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Gynecologic and Obstetric Surgery. Challenges and Management Options

  • ID: 3335873
  • Book
  • 576 Pages
  • John Wiley and Sons Ltd
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Gynecologic and obstetric surgery is a craft that requires sound knowledge and skills. The specifics of each individual case must be understood to enable the best surgical management approach and to minimize complications. This resource book offers insightful management options to many of the challenges a gynecologic or obstetric surgeon may face before, during and after an operation.

Divided into two sections, the book first covers general preoperative, intraoperative and postoperative challenges and, second, specific surgical procedures. It provides advice on both general gynecologic and obstetric operations, as well as subspecialist areas such as reproductive surgery, urogynecology and gynecologic oncology.

The chapters are concise, beginning with illustrative case histories followed by background, management options, and any preventative approaches. Designed to guide the surgeon to safe practice throughout all stages, they offer practical and step–by–step help.

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Contributors, x

Preface, xv

List of Abbreviations, xvi

Part I: General Preoperative, Intraoperative, and Postoperative Challenges

Section 1: Preoperative CareEditors: Phil Moore and Arri Coomarasamy

1 Patient with Poor ASA Score, 3Phil Moore

2 Patient on Medication, 6Arri Coomarasamy

3 Patient with Ischemic Heart Disease, 9Sohail Q. Khan and Jonathan N. Townend

4 Patient with Arrhythmias, 13Sanoj Chacko and Joseph de Bono

5 Patient with a Pacemaker or Implantable Defibrillator, 17Howard Marshall

6 Patient with Complex Congenital Heart Disease (Fontan Circulation), 20Yaso Emmanuel and Sara A. Thorne

7 Hypertensive Patient, 22Aarthi R. Mohan and Catherine Nelson–Piercy

8 Patient with Respiratory Disease, 25Heinke Kunst

9 Patient with Diabetes, 28Arri Coomarasamy and Dukaydah van der Berg

10 Patient with Thyroid Disease, 30Ramy Labib and Shiao–yng Chan

11 Patient with Renal Disease, 33Khalid Hasan

12 Patient with Liver Disease, 35Joanna K. Dowman and Philip N. Newsome

13 Patient with Rheumatologic Diseases, 38Amita A. Mahendru and Justin Chu

14 Patient with Hematologic Disorders, 41Chieh Lin Fu

15 Patient at High Risk of Venous Thrombosis, 44Ian A. Greer

16 Patient on Anticoagulant Therapy, 47Sophie Lee and Will Lester

17 Patient on Steroid Therapy, 50Shaista Nazir and John Ayuk

18 Patient with Epilepsy, 54Danita Jones and Virgilio Salanga

19 Patient with a Psychiatric Condition, 56Idnan Yunas

20 Patient with Organ Transplant, 59Sarah Winfield

21 Patient with Hepatitis B or C, 61Firas Al–Rshoud and Arri Coomarasamy

22 Patient with HIV, 64Firas Al–Rshoud and Arri Coomarasamy

23 Obese Patient, 67Phil Moore

24 Patient with Poor Nutritional Status, 69Phil Moore

25 Pregnant Patient Requiring Non–obstetric Surgery, 71Arri Coomarasamy

Section 2: Intraoperative Care
Editors: Arri Coomarasamy and Mahmood I. Shafi

26 Transverse Incision on the Abdomen Inadequate for Surgery, 77Arri Coomarasamy

27 Previous Multiple Abdominal Scars, 79Mohammed Khairy and Arri Coomarasamy

28 Patient with Previous Mesh Incisional Hernia Repair Requiring a Laparotomy, 83Christopher Smart and Chris Keh

29 Patient with Previous Mesh Incisional Hernia Repair Requiring a Laparoscopy, 86Emanuele Lo Menzo, Samuel Szomstein, and Raul J. Rosenthal

