By Victor Gomel, Andrew Brill

New pondering and advances in surgical procedure have revolutionized the prognosis and remedy of universal gynecologic stipulations. Endometriosis, uterine fibroids, utero-vaginal prolapse, urinary incontinence, ovarian neoplasms, and adhesions are yet many of the parts the place even a basic gynecologist should be conscious of the hot possibilities provided and considered necessary potential. also, in parallel with the present pattern to hold up being pregnant, there's an expanding consciousness inside gynecologic surgical procedure that fertility renovation could be a relevant goal every time attainable. As a part of this transformation of emphasis, reproductive surgical procedure is turning into reconnected with mainstream gynecologic surgical procedure. This ground-breaking e-book from a hugely special editorial group educates surgeons at the strategies and techniques now wanted in either reconstructive and reproductive surgical procedure in Gynecology; it truly is illustrated via schematic artwork and colour pictures of operative approaches.

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Sample text

Guided by the Hippocratic charge to “primum non nocere,” the ultimate aim of energy-assisted surgery is the attainment of anatomical dissection and hemostasis with the 27 least amount of collateral damage and subsequent scar tissue formation. Ideally, the surgeon’s final view of the operative field should accurately approximate the topography discoverable after postoperative healing. Despite the continued innovation of products borne to reduce thermal damage and then marketed as being comparatively safer, it is the hands and mind of the surgeon that serve to preserve tissue integrity by reducing the burden of delayed thermal necrosis and taking steps to prevent excessive devitalization of tissue.

In the latter case, the electrified clamp and the surgeon’s fingers are conductors with significantly different potentials. Activating the electrode, especially prior to contacting the clamp (generating higher voltage), induces a coupled current on the surgeon’s fingers. If the area of contact between the fingers and the clamp is small, the current density will be high enough to generate a burn. Capacitance-induced burns across surgical gloves can be eliminated by avoiding open circuit (noncontact) activation and cradling the surgical clamp with a large surface area.

Brill AI. Bipolar electrosurgery: Convention and innovation. Clin Obstet Gynecol 2008; 51(1):153–158. 12. Wu MP, et al. Complications and recommended practices for electrosurgery in laparoscopy [abstract]. Am J Surg 2000; 179: 67–73. aModele=afficheN&cpsidt=1288652. Accessed 16 March, 2009. 13. Brill A. Principles & Practice: Electrosurgery and Ultrasonics. As presented at AAGL 2007. pdf. Accessed 16 March, 2009. P1: KNP c03 IHBK068-Gomel 28 August 16, 2010 15:14 Trim: 285mm×214mm RECONSTRUCTIVE AND REPRODUCTIVE SURGERY IN GYNECOLOGY 14.

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