Hysterectomy and the Alternatives, An Issue of Obstetrics and Gynecology Clinics of North America
1. Auflage
Erschienen am 21. August 2016
100 Seiten
978-0-323-46283-9 (ISBN)
Beschreibung
The Guest Editors have created a comprehensive issue devoted to the most current and clinically relevant approach to hysterectomies and their alternatives. Top experts have written articles on the following topics: Alternatives to Hysterectomy: Management of Uterine Fibroids; Alternatives to Hysterectomy: Management of Menorrhagia; Hysterectomy for benign conditions of the uterus: Total Abdominal Hysterectomy; Hysterectomy for benign conditions of the uterus: Total Vaginal Hysterectomy; Hysterectomy for benign conditions of the uterus: Total Laparoscopic Hysterectomy/Laparoscopically Assisted Vaginal Hysterectomy; Hysterectomy for benign conditions of the uterus: Radical Hysterectomy Evidence basis for hysterectomy; Cesarean Hysterectomy; Management of ovaries at the time of benign Hysterectomy; Management of the peri- and postoperative patient undergoing hysterectomy; and Simulation and surgical competency: Current issues.
Weitere Details
Weitere Ausgaben
Inhalt
- Front Cover
- Hysterectomy and the Alternatives
- Copyright
- Contributors
- CONSULTING EDITOR
- EDITORS
- AUTHORS
- Contents
- Foreword: Fewer Hysterectomies and So Many Alternatives
- Preface: Hysterectomy and the Alternatives
- Alternatives to Hysterectomy: Management of Uterine Fibroids
- Management of Abnormal Uterine Bleeding with Emphasis on Alternatives to Hysterectomy
- Hysterectomy for Benign Conditions of the Uterus: Total Abdominal Hysterectomy
- Hysterectomy for Benign Conditions of the Uterus: Total Vaginal Hysterectomy
- Total Laparoscopic Hysterectomy and Laparoscopic-Assisted Vaginal Hysterectomy
- The Essential Elements of a Robotic-Assisted Laparoscopic Hysterectomy
- Evidence Basis for Hysterectomy
- Cesarean Hysterectomy and Uterine-Preserving Alternatives
- Management Strategies for the Ovaries at the Time of Hysterectomy for Benign Disease
- Enhanced Recovery Pathway in Gynecologic Surgery: Improving Outcomes Through Evidence-Based Medicine
- Surgical Simulation and Competency
- Current Issues with Hysterectomy
- OBSTETRICS AND GYNECOLOGY CLINICS
- FORTHCOMING ISSUES
- December 2016
- March 2017
- June 2017
- RECENT ISSUES
- June 2016
- March 2016
- December 2015
- Foreword: Fewer Hysterectomies and So Many Alternatives
- Preface: Hysterectomy and the Alternatives
- Alternatives to Hysterectomy
- Key points
- INTRODUCTION
- EVALUATION
- MANAGEMENT GOALS
- Asymptomatic Fibroids
- Heavy Menstrual Bleeding
- Hysteroscopic myomectomy
- Bulk Symptoms with or Without Heavy Menstrual Bleeding
- GnRH agonists and antagonists
- Ulipristal acetate
- Nonpharmacologic Strategies
- Magnetic resonance-guided focused ultrasound ablation
- Uterine artery embolization (or uterine fibroid embolization)
- Laparoscopic radiofrequency volumetric thermal ablation
- Abdominal myomectomy
- Special consideration: morcellation
- REPRODUCTION AND FIBROIDS
- SUMMARY/DISCUSSION
- REFERENCES
- Management of Abnormal Uterine Bleeding with Emphasis on Alternatives to Hysterectomy
- Key points
- INTRODUCTION
- INITIAL EVALUATION
- INITIAL MEDICAL MANAGEMENT
- Chronic Abnormal Uterine Bleeding
- Systemic estrogen and progestin
- Systemic progestin
- Nonhormonal medications
- Acute Abnormal Uterine Bleeding
- FOLLOW-UP
- MANAGEMENT OF PERSISTENT ABNORMAL UTERINE BLEEDING
- LEVONORGESTREL INTRAUTERINE SYSTEM
- Levonorgestrel Intrauterine System and Abnormal Uterine Bleeding-PALM
- Levonorgestrel Intrauterine System and Abnormal Uterine Bleeding-COEIN
