Manual Vacuum Aspiration is a procedure conducted between six to sixteen weeks of gestation. The surgery begins with the administration of a local anesthetic, in order to numb your cervix. A surgical instrument called the tenaculum is used to hold the cervix in place for it to be dilated. When the cervix is wide enough, a cannula, a long plastic tube connected to the suction tube, is used to suck out the fetus and placenta.