30 Unexpected Pathology: Ovarian Cyst, 89Mohan Kumar

31 Unexpected Pathology: Abnormal Appearance of the Uterus, 92Arri Coomarasamy

32 Unexpected Pathology: Severe Pelvic Adhesions, 94Stephen E. Zimberg and Michael L. Sprague

33 Unexpected Pathology: Abnormal Appearance of Bowel, 97Olivia Will and Justin Davies

34 Unexpected Pathology: Retroperitoneal Mass, 100Mohamed Mehasseb

35 Bladder Injury, 103Arri Coomarasamy and Richard Popert

36 Ureteric Injury, 106Arri Coomarasamy and Richard Popert

37 Small and Large Bowel Injury, 111Howard Joy

38 Inferior Epigastric Vessel Injury, 116Manas Chakrabarti and Sudha Sundar

39 Bleeding from Retracted Pedicular (Pelvic Sidewall) Vessels, 119Michael L. Sprague and Stephen E. Zimberg

40 Massive Hemorrhage, 121Karen Louise Moores, William Parry–Smith, and Martyn Underwood

41 Broken Needle, 125Joanne Kathleen Ritchie, Anuradha Radotra, and Martyn Underwood

42 Lost Swab, Needle or Instrument, 127Joanne Kathleen Ritchie, Martyn Underwood, and William Parry–Smith

Section 3: Postoperative Care
Editors: Arri Coomarasamy and Janesh Gupta

43 Postoperative Care, 131Janesh Gupta, Robbert Soeters, and Aaron Ndhluni

44 Excessive Nausea and Vomiting after Surgery, 133Phil Moore

45 Excessive Abdominal Pain after Surgery, 136Manjeet Shehmar

46 Bowel Damage: Postoperative Presentation, 139Ketan Gajjar and Mahmood I. Shafi

47 Wound Infection, 142Pallavi Latthe and James Gray

48 Wound Dehiscence, 147T. Justin Clark

49 Late Wound Failure: Incisional Hernia, 150Saloney Nazeer

50 Necrotizing Fasciitis, 153Tariq Ahmad

51 Management of Surgical Drains, 156Ahmed M. El–Sharkawy and Sherif Awad

52 Shocked Patient, 159Manjeet Shehmar

53 Breathless Patient: Postoperative Pulmonary Complications, 162Heinke Kunst

54 Confused Postoperative Patient, 165Idnan Yunas

55 Patient with Poor Urine Output, 167Amelia Davison and Jackie A. Ross

56 Electrolyte Imbalance, 170Manjeet Shehmar and Arri Coomarasamy

57 Swollen Leg, 174Edwin Stephen, Indrani Sen, and Tim Lees

58 Cardiorespiratory Arrest, 177Jennie Kerr

PART II: Operations and Challenges

Section 4: General and Minimal Access GynecologyEditors: T. Justin Clark, Kiong K. Chan, and Arri Coomarasamy

59 Difficulty in Dilating the Cervix: Cervical Stenosis and Cervical Closure, 183Arri Coomarasamy

60 Uterine Perforation, 186Arri Coomarasamy

61 Surgical Uterine Evacuation: Excessive Bleeding, 189Rajesh Varma

62 Surgical Uterine Evacuation in a Woman with Multiple Fibroids, 191Rajesh Varma

63 Use of Excessive Distension Media at Hysteroscopy, 194Arri Coomarasamy

64 Hysteroscopy: Endometrial Resection and Ablation in the Abnormal Uterine Cavity, 197Alessandro Conforti and Adam Magos

