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11 Cards in this Set
- Front
- Back
Reproduction System- Hysterectomy, indications by Aliff
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Reproduction System- Hysterectomy, indications by Aliff
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Total hysterectomy, subtotal, radical, and bilateral salpingoopherectomy
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Total Hysterectomy – Removal of the uterus and cervix
Subtotal Hysterectomy (supracervical)– Removal of the uterus Radical Hysterectomy – Removal of the uterus, cervix, parametrium and uterosacral ligaments (important in staging of cervical cancer); does not include tubes and ovaries. Bilateral Salpingoopherectomy – Removal of both tubes and both ovaries TAH – total abdominal hysterectomy TVH – total vaginal hysterectomy LAVH – laparoscopic assisted vaginal hysterectomy LSH – laparoscopic assisted supracervical hysterectomy BSO, RSO, LSO – bilateral, right, or left salpingo-opherectomy C Hyst – cesarean hysterectomy Rad Hyst – radical hysterectomy |
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to have a radical hysterectomy you also have to take out what...and when i the only time you have to do one?
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the upper one third of the vagina
Cervical cancer!! Beyond microinvasive but no spread to parametrium Parametrial involvement – stage IIB – “To be” irradiated Microinvasive is treated with a simple TAH/BSO or TVH/BSO |
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at what point can you not do surgery anymore and just have to radiate?
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stage IIB
when the invasive cervical cancer has spread (perimetrial involvement) |
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Rad Hyst - Complications
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Ureters lose vascularization, innervation
Hydronephrosis Ureteral fistula Uroma formation Urinary ascites – BUN of peritoneal fluid on paracentesis |
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C - Hyst.. when do you do this ish?
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C – section followed by hysterectomy
Often supracervical Uncontrolled postpartum hemorrhage Uterine atony Placenta previa Placenta accreta, increta, percreta |
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What do you do for ovarian or uterine cancer?
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TAH BSO indicated (total abdo hyster, bilateral salpingoopherectomy)
Potential for pelvic lymph node dissection – internal iliac nodes Omentectomy in ovarian cancer Usually a vertical incision for better access and visualization |
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out of all those abbreviations, which is the most common procedure? what's the most common indication?
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TAH
600,000 hysterectomies per year Majority done abdominally No strict guidelines for choosing route Most common indication is symptomatic fibroid uterus Vertical, Pfannensteil, Kustner, Maylard, Cherney, Misgav Ladach |
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Risks of Hysterectomy..most common infection causes what? TAH vs TVH and risks?
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-Bleeding
-**Infection – Bacterial Vaginosis most common cause of cuff cellulitis -Damage to bowel, bladder, ureter, blood vessels -Death -Risk of anesthesia -All of these risks are greater with TAH than TVH |
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What are advantages of TVH?
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Shorter operating time
Shorter hospital stay No risk of hernia No abdominal incision Less pain Significantly lower risk of damage to ureters Opportunity to repair other defects |
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General Surgeons vs. Gynecologists
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The only thing that sets a gynecologist apart from a general surgeon is the ability to operate vaginally.
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