By Geoffrey W. Cundiff MD FACOG FACS FRCPSC, Ricardo Azziz MD MPH MBA, Robert E Bristow MD MBA FACS
Because the box of gynecologic surgical procedure evolves at a swift speed, remain prior to the gang with Te Linde’s Atlas of Gynecologic surgical procedure, your most effective advisor to pelvic anatomy and surgical applied sciences. excellent for either gynecologists-in-training and veteran physicians, this tome of knowledge imparts the most recent novel innovations that may preserve your perform at the industry’s innovative. even if you’re simply getting all started, seeking to hone your surgical concepts, or just looking for an exceptional advisor to maintain your reminiscence fresh—this textual content may help you achieve mastery of the newest advancements in gynecologic surgical procedure.
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Additional resources for Te Linde’s Atlas of Gynecologic Surgery
In any case, a preoperative Type and Screen is prudent. Drugs and supplements that increase the risk of surgical bleeding should be discontinued prior to surgery. Patients taking oral contraceptives for abnormal uterine bleeding may not be able to discontinue them prior to surgery. In these patients, there is a moderate risk of venous thromboembolism based on this risk factor alone, so careful prophylaxis against deep vein thrombosis should be administered. Preoperative bowel preparation is not necessary for vaginal hysterectomy.
Postoperative care is generally straightforward. 6 Total laparoscopic hysterectomy: The uterine vessels are coagulated and divided at the level of the uterine isthmus. (c) 2015 Wolters Kluwer. All Rights Reserved. 7 Total laparoscopic hysterectomy: The cardinal ligament is coagulated and divided down to the level of the cervicovaginal junction. time was not prolonged. Diet can be advanced rapidly the day of surgery, once the patient has recovered from the effects of anesthesia, and will allow for same-day or next-day discharge in the majority of cases.
In tying down sutures, the most efficient use of limited space is to push down the knot with the surgeon’s contralateral index finger posterior to the cervix. After ligating the uterine vessels bilaterally, if the uterus is large, there are several options to decrease the uterine volume, thereby increasing space for further pedicle placement. Bivalving, intramyometrial coring, and sequential myomectomy are all options to allow easier delivery of the uterus through the vault. Further clamps are placed sequentially on the broad ligament, and pedicles are cut and suture-ligated up to the utero-ovarian ligaments.