An attempt to pass the biopsy device, without other instrumentation, may be made at this time. If the cervical os is open enough, the biopsy device may pass, saving the patient the additional discomfort and risk from using the tenaculum or sound. Keep the biopsy device as sterile as possible by avoiding contact with tissue except the cervix and other sterile instruments. Replace the biopsy device in its sterile package or on a sterile field, to prevent contamination.
Once the biopsy device is inserted in the uterine canal, the plunger is withdrawn to the hub, producing a suction within the device. The device is moved in and out several centimeters, to cover the length of the canal, without exiting the canal (as this would cause loss of the vacuum within the device). At the same time the device is moved in and out it is twisted or rotated between the fingers to expose the tip to all surfaces of the endometrium. This process is uncomfortable for the patient and should be completed within several seconds.