65 Laparoscopy in a Pediatric Patient, 199Suketu M. Mansuria, Cara R. King, and Arri Coomarasamy

66 Safe Laparoscopic Entry in a Thin Patient, 202Janesh Gupta and Justin Chu

67 Laparoscopy: Unable to Gain Entry, 205Mohamed Mehasseb

68 Surgical Emphysema, 208Arri Coomarasamy

69 Venous Air Embolism, 210Anneke Chu and Jennie Kerr

70 Laparoscopy: Problems with Monopolar Diathermy, 213Thomas G. Lang and Resad Pasic

71 Laparoscopy: Problems with Bipolar Diathermy, 216Thomas G. Lang and Resad Pasic

72 Laparoscopy: Bladder Injury, 218Peter L. Rosenblatt

73 Laparoscopy: Ureteric Injury, 221Peter L. Rosenblatt

74 Bowel Injury During Laparoscopy: Intraoperative Presentation, 224Alan Lam

75 Bowel Injury After Laparoscopy: Late Presentation, 227Alan Lam

76 Blood Vessel Injury at Laparoscopy, 230Elizabeth Ball

77 Laparoscopy for Large Ovarian Cyst, 233T. Justin Clark

78 Laparoscopy for an Ovarian Cyst in Pregnancy, 235T. Justin Clark

79 Laparoscopic Removal of Rectovaginal Endometriosis, 238Alan Lam

80 Laparoscopic Myomectomy, 242Ertan Saridogan

81 Total Laparoscopic Hysterectomy, 245Alan Farthing

82 Laparoscopic Hysterectomy for a Large Fibroid Uterus, 247Alan Lam

83 Laparoscopy: Difficulty in Tissue Retrieval, 250Su–Yen Khong and Alan Lam

84 Surgery for Cornual or Interstitial Pregnancy, 253Ayesha Mahmud and Yousri Afifi

85 Surgery for Cervical Ectopic Pregnancy, 256Bassel H. Al Wattar and Yousri Afifi

86 Surgery for Cesarean Scar Pregnancy, 259T. Justin Clark

87 Surgery for Adnexal Torsion, 262Mohamed Otify and Jackie A. Ross

88 Laparoscopic Appendectomy, 264Edward Rawstorne, Christopher Smart, and Chris Keh

89 Laparoscopic Surgery: When to Convert to Laparotomy?, 267Mohamed Mehasseb

90 Laparoscopy: Port–site Herniation, 269Ayesha Mahmud and Yousri Afifi

Section 5: Reproductive Surgery
Editors: Arri Coomarasamy and Mahmood I. Shafi91 Uterine Septum, 275Basim Abu–Rafea and Khaldoun Sharif

92 Surgery for Intrauterine Adhesions, 278Mohan Kumar

93 Myomectomy: Breach of the Endometrial Cavity, 280Masoud Afnan and Arri Coomarasamy

94 Myomectomy: Multiple Large Fibroids, 282Justin Chu and Arri Coomarasamy

95 Myomectomy: Massive Intraoperative Hemorrhage, 284Neelam Potdar and Arri Coomarasamy

96 Vaginal Myomectomy, 287Adam Magos

97 Surgery for Proximal Tubal Blockage, 289Spyros Papaioannou

98 Surgery for Distal Tubal Disease, 292Lynne Robinson, Hemant N. Vakharia, and Yousri Afifi

99 Reversal of Sterilization, 295Hemant N. Vakharia, Lynne Robinson, and Yousri Afifi

100 Surgery for Congenital Abnormalities of the Genital Tract, 299Naomi S. Crouch

101 Surgical Sperm Retrieval, 304David Muthuveloe and Y. Zaki Almallah

Section 6: Urogynecologic Surgery
Editors: Pallavi Latthe and G. Willy Davila

102 Sling Procedures: Bladder Injury, 309Fidan Israfil–Bayli and Philip Toozs–Hobson

103 Sling Procedures: Urethral Injury, 311Gamal M. Ghoniem

104 Sling Procedures: Retropubic Hematoma, 314Fidan Israfil–Bayli and Philip Toozs–Hobson

105 Sling Procedures: Bowel Injury, 316Fidan Israfil–Bayli and Philip Toozs–Hobson

106 Sling Procedures: Voiding Dysfunction after Stress Urinary Incontinence Surgery, 318Margarita M. Aponte and Victor W. Nitti

