomography (CT) and magnetic resonance imaging (MRI) compatibility.

Materials and methods: Injection moulding of carefully-selected medical grade polymers enabled ten improvements to the original sleeve; some were impossible to achieve with lathe turned items. The most important innovation was the addition of two delicate and very soft "wings" to the sleeves near the tips The sleeves were used in 50 consecutive patients with advanced carcinoma of the cervix. Metal markers could be eliminated by adding barium to the polymers.

Results: Not a single sleeve fell out in any of the 50 patients. No complications related to the use of the sleeves were observed. These sleeves are now used exclusively in this clinic.

Conclusions: The improvements were very successful; none fell out and no suturing was required, which made them still more cost-effective and more comfortable to patients.