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29 Cards in this Set
- Front
- Back
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Hysterectomy |
– is removal of the uterus & may be performed to treat many conditions that affect the uterus, such as cancer, chronic pelvic pain, abnormal uterine bleeding, uterine fibroids, endometriosis & pelvic support problems (uterine prolapsed) |
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What is the position, draping and incision of a TAH? |
Position – Supine Anesthesia – General Draping – Laparotomy Incision – Pfannenstiel |
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What ligaments are ligated in a TAH? |
Ligaments that are clamped – round, ovarian, broad, ovary or suspensory ligaments. |
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What is the largest ligament in the female pelvis? |
Broad ligament |
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What method is used in ligating ligaments in a TAH? |
clamp, clamp, cut, tie |
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What type of stick tie is used in a TAH? |
Heaney needleholder (curved jaws) |
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What other ways is used to divide ligaments in a TAH? |
electrosurgery, linear staplers, or the harmonic scalpel |
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What is used to close the vaginal “cuff”? |
with interrupted or running #1 or 0 absorbable suture or stapled. |
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What is the wound classification is a TAH? |
Class II – Clean-contaminated |
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Vaginal hysterectomy |
the removal of the uterus |
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What is the position of a vaginal hysterectomy? |
lithotomy |
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What instruments are used in a vaginal hysterectomy? |
The Auvard weighted speculum, two right angle retractors or deavers. The cervix is grasped with the tenaculum for traction |
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What ligaments are clamp, cut and tied? |
The uterosacral ligaments |
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If the ovaries are preserved |
the round, ovarian & fallopian tubes are clamped, cut & ligated. |
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Cul-de-sac |
closed by placing sutures from the vaginal wall through the infundibulopelvic (suspensory ligament of ovary) & round ligaments. The round, uterosacral & cardinal ligaments are approximated & reattached to the angle of the vagina. |
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LAVH |
is removal of the same structures as the abdominal hysterectomy. Shortens patient’s hospital stay, is more expensive with longer operative time. The procedure begins with the laparoscopic abdominal approach first. |
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What is the position of a LAVH? |
Lithotomy with Allen Stirrups or Yellowfins |
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What is the equipment used in a LAVH? |
Video equipment & GYN laparoscopic instrumentation |
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What are the supplies of a LAVH? |
– Endoscopic linear stapling devices (used on the ligaments), endoscopic trocars (placed in abdomen) |
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What medications are used in a LAVH? |
– 1% lidocaine with epinephrine (injected in the vaginal mucosa to reduce bleeding) |
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Robotic Assisted Hysterectomy |
Preparations are similar to those of laparoscopic surgical procedures. Use of robotic arms to hold the instrumentation. Once the arms & ports are set, the surgeon will sit @ the robot console. Once the surgeon has completed the vaginal cuff closure, the specimen is then removed from the vagina by the surgical technologist. |
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Radical hysterectomy |
is the en bloc removal of the ovaries, fallopian tubes, uterus, ligaments, upper third of vagina & lymph nodes. |
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Why is a Radical hysterectomy preformed? |
Usually performed due to extensive malignant tumor. |
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What is another name for a radical hysterectomy? |
Wertheim procedure |
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What organs are removed in a Pelvic Exenteration procedure? |
The procedure entails the removal of the rectum, distal sigmoid colon, urinary bladder & distal ureters, ovaries, fallopian tubes, uterus, cervix, vagina, pelvic lymph nodes, section of the levator ani muscles, pelvic peritoneum, perineum, & internal iliac vessels. |
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Pelvic Exenteration |
Permanent ileostomy (created on right side of the abdomen by creation of an ileal pouch & the ureter attach to it & colostomy (created on the left side of the abdomen) are created |
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What is Pelvic Exenteration used to treat? |
Used to treat recurrent or chronic cervical cancer that is resistant to radiation therapy. |
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What procedure will frozen section specimens will be taken? |
Pelvic Exenteration |
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Anterior (Cystocele) & Posterior (Rectocele) Colporrhaphy |
*may need extra allis/allis-adair clamps for these procedures* |