- How to Optimize Levonorgestrel Intrauterine System Outcomes
- ENDOMETRIAL ABLATION
- Endometrial Ablation and Abnormal Uterine Bleeding-Polyp
- Endometrial Ablation and Abnormal Uterine Bleeding-Adenomyosis
- Endometrial Ablation and Abnormal Uterine Bleeding-Leiomyoma
- Endometrial Ablation and Abnormal Uterine Bleeding-Coagulopathy
- Endometrial Ablation and Abnormal Uterine Bleeding-Ovulatory Dysfunction
- Endometrial Ablation and Abnormal Uterine Bleeding-Endometrial
- How to Optimize Outcomes After Endometrial Ablation
- SUMMARY
- REFERENCES
- Hysterectomy for Benign Conditions of the Uterus
- Key points
- HISTORICAL PERSPECTIVE
- CURRENT TRENDS
- PREOPERATIVE PREPARATION
- SURGICAL TECHNIQUE
- POSTOPERATIVE CARE
- COMPLICATIONS
- CONTROVERSIAL ISSUES
- Total Hysterectomy Versus Subtotal (Supracervical) Hysterectomy
- Adnexal Removal
- SUMMARY
- REFERENCES
- Hysterectomy for Benign Conditions of the Uterus
- Key points
- HISTORICAL PERSPECTIVE
- TRENDS
- BEST SURGICAL APPLICATIONS
- TECHNIQUES
- Preoperative Considerations
- Screen for pregnancy
- Bowel preparation
- Povidone-iodine douche
- Perineal hair removal
- Bladder volume
- Prophylactic antibiotics
- Patient Positioning
- Examination Under Anesthesia
- Procedure Technique: Simple Vaginal Hysterectomy
- Vaginal Incision
- Development of the Vesicovaginal Space
- Anterior Entry
- Peritoneal Entry
- Uterosacral Ligament
- Ureteral Identification or Palpation
- Cardinal Ligament
- Utero-Ovarian Pedicle
- Evaluate for Hemostasis
- Addressing the Adnexa
- Modified McCall Apical Suspension
- Reperitonealization
- Vaginal Cuff Closure
- Summary and Key Points
- CHALLENGING SITUATIONS
- Previous Pelvic Surgery or Cesarean Delivery
- Cervical Elongation
- Enlarged Uterus
- Obese Body Habitus
- COMPLICATIONS
- Bladder Injury
- Ureteral Injury
- SUMMARY
- REFERENCES
- Total Laparoscopic Hysterectomy and Laparoscopic-Assisted Vaginal Hysterectomy
- Key points
- HISTORICAL PERSPECTIVE
- INDICATIONS/CONTRAINDICATIONS
- TRENDS
- TECHNIQUE/PROCEDURE
- Preparation
- Patient Positioning
- Energy Sources
- Approach
- Technique/procedure (detailed steps)
- Uterine manipulation
- Laparoscopic entry
- Round ligament transection
- Bladder flap development
- Ligating the cornual pedicles
- Uterine vessel skeletonization
- Securing the uterine artery
- Colpotomy
- Vaginal cuff closure
- VAGINAL ASSISTANCE TO LAPAROSCOPIC HYSTERECTOMY
- Colpotomy
- Secure the Uterine Artery
- Vaginal Cuff Closure
- COMPLICATIONS AND MANAGEMENT
- Bleeding
- Urinary Tract Injury
- POSTOPERATIVE CARE
- REPORTING, FOLLOW-UP, AND CLINICAL IMPLICATIONS
- OUTCOMES
- CURRENT CONTROVERSIES/FUTURE CONSIDERATIONS
- SUMMARY
- REFERENCES
- The Essential Elements of a Robotic-Assisted Laparoscopic Hysterectomy
- Key points
- INTRODUCTION
- PREOPERATIVE EVALUATION
- INTRAOPERATIVE SETUP
- Patient Positioning
- Port Placement
- Robotic Docking/Instrumentation
- STEPS OF THE PROCEDURE
- Anatomic Survey
- Ovarian Conservation
- Transection of the Round Ligament
- Broad Ligament Dissection
- Bladder Flap Development
- Skeletonization and Transection of Uterine Vessels
- Colpotomy/Specimen Removal/Vaginal Cuff Closure
- POSTOPERATIVE CARE
- OUTCOMES
- COMPLICATIONS
- FUTURE CONSIDERATIONS/CONTROVERSY
- SUMMARY
- SUPPLEMENTARY DATA
- REFERENCES
- Evidence Basis for Hysterectomy
- Key points
- INTRODUCTION
- USING THE EVIDENCE TO CHOOSE THE BEST APPROACH
- Vaginal Hysterectomy Versus Total Abdominal Hysterectomy
- Vaginal Hysterectomy Versus Laparoscopic Hysterectomy
- Vaginal Hysterectomy Versus Robotic Hysterectomy
- COST DIFFERENCES
- VAGINAL CUFF DEHISCENCE