107 Sling Procedures: Tape Erosion into the Bladder, 321Samuel J.S. Grimsley and Y. Zaki Almallah

108 Sling Procedures: Sexual Dysfunction, 323Swati Jha and Ranee Thakar

109 Sling Procedures: Persistent Urine Leakage, 325Luis Manuel Espaillat–Rijo and G. Willy Davila

110 Difficult Vaginal Hysterectomy, 329G. Willy Davila

111 Vaginal Hysterectomy: Difficulty in Entering the Posterior Pouch, 332Alfredo Jijon and G. Willy Davila

112 Salpingo–oophorectomy at the Time of Vaginal Hysterectomy, 335Alfredo Jijon and G. Willy Davila

113 Bladder Injury During Anterior Vaginal Repair or Vaginal Hysterectomy, 338Pallavi Latthe, Suneetha Rachaneni, and Mohammed Belal

114 Difficult Sacrocolpopexy, 341Orfhlaith E. O Sullivan and Barry A. O Reilly

115 Difficult Sacrospinous Fixation, 345Smita Rajshekhar and Rohna Kearney

116 Recurrent Pelvic Organ Prolapse, 348Monika Vij and Robert Freeman

117 Colpocleisis, 351Kalaivani Ramalingam and Ash Monga

118 Uterine Suspension Procedures: Laparoscopic Hysteropexy, 353Natalia Price and Simon Jackson

119 Mesh Tape Exposure Following Tension–free Vaginal Tape, 356Helen Bolton and Mark Slack

120 Vaginal Vault Evisceration, 360Swati Jha

121 Complications in Laparoscopic Pelvic Floor Surgery, 362Nir Haya and Christopher Maher

122 Robotic Urogynecology Procedures, 367Orfhlaith E. O Sullivan and Barry A. O Reilly

123 Complications in Robotic Pelvic Floor Surgery, 370Amie Kawasaki

124 Neovagina, 372Lynsey Hayward and G. Willy Davila

125 Vaginal Stricture After Pelvic Organ Prolapse Surgery, 375Ted M. Roth, G. Rodney Meeks and G. Willy Davila

126 Urethral Diverticula and Other Periurethral Masses, 378Bhavin Patel and Kathleen C. Kobashi

127 Vesicovaginal Fistulae, 382Karolynn T. Echols,Tamara V. Toidze, and Edward Stanford

128 Urethrovaginal Fistulae, 386Sohier Elneil

129 Rectovaginal Fistulae, 389Claire Burton and Simon Radley

130 Secondary Anal Sphincter Repair, 392Steven D. Wexner and Emanuela Silva

Section 7: Gynecologic Oncology
Editors: Kavita Singh, Mahmood I. Shafi, and Kiong K. Chan131 Large Loop Excision of the Transformation Zone, 399Mahmood I. Shafi

132 Knife Cone Biopsy, 401Najum Qureshi

133 Staging Procedures: Examination Under Anesthesia, Cystoscopy, Sigmoidoscopy, and Biopsy Techniques, 403Mahmood I. Shafi

134 Radicality of Surgery for Cervical Cancer, 406Mahmood I. Shafi

135 Pelvic and Para–aortic Lymphadenectomy in Gynecologic Cancers, 408Kavita Singh and Rami Fares

136 Trachelectomy for Treatment of Cervical Cancer, 412Kavita Singh and Janos Balega

137 Laparoscopic Radical Surgery for Cervical Cancer, 414Mohamed Mehasseb

138 Groin and Retroperitoneal Lymphocele, 416David M. Luesley

139 Laparotomy for a Pelvic Mass of Uncertain Nature, 418Mahmood I. Shafi

140 Gynecologic Cancer Extending to the Bowel, 420Kiong K. Chan

141 Omental Procedures: Supracolic Omentectomy, Infracolic Omentectomy, and Omental Biopsy, 423Kiong K. Chan

142 Diaphragmatic Surgery in Advanced Ovarian Cancer, 425Ariella Jakobson–Setton and Kavita Singh

143 Fine–needle Aspiration Biopsy of Superficial Groin Lymph Node, 428Moji Balogun

144 Vulval Surgery: Wide Local Excision and Vulvectomy, 431Mahmood I. Shafi

145 Sentinel Node Biopsy in Gynecologic Cancer, 433Kavita Singh

146 Groin Lymphadenectomy, 435Ketan Gajjar

147 Plastic Surgical Techniques in Vulval or Perineal Procedures, 438Mahmood I. Shafi

148 Vaginectomy, 441Janos Balega and Kavita Singh

149 Urinary Diversion, 443John Parkin

150 Pelvic Exenteration, 446Kavita Singh

151 Gynecologic Cancer and Concurrent Pregnancy, 449Nirmala Rai Talapadi and Sudha Sundar

Section 8: Obstetric Surgery
Editors: Pallavi Latthe, Kiong K. Chan, and Arri Coomarasamy

