- Covers both obstetrics and gynecology, and subspecialties
- Chapters based on real problems
- Structured chapters with key point summaries
- immediately accessible practical advice
- Focused, evidence based chapters
Obstetric and gynecologic surgery is a craft that requires sound knowledge and skills.
The knowledge and skills will need to be applied to the specifics of each surgical patient to enable the best surgical management and minimize complications. This resource book offers insightful management options to many of the challenges a gynecologic or obstetric surgeon may face before, during or after an operation. Designed to guide the surgeon to safe practice throughout all stages of surgical management, it offers case studies, management options with tips and tricks, and ideas for prevention of complications.
Key points and summaries are provided at the end of each chapter for 'elevator reading', i.e., quick brushing up of facts on the way to facing a challenge.
Divided into two sections the book first covers general pre, intra and post-operative challenges and, second, specific operative procedures within the specialist areas in obstetrics and gynecology.
Table of ContentsPART I: GENERAL PRE, INTRA, and POST OPERATIVE CHALLENGES
SECTION 1: PRE-OPERATIVE CARE
- 1 Patient with poor ASA score
- 2 Patient on medication
- 3 Patient with ischaemic heart disease
- 4 Patient with Arrhythmias
- 5 Patient with a pace-maker or implantable defibrillator
- 6 Patient with complex congenital heart disease (a Fontan Circulation)
- 7 Hypertensive patient
- 8 Patient with respiratory disease
- 9 Patient with diabetes
- 10 Patient with thyroid disease
- 11 Patient with renal disease
- 12 Patient with liver disease
- 13 Patient with rheumatologic diseases
- 14 Patient with hematologic disorders
- 15 Patient at high risk of venous thrombosis
- 16 Patient on anti-coagulant therapy
- 17 Patient on steroid therapy
- 18 Patient with epilepsy
- 19 Patient with a psychiatric condition
- 20 Patient with organ transplant
- 21 Patient with Hep B or Hep C
- 22 Patient with HIV
- 23 Obese patient
- 24 Patient with poor nutritional status
- 25 Pregnant patient requiring non-obstetric surgery
SECTION 2: INTRA-OPERATIVE CARE
- 26 Transverse incision on the abdomen inadequate for surgery
- 27 Patient with multiple abdominal scars
- 28 Patient with previous mesh incisional hernia repair requiring a laparotomy
- 29 Patient with previous mesh incisional hernia repair requiring a laparoscopy
- 30 Unexpected pathology: ovarian cyst
- 31 Unexpected pathology: abnormal appearance of the uterus
- 32 Unexpected pathology: severe pelvic adhesions
- 33 Unexpected pathology: abnormal appearance of bowel
- 34 Unexpected pathology: retro-peritoneal mass
- 35 Bladder injury
- 36 Ureteric injury
- 37 Small and large bowel injury
- 38 Inferior epigastric vessel injury
- 38 Inferior epigastric vessel injury
- 39 Bleeding from retracted pedicular (pelvic sidewall) vessels
- 40 Massive haemorrhage
- 41 Broken needle
- 42 Lost swab, needle or instrument
SECTION 3: POST-OPERATIVE CARE
- 43 Post-operative care
- 44 Excessive nausea and vomiting after surgery
- 45 Excessive abdominal pain after surgery
- 46 Bowel damage: postoperative presentation
- 47 Wound infection
- 48 Wound dehiscence
- 49 Late wound failure: incisional hernia
- 50 Necrotising fasciitis
- 51 Surgical drains
- 52 Shocked patient
- 53 Breathless patient: post-operative pulmonary complications
- 54 Confused post-operative patient
- 55 Patient with poor urine output
- 56 Electrolyte imbalance
- 57 The swollen leg
- 58 Cardiorespiratory arrest
PART II: OPERATIONS and CHALLENGES
SECTION 4: GENERAL and MINIMAL ACCESS GYNECOLOGY
- 59 Difficulty in dilating a cervix: Cervical stenosis and cervical closure
- 60 Uterine perforation
- 61 Surgical uterine evacuation: excessive bleeding
- 62 Surgical uterine evacuation in a woman with multiple fibroids
- 63 Use of excessive distension media at hysteroscopy
- 64 Hysteroscopy: endometrial resection and ablation in the abnormal uterine cavity
- 65 Laparoscopy in a pediatric patient
- 66 Safe laparoscopic entry in a thin patient
- 67 Laparoscopy: unable to gain entry
- 68 Surgical emphysema
- 69 Venous Air Embolism
- 70 Laparoscopy: problems with monopolar diathermy
- 71 Laparoscopy: problems with bipolar diathermy
- 72 Laparoscopy: bladder injury
- 73 Laparoscopy: ureteric injury
- 74 Bowel injury during laparoscopy: intraoperative presentation
- 75 Bowel injury after laparoscopy: late presentation
- 76 Blood vessel injury at laparoscopy
- 77 Laparoscopy for large ovarian cyst
- 78 Laparoscopy for an ovarian cyst in pregnancy
- 79 Laparoscopic removal of recto-vaginal endometriosis
- 80 Laparoscopic myomectomy
- 81 Total laparoscopic hysterectomy
- 82 Laparoscopic hysterectomy for a large fibroid uterus
- 83 Laparoscopy: difficulty in tissue retrieval
- 84 Surgery for cornual or interstitial pregnancy
- 85 Surgery for cervical ectopic pregnancy
- 86 Surgery for caesarean scar pregnancy
- 87 Surgery for adnexal torsion
- 88 Laparoscopic appendicectomy
- 89 Laparoscopic surgery: When to convert to laparotomy?
