Testimonials & Clinical Feedback | Dr. V. Panicker

Testimonials & Clinical Feedback

Read real clinical feedback and watch video demonstrations from senior obstetricians and gynaecologists on their experience with Dr. Panicker’s patented medical inventions.

My Experience With Panicker’s PPH Cannula: A Must-Have Tool in Obstetric Practice

Senior Gynaecologist • Panicker's Mother And Child Hospital

"This device has prevented obstetric hysterectomy in the majority of the cases I’ve managed. It deserves a place in the essential armamentarium of every obstetrician."

Among all the instruments I use in obstetrics and gynecology, only two are truly close to my heart: Panicker’s PPH cannula and the bipolar shearer for both laparoscopic and open surgery. Today, I want to focus on Panicker’s PPH cannula — because it deserves far more attention than it gets.

I have been working at a tertiary-care institute for the last four years, and I have used this device consistently throughout this period. I have applied it in almost every conceivable scenario of obstetric hemorrhage, except in placenta percreta where its role is understandably limited.

I have used the PPH cannula in situations ranging from:

Atonic PPH after normal delivery
Atonic PPH during caesarean section
Traumatic cervical injuries
Deep episiotomy repairs — where the device prevents uterine cavity trickling and allows clean, bloodless suturing of deep lateral extensions
Placenta accreta
DIC cases with deranged INR requiring time for correction
Second-trimester MTPs
Severe thrombocytopenia, including one memorable case of pregnancy-related aplastic anemia with platelet counts between 3,000–10,000

In almost all these scenarios, the cannula has worked reliably. Only in a few cases have I needed to proceed to obstetric hysterectomy. One such case involved a large lower-segment and cervical defect during LSCS for placenta accreta. Even then, inserting the cannula intraoperatively helped approximate the defect, apply vacuum, temporarily control bleeding, and crucially — gave me the time to arrange blood and perform a planned hysterectomy safely.

Over time, I have used suction pressures ranging from 400 mmHg to 750 mmHg, though my standard setting remains 600–650 mmHg. Both the metallic and the newer plastic variants work equally well.

Since incorporating this device, my need for stepwise devascularisation or internal iliac artery ligation has become almost zero.

I have used the cannula for durations ranging from 1 hour to 12 hours, especially in atonic and DIC patients who required time for coagulation correction. My preferred protocol is:

45 minutes suction “ON”
10 minutes “OFF”, keeping the system attached

This allows continuous hemostatic pressure while preventing endometrial tissue injury and providing periodic reperfusion.

There is often debate between Panicker’s cannula and the SR cannula, but in real-world practice, Panicker’s version feels more physiological and user-friendly.

Removal Technique — For safe removal, I:

Gradually release the pressure
Wait 15–20 minutes
Rotate the cannula clockwise and anticlockwise 2–3 times
Ensure I can rotate it almost 360° before removing it

Occasionally, tissue gets stuck in the fenestrations of the metallic cannula, but this maneuver frees it easily.

This device has prevented obstetric hysterectomy in the majority of the cases I’ve managed. It deserves a place in the essential armamentarium of every obstetrician. Most importantly, it is a reminder to all of us that we often underestimate our own Indian colleagues who innovate tirelessly in our field. Panicker’s PPH cannula is one such brilliant contribution — and I strongly feel it should have been introduced to us right from our postgraduate days.

Closing Note: "So many colleagues are blessing you with your device for saving patients lives."