152 Ovarian Cyst Identified at Cesarean Section, 455Kiong K. Chan and Ioannis Gallos

153 Laparoscopy in Pregnancy, 457Kevin J.E. Stepp and Anjana Nair

154 Cervical Cerclage, 459Ayesha Mahmud and Yousri Afifi

155 Cesarean Section in a Woman with Fibroids, 463Andrew Prentice

156 Cesarean Section at the Limits of Viability, 465Catherine Aiken and Jeremy Brockelsby

157 Difficult Delivery of the Fetal Head During Cesarean Section, 468Parveen Abedin

158 Surgical Management of Massive Obstetric Hemorrhage from the Uterus, Cervix, or Vagina, 470Phil Steer

159 Surgical Management of Placenta Praevia, 475Vibha Giri and Mohan Kumar

160 Surgical Management of Placenta Accreta, 479Vibha Giri and Mohan Kumar

161 Surgical Management Options for Shoulder Dystocia: Zavanelli Maneuver, Abdominal Rescue, Symphysiotomy, and Cleidotomy, 482Syeda Batool Mazhar and Asia Nazir

162 Uterine Inversion, 485Phil Steer

163 Episiotomy and Second–degree Tear, 488Khaled M.K. Ismail and Sara S. Webb

164 Obstetric Anal Sphincter Tear, 490Natalie P. Nunes, Helen Stevenson, and Matthew Parsons

165 Pregnancy and Female Genital Mutilation, 493Naomi Low–Beer and Gubby Ayida

166 Destructive Operations on a Dead Fetus, 496Hany Abdel–Aleem

167 Development of a Basic Obstetric Theater Facility in a Low–resource Setting, 499Zahida Qureshi and Alfred Murage

Section 9: Miscellaneous
Editors: Mahmood I. Shafi and Arri Coomarasamy

168 Enhanced Recovery, 505
Manjeet Shehmar
169 Major Surgery in a Jehovah s Witness Patient, 507Martyn Underwood and William Parry–Smith

170 Termination of Pregnancy at Advanced Gestation, 509Rohan Chodankar and Janesh Gupta

171 Cervical Fibroids: Techniques for Myomectomy and Hysterectomy, 511Deborah R. Karp

172 Hysterectomy for Broad Ligament Fibroids, 514
Kiong K. Chan

173 Hysterectomy for a Double Uterus, 516Kiong K. Chan

174 Cervical Stump Excision, 518Kiong K. Chan

175 Surgery for Ovarian Remnant, 520
Kiong K. Chan and Arri Coomarasamy

176 Surgery for Missing Intrauterine Contraceptive Device, 522Toh Lick Tan

177 Management of Imperforate Hymen, Transverse and other Vaginal Septa, 525Jane MacDougall

178 Benign Lesions in the Groin and Vulva, 528Jennifer Byrom

179 Cystic Structure in the Upper Vagina, 531Ted M. Roth and G. Rodney Meeks180 Adnexal Masses in Infants and Children, 533Rachel J. Miller and Kris Ann P. Schultz

181 Nerve Injuries Associated with Gynecologic and Obstetric Surgery, 536Djavid Alleemudder

182 Consent Challenges, 540William Parry–Smith and Martyn Underwood

183 Dealing with Complaints, 542Mahmood I. Shafi

184 Dealing with Litigation, 544Rebekah Ley and Mahmood I. Shafi

Index, 547

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Arri Coomarasamy
Mahmood Shafi
G. Willy Davila
K. K. Chan
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