- ADDITIONAL FACTORS TO CONSIDER
- Increasing Vaginal Hysterectomy Utilization
- Increased Risk of Prolapse
- Impact on Trainees
- SUMMARY
- REFERENCES
- Cesarean Hysterectomy and Uterine-Preserving Alternatives
- Key points
- BACKGROUND
- POSTPARTUM HEMORRHAGE
- UTERINE ATONY
- SURGICAL SITE BLEEDING AND ARTERIAL LIGATION
- COMPRESSION SUTURES
- UTERINE TAMPONADE
- INTERVENTIONAL RADIOLOGY
- MASSIVE TRANSFUSION
- ANTIFIBRINOLYTICS
- TOPICAL HEMOSTATIC AGENTS
- ACTIVATED FACTORS
- INVASIVE PLACENTATION, MORBIDLY ADHERENT PLACENTATION, PLACENTA ACCRETA, PLACENTA INCRETA, AND PLACENTA PERCRETA
- UNEXPECTED PLACENTA ACCRETA
- CONSERVATIVE MANAGEMENT
- CESAREAN HYSTERECTOMY PROCEDURE
- TECHNIQUE
- SUMMARY
- REFERENCES
- Management Strategies for the Ovaries at the Time of Hysterectomy for Benign Disease
- Key points
- INTRODUCTION
- ELECTIVE VERSUS RISK-REDUCING BILATERAL SALPINGO-OOPHORECTOMY AND OVARIAN CANCER
- OPPORTUNISTIC SALPINGECTOMY
- HYSTERECTOMY WITH AND WITHOUT BILATERAL SALPINGO-OOPHORECTOMY AND INCIDENT CANCER RISK
- BILATERAL SALPINGO-OOPHORECTOMY AND OVERALL MORTALITY
- CORONARY HEART DISEASE
- SEXUAL FUNCTION
- OSTEOPOROTIC HIP FRACTURES
- SUBSEQUENT ADNEXAL SURGERY
- BILATERAL SALPINGO-OOPHORECTOMY AND ROUTE OF HYSTERECTOMY
- SUMMARY
- REFERENCES
- Enhanced Recovery Pathway in Gynecologic Surgery
- Key points
- INTRODUCTION
- BASIC CONCEPTS OF ENHANCED RECOVERY AFTER SURGERY PATHWAYS
- Preoperative
- Patient counseling and education
- Preoperative diet
- Avoiding mechanical bowel preparation
- Preemptive analgesia
- Intraoperative
- Anesthesia
- Maintaining normothermia
- Avoiding intraoperative fluid overload
- Prevention of postoperative nausea and vomiting
- Avoiding nasogastric tubes
- Limiting prophylactic peritoneal drains
- Postoperative
- Early postoperative feeding
- Early mobilization
- Early urinary catheter removal
- Perioperative pain management
- Multimodal pharmacologic analgesia
- Regional analgesia
- Thoracic epidural analgesia
- Transversus abdominis plane block
- Wound infiltration
- Intraperitoneal local anesthetic
- Considerations specific to vaginal hysterectomy
- Considerations specific to minimally invasive gynecologic surgery
- Postoperative fluid management
- Laxative use and prevention of postoperative ileus
- HASTENING POSTOPERATIVE RECOVERY
- Enhanced Recovery After Surgery and Benign Abdominal Hysterectomy
- Enhanced Recovery After Surgery and Vaginal Hysterectomy
- Enhanced Recovery After Surgery and Laparoscopic Hysterectomy
- HEALTH ECONOMICS
- HEALTH-RELATED QUALITY OF LIFE AND PATIENT SATISFACTION
- SUMMARY
- REFERENCES
- Surgical Simulation and Competency
- Key points
- INTRODUCTION
- OPTIONS FOR SURGICAL SIMULATION
- Animal and Human Cadaver Simulation
- Low-Fidelity Trainers
- Virtual Reality Simulation
- CURRENT ROLE OF SIMULATION IN SURGICAL TRAINING
- SIMULATION'S ROLE IN COMPETENCY-BASED MEDICAL EDUCATION
- Meaning of Competency and Competency-based Medical Education
- Assessment in Competency-based Medical Education
- Adoption of Competency-based Training in North America
- Simulation's Role in Achieving Competency
- TRANSLATION OF SIMULATION COMPETENCY TO SURGICAL COMPETENCY
- EXISTING SIMULATORS SPECIFIC TO HYSTERECTOMY
- SUMMARY
- Areas of Future Study/Development
- REFERENCES
- Current Issues with Hysterectomy
- Key points
- INTRODUCTION
- MORCELLATION
- REIMBURSEMENT AND HEALTH CARE REFORM
- Merit-based Incentive Payment System
- Quality (30 points)
- Meaningful use of technology (25 points)
- Resource use (30 points)
- Clinical practice improvement (15 points)
- Alternate Payment Model
- DISCUSSION
- REFERENCES
- Index