- 90 Laparoscopy: late complication - Port site herniation
SECTION 5: REPRODUCTIVE SURGERY
- 91 Uterine septum division
- 92 Surgery for intrauterine adhesions
- 93 Myomectomy: breach of the endometrial cavity
- 94 Myomectomy: multiple large fibroids
- 95 Myomectomy: massive intraoperative haemorrhage
- 96 Vaginal myomectomy
- 97 Surgery for proximal tubal blockage
- 98 Surgery for distal tubal blockage
- 99 Reversal of female sterilisation
- 100 Surgery for congenital abnormalities of the genital tract
- 101 Surgical sperm retrieval
SECTION 6: UROGYNECOLOGIC SURGERY
- 102 Sling procedures: bladder injury
- 103 Sling procedures: urethral injury
- 104 Sling procedures: retropubic haematoma
- 105 Sling procedures: bowel injury
- 106 Sling procedures: voiding dysfunction after stress urinary incontinence surgery
- 107 Sling procedures: tape erosion into bladder
- 108 Sling procedures: sexual dysfunction
- 109 Sling procedures: persistent urine leakage
- 110 Difficult vaginal hysterectomy
- 111 Vaginal hysterectomy: difficulty in entering the posterior pouch
- 112 Salpingo-oopherectomy at the time of vaginal hysterectomy
- 113 Bladder injury during anterior vaginal repair or vaginal hysterectomy
- 113 Bladder injury at anterior repair
- 113 Bladder injury at anterior repair
- 113 Bladder injury at anterior repair
- 113 Bladder injury at anterior repair
- 113 Bladder injury at anterior repair
- 114 Difficult sacrocolpopexy
- 115 Difficult sacrospinous fixation
- 116 Recurrent pelvic organ prolapse
- 117 Colpocleisis
- 118 Uterine suspension procedures: Laparoscopic hysteropexy
- 119 Mesh tape exposure following tension free vaginal tape (TVT)
- 120 Vaginal vault evisceration
- 121 Complications in laparoscopic pelvic floor surgery
- 122 Robotic urogynecology procedures
- 123 Complications in robotic pelvic floor surgery
- 124 Neovagina
- 125 Vaginal stricture after pelvic organ prolapse surgery
- 126 Urethral diverticula and other periurethral masses
- 127 Vesico-vaginal fistulae
- 128 Urethro-vaginal fistulae
- 129 Recto-vaginal fistulae
- 130 Secondary anal sphincter repair
SECTION 7: GYNECOLOGIC ONCOLOGY
- 131 Large loop excision of the transformation zone (LLETZ)
- 132 Knife cone biopsy
- 133 Staging procedures: examination under anaesthesia, cystoscopy, sigmoidoscopy and biopsy techniques
- 134 Radicality of surgery for cervical cancer
- 135 Pelvic and para-aortic lymphadenectomy in gynecologic cancers
- 136 Trachelectomy for treatment of cervical cancer
- 137 Laparoscopic radical surgery for cervical cancer
- 138 Groin and retroperitoneal lymphocele
- 139 Laparotomy for a pelvic mass of uncertain nature
- 140 Gynecologic cancer extending to the bowel
- 141 Omental procedures: supracolic omentectomy, infracolic omentectomy, omental biopsy
- 142 Diaphragmatic surgery in advanced ovarian cancer
- 143 Fine needle aspiration; biopsy of superficial groin lymph node
- 144 Vulval surgery: wide local excision and vulvectomy
- 145 Sentinel node biopsy in gynecologic cancer
- 146 Groin lymphadenectomy
- 147 Plastic surgical techniques used in vulval or perineal procedures
- 148 Vaginectomy
- 149 Urinary diversion
- 150 Pelvic exenteration
- 151 Gynecologic cancer and concurrent pregnancy
SECTION 8: OBSTETRIC SURGERY
- 152 Ovarian cyst identified at caesarean section
- 153 Laparoscopy in pregnancy
- 154 Cervical cerclage
- 155 Caesarean section in a woman with fibroids
- 156 Caesarean section at the limits of viability
- 157 Difficult delivery of the fetal head during caesarean section
- 158 Surgical management of massive obstetric haemorrhage from the uterus, cervix or vagina
- 159 Surgical management of placenta praevia
- 160 Surgical management of placenta accreta
- 161 Surgical management options for shoulder dystocia: Zavanelli maneuver, abdominal rescue, symphsiotomy and cleidotomy
- 162 Uterine inversion
- 163 Episiotomy and second degree tear
- 164 Obstetric anal sphincter tear
- 165 Pregnancy and female genital mutilation
- 166 Destructive operations on a dead fetus
- 166 Destructive operations on the fetus
- 167 Setting up of a basic obstetric theatre facility in a low-resource setting
SECTION 9: MISCELLANEOUS
- 168 Enhanced recovery
- 169 Major surgery in a Jehovah's Witness patient
- 170 Termination of pregnancy at advanced gestation
- 171 Cervical fibroids: techniques for myomectomy and hysterectomy
- 172 Hysterectomy for broad ligament fibroids
- 173 Hysterectomy for a double uterus
- 174 Cervical stump excision
- 175 Surgery for ovarian remnant
- 176 Surgery for a missing intrauterine contraceptive device
- 177 Management of imperforate hymen, transverse and other vaginal septa
- 178 Benign lesions in the groin and vulva
- 179 Cystic structure in the upper vagina
- 180 Adnexal masses in infants and children
- 181 Nerve injuries associated with gynecologic and obstetric surgery
- 182 Consent challenges
- 183 Dealing with complaints
- 184 Dealing